PLEASE READ INSTRUCTIONS BEFORE COMPLETING THIS FORM
INDEMNITY CUM AFFIDAVIT
ON STAMP PAPER OF RS 300/
TO BE NOTARISED
This Indemnity cum Affidavit is executed at ___________ this ____ day of ________, by :
(1) Mr ______________ Age: ____ years, Occupation: ____, residing at ____________________ (hereinafter referred to as “Indemnifier 1”)
(2) Mr ______________ Age: ____ years, Occupation: ____, residing at ____________________ (hereinafter referred to as “Indemnifier 2”)
(3) Mr ______________ Age: ____ years, Occupation: ____, residing at ____________________ (hereinafter referred to as “Indemnifier 3”)
(4) Mr ______________ Age: ____ years, Occupation: ____, residing at ____________________ (hereinafter referred to as “Indemnifier 4”)
(5) Mr ______________ Age: ____ years, Occupation: ____, residing at ____________________ (hereinafter referred to as “Indemnifier 5”)
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(hereinafter, collectively referred to as “Indemnifiers”).
IN FAVOUR OF
th
________________________, a Company having its Registered Office at ________________________________________, hereinafter called “the Indemnity Holder”.
The expressions, “Indemnifier”, “Indemnifiers” and “Indemnity Holder(s)” shall, unless it be repugnant to
the context or meaning thereof, be deemed to mean and include their respective successors and assigns. The abovementioned Indemnifiers do solemnly affirm and declare as follows:
(1) The following shares of Crompton Greaves Limited are registered in the name of Late _______________:
Folio No No of Shares(Face Value per share Rs___) Certificate No(s) Distinctive No(s)
From To
Indemnifiers will be all heirs and two sureties
(2) Mr/Ms. __________ died without leaving a will (intestate) and though due and diligent search has been made for his / her will, no such will has been found so far
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OR
(2) Mr/Ms. __________ died leaving his last will and testament dated ______ in respect of which no probate/letter of administration/succession certificate had been obtained.
(3) Under the personal law, applicable to the deceased, the following become his sole legal heirs and are entitled to inherit jointly the aforesaid shares.
a. Mrs ......................................... Wife
b. Mr .......................................... Son
c. Ms .......................................... Daughter
(4) The above mentioned shares were the separate and self acquired property of the deceased.
(5) Indemnifier 1, Indemnifier 2*, Indemnifier 3* are the legal heirs and do hereby give consent for the transfer of these shares into the name of ......................................... (hereinafter referred to as “Beneficiaries”) and to pay to them the arrears of dividend , if any and also issue in bonus shares, on the said shares, without insisting on production of legal representation to the estate of the deceased shareholder.
(6) The following information may be relied upon for processing the transmission formalities:
3 Full Name and address of the deceased member:
3 Nature of shareholding – single / joint:
3 Date of death of the deceased as per English Calendar:
3 Present market value of shares held in the Company:
3 Name of the person in whose custody the share certificates are presently available and reasons therefor:
3 No of shares held by the deceased in other companies: Name of Co No of shares
.......................... ................................................. .......................
1 Particularsof the property (movable & immovable) of the deceased other than shares:
2 Particulars of the debts of the deceased. Please state the amount and nature of debts:
3 Full details of surviving legal heirs:
4 Law by which the deceased was governed (If Hindu or Mohammaden state the school of Law):
5 Heirs of the deceased in according with the aforesaid law:
Name Address Relationship Age Marital Status Guardian details5
with the Deceased
(i)
(ii)
(iii)
(iv)
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Strike out whichever is not applicable
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Indicate in case of minor children of the deceased. Please mention name, address, whether natural guardian or appointed under Guardian And Wards Act.
12. In case deceased was member of Hindu Undivided Family(HUF), full details of surviving legal members:
Name Address Relationship with the Deceased Age Marital Status
(i)
(ii)
(iii)
1 Specify whether deceased was "Karta" of the HUF:
2 Specify whether the shares in the Company were part of his personal estate or part of HUF property:
3 Particulars of the Beneficiaries:
4 Residential Status of the Beneficiaries : Resident / Non Resident
5 Names of Indemnifiers who are acting as sureties:
6 Any other information to support the : ....................................................Beneficiaries claim to the shares of the ....................................................deceased member .....................................................
Name Father’s / Address Occupation Relationship Age Marital
Husband’s with the Deceased Status
Name
(i)
(ii)
(iii)
(7) In consideration of the Company transferring the abovementioned shares as requested at Clause (5) all the Indemnifiers hereby undertake jointly and severally that:
(i) they themselves and their heirs, executors and administrators respectively, will at all times and from time to time save, defend, keep harmless and indemnify the Company, its successors, assignees and the Directors thereof and their respective heirs, executors, administrators, estates and effects from and against all actions, causes, suits, proceedings, accounts, claims, demands, and all losses, damages, costs, charges, liabilities, expenses and sums of money incurred in respect thereof, whatsoever on account of the Company, at their request, transferring the abovementioned and also Bonus shares to the Beneficiaries and paying arrears of dividend on the said shares, without insisting on the production of legal representation to the estate of the deceased shareholder.
(ii) the determination by the Indemnity Holders of the extent of any and all such losses, damages, claims, penalties, proceedings, costs and all other liabilities, shall be binding on all the Indemnifiers, without questioning the reasonableness, validity or otherwise of any payments made by the Indemnity Holders, in response to a claim that has been made by the Indemnity Holders;
(iii) In case, the Indemnifiers fail to defend, settle or mitigate the claim, the Indemnity Holders shall have full rights to defend, pay or settle said claim on the Indemnifiers’ behalf, without notice to Indemnifiers, and notwithstanding any direction on the contrary by the Indemnifiers, with full rights to recourse against the Indemnifiers for all fees, costs, expenses and payments made or agreed to be paid to discharge the claims.
(iv) Upon default, the Indemnifiers further agree to pay all reasonable attorneys’ fees necessary to enforce this Agreement.
(v) This Agreement shall be unlimited as to amount or duration.
(vi) This Indemnity is in addition to and not in derogation of any other Indemnity/Guarantee and/or Security which the Indemnifiers may have executed in favor of the Indemnity Holders or which Indemnity Holders may at any time hold.
(vii) that this Indemnity cum Affidavit shall ensure upon and also be enforceable jointly and severally against all the Indemnifiers and all their respective legal heirs, representatives, successors and assigns, for all times in future.
(8) In consideration of the Company transferring the abovementioned shares as requested at Clause (5) the Indemnifiers hereby declare and agree that in the event of their failure to compensate the Indemnity Holders as per Clause (7) above, the Company can have a lien in general on all shares/debentures or other securities which the Indemnifiers may be holding presently or in the future and also the dividend. interest declared or payable on the shares/debentures or other securities.
VERIFICATION
We, the Indemnifiers abovenamed, do hereby verify that the statements mentioned in the above paragraphs are true to the best of our knowledge and belief and that nothing material has been concealed.
Verified at ................................. on this ..............day of .............20
IN WITNESS WHEREOF the Indemnifiers have hereunto set and subscribed their hands to this document the day and year hereinabove mentioned.
Name 6 Address Signature Phone No Email Id Bank Details7
Heir 1
Heir 2
Heir 3
Surety No 1
Surety No 2
Witness for Heir 1
Witness for Heir 2
Witness for Heir 3
Witness for Surety No 1
Witness for Surety No 2
: BEFORE ME (Signature & Stamp of Notary Public)
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Please take care that sureties and witness are not the same individuals. Further sureties should be in addition to the heirs
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Name of Bank, Branch and Account No. to be filled in
SURETY DETAILS
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SURETY NO 1(Private & Confidential)
1 Name in Full :
2 Permanent Residential Address :
3 Phone no :
4 E-Mail Id :
5 Age :
6. Employment :
(i) Place of employment
(ii) Name of employer
(iii) Annual salary and other emoluments
7. Details of immovable property owned (absolutely in your name, not as member of HUF) within municipal limits*
(i) Situation
(ii) Valuation
(iii) Annual rent realized
(please specify whether the immovable propertyconsists of houses or mere lands)
8. Nature and value of business* (In your own name & not as partner)
(i) Annual turnover
(ii) Annual Profits
Date: (Signature of the Surety) Note: Reply if applicable, otherwise kindly write NOT APPLICABLE against the relevant Column.
Sureties should be different to the shareholders and witnesses
SURETY DETAILS
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SURETY NO 2(Private & Confidential)
1 Name in Full :
2 Permanent Residential Address :
3 Phone no :
4 E-Mail Id :
5 Age :
6. Employment :
(iv) Place of employment
(v) Name of employer
(vi) Annual salary and other emoluments
7. Details of immovable property owned (absolutely in your name, not as member of HUF) within municipal limits*
(iv) Situation
(v) Valuation
(vi) Annual rent realized
(please specify whether the immovable propertyconsists of houses or mere lands)
8. Nature and value of business* (In your own name & not as partner)
(iii) Annual turnover
(iv) Annual Profits
Date: (Signature of the Surety) Note: Reply if applicable, otherwise kindly write NOT APPLICABLE against the relevant Column.
Sureties should be different to the shareholders and witnesses
INSTRUCTIONS
1. The Company has provided procedures for transmission of shares
Transmission without legal documents
This is permissible only if the market value of the shares is upto Rs 2.5 lacs. In terms of Article 57 of Articles of Association of the Company, the Board of Directors is competent to permit a transmission of shares without insisting on legal Documents upto a specified limit. This has been fixed at Rs 2.5 Lacs. However the Company may not choose to offer this privilege in certain doubtful cases, and may insist on completion of full legal formalities for claiming the shares of the deceased shareholder, which includes production of the Probate or Letters of Administration or Succession Certificate.
The documents to be submitted for this purpose are: •Indemnity Bond cum Affidavit on stamp paper of Rs 300/- •Original share certificates •Death certificate attested by a Bank Manager •Surety details form for two sureties•Copy of Will, where available
In case shares are to be transmitted in favour of a particular heir, the balance heirs are requested to provide “No Objection Certificates”.
1 Kindly execute the Indemnity Cum Affidavit For Duplicate Issue on a Non-judicial stamp paper of Rs. 300/- or affix special adhesive stamps or frank the form for the same amount.
2 The stamp paper must be purchased in the name of the first Legal Heir.
3 In case adhesive stamps are used, the same must be cancelled by the issuing authority.
4 The Indemnity Cum Affidavit must be signed by all the heirs alongwith two Surety(ies). The execution date on the form must be subsequent to the date of the stamping.
5 The duly executed Indemnity Cum Affidavit must be notarized by a Notary Public under his/her official seal.
6 The heirs cannot be sureties. These must be separate individuals of good financial standing.
7 Witnesses must be other than heirs or the sureties.
8 In case of NRI shareholders, the Indemnity Cum Affidavit can be executed on plain paper and a demand draft towards the stamping amount may be issued in favour of M/S Datamatics Financial Services Limited, Mumbai, the Company’s Registrar & Share Transfer Agent for addressing the Regulatory formalities. The duly executed Indemnity Cum Affidavit must be notarized by the Consulate/Embassy other Authorities permitted under local laws to issue oaths.
9 Thumb Impression (Left Hand only) will be accepted only if it is attested by a Bank Manager of a Nationalised Bank or a Share Broker having SEBI Registration Number or a Notary Public.
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