Application to the Authority for claiming unpaid amounts and shares out of Investor Education and Protection Fund

X X   X X   Extracts   X X   X X

Full Text of the Document

X X   X X   Extracts   X X   X X

....ation No. G.S.R. 733(E) dated 01-10-2025 before it was read as,  "5[Form No. IEPF-5 Application to the Authority for claiming unpaid amounts and shares out of Investor Education and Protection Fund [Pursuant to Section 125 (3) of the Companies Act, 2013 and rule 7 of the Investor Education and Protection Fund Authority (Accounting, Audit, Transfer and Refund) Rules, 2016]" ============= Document 1 8 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II-SEC. 3(i)] टिप्पण: मूल नियम भारत के राजपत्र, असाधारण, भाग II, खंड 3 उप-धारा (i) में संख्या सा.का.नि. 854 (अ), तारीख 5 सितम्बर, 2016 द्वारा प्रकाशित किए गए थे और तत्पश्चात अधà....

X X   X X   Extracts   X X   X X

Full Text of the Document

X X   X X   Extracts   X X   X X

....tection Fund Authority (Accounting, Audit, Transfer and Refund) Rules, 2016, for the Form No. IEPF-5, the following Form shall be substituted, namely :- "Form No. IEPF-5 Form language English Hindi Application to the Authority for claiming unpaid amounts and shares out of Investor Education and Protection Fund [Pursuant to Section 125 (3) of the Companies Act, 2013 and rule 7 of the Investor Education and Protection Fund Authority (Accounting, Audit, Transfer and Refund) Rules,2016] भारत सरकार Refer instruction kit for filing the form All fields marked in * are mandatory Yes C No 1. Entitlement Letter issued by Company/Bank If ' Yes' is selected in field no. 1 Copy of an Entitlement Letter Max 2 MB Choose File Download Remove Authorised Representative Self 2. Claim is to be filed by If filing as Authorised Representative Signed copy of Authority Letter Max 2 MB Download Choose File Remove 3. Applicant details 9 [भाग II-खण्ड 3(i)] भारत का राजपत्र : असाधारण Particulars....

X X   X X   Extracts   X X   X X

Full Text of the Document

X X   X X   Extracts   X X   X X

....d Remove Choose Download (j) Any other document required under rules Max 2 MB Choose Remove Details of the Claim Amount and Shares Shares Amount 6. *Type of Claim 7. Details of shares claimed (More than one Folio for one company/bank can be added (a) Number of Folio Max. 15 Entries S.No.Type of Holding (Physical / Demat) DFolio No. from which transfer has been made to IEPFType of Share (Equity / Preference)Number of shares Complete Demat account number from which transfer has been made to IEPF Total 8. Details of amount claimed Max. 15 Entries (a) Number of claims (b) Year wise details of securities/deposits for which the amount is claimed S.No.Type of claim (Unpaid dividend/ Application money due for refund/ Matured deposits/ Matured debentures/ OthersType of Holding (Physical / Demat)Folio No. from which transfer has been made to IEPF Complete Demat account number from which transfer has been made to IEPF Amount of the claimFinancial year to which claim relates (YYYY- YYYY)Reason for non-receipt/ non- encashment of the instrument of payment Total 12 [PART II-SEC. 3(i)] THE GAZETTE OF INDIA : EXTRAORDINARY NSDL C CDSL 9. * Name of Depository A. * D....

X X   X X   Extracts   X X   X X

Full Text of the Document

X X   X X   Extracts   X X   X X

....ative Membership/DIN No /PAN No of the Authorised Representative Declaration by Claimant I declare that all the requirements of Companies Act, 2013 and the rules made thereunder in respect of the subject matter of this form and matters incidental thereto have been complied with. I further declare that all the information given herein including the attachments to this form is true, correct and complete and nothing material has been concealed. I declare that I have not claimed/ will not claim, the shares and/or amount claimed under the same folio and/or for same financial year on any earlier occasion for this company/bank. * I understand that I, am the claimant/authorised representative, after filing the refund claim in this form online, shall send the attachments prescribed below to Nodal Officer (IEPF) of the company / bank at its registered office in an envelope marked "claim for refund from IEPF Authority" for initiating the verification for claim 1 Print out of duly filled claim form with claimant signature 2 Copy of acknowledgement mail 3 Indemnity Bond (original) with claimant signature 4 In case of refund of matured deposit or debenture, original certificate theret....

X X   X X   Extracts   X X   X X

Full Text of the Document

X X   X X   Extracts   X X   X X

....d rule 7(1) of the Investor Education and Protection Fund Authority (Accounting, Audit, Transfer and Refund) Rules, 2016] Form language O English O Hindi Refer instruction kit for details. सत्यमेव जयते Note - All fields marked in * are to be mandatorily filled. 1. Particulars of the applicant (a) *Name of the applicant (b) *Address of the applicant (c) Phone number (d) Mobile Number (e) E-mail ID 2. Particulars of the Company [***] from which the amount is due (a) *Corporate identity number (CIN) of company [***] (b) Name of the company [***] (c) Address of registered office of the company [***] (d) email id of the company [***] 3. Details of shares claimed Folio No./ Category DP ID -Client ID- Account number 4. Details of amount claimed Pre-fill Kind of Number of Total nominal share shares amount of the share S No. Particulars (i) (ii) Dividend amount Application money due for refund (iii) Matured deposits with company (iv) Matured debentures with company (v) € (vi) Interest accrued on application money due for refund Interest accrued on matured deposits with company (vii) In....

X X   X X   Extracts   X X   X X

Full Text of the Document

X X   X X   Extracts   X X   X X

....ns of Section 448 of Companies Act, 2013 which status that- "Save as otherwise provided in this Act, if in any return, report, certificate, financial statement, prospectus, statement or other document required by, or for, the purposes of any of the provisions of this Act or the rules made thereunder, any person makes a statement,- (a) which is false in any material particulars, knowing it to be false; or (b) which omits any material fact, knowing it to be material, he shall be liable under section 447." Modify Check Form Prescrutiny For office use only: eForm Service request number (SRN) This e-Form is hereby approved Affix filing details eForm filing date Digital signature of the authorising officer This e-Form is hereby rejected Date of signing Confirm Submission (DD/MM/YYYY) Submit (DD/MM/YYYY) Document 3 FORM NO. IEPF-5 [Pursuant to sub-section (3) of section 125 of the Companies Act, 2013 and rule 7(1) of the Investor Education and Protection Fund Authority (Accounting, Audit, Transfer and Refund) Rules, 2016] 1. Particulars of the applicant सत्यमेव जयते (a) *Category of the applicant Individu....

X X   X X   Extracts   X X   X X

Full Text of the Document

X X   X X   Extracts   X X   X X

....transaction etc.) Browse (e) Notarised Copy of death certificate (f) Notarised Succession Certificate/Probate/will Browse (g) No Objection Certificate from Other holder Browse (h) Indemnity Bond, duly notarised. Browse (i) Affidavit in form of surety. (j) Others Browse Browse Declaration I declare that all the requirements of Companies Act, 2013 and the rules made thereunder in respect of the subject matter of this form and matters incidental thereto have been complied with. I further declare that all the information given herein above is true, correct and complete including the attachments to this form and nothing material has been suppressed. I declare that I have not claimed/ will not claim, the shares and/or amount claimed under the same folio and/or for same financial year on any earlier occasion for this company. I understand that I, am the claimant and after filing the refund claim in this form online, shall send the attachments prescribed below to Nodal Officer (IEPF) of the company at its registered office in an envelope marked "claim for refund from IEPF Authority" for initiating the verification for claim 1. Print out of duly filled claim form with ....

X X   X X   Extracts   X X   X X

Full Text of the Document

X X   X X   Extracts   X X   X X

....No. (in case of NRI/foreigners) (r) *PAN of applicant 2. Particulars of the Company from which the amount is due (a) *Corporate identity number (CIN) of company Send OTP Verify OTP Verify PAN Detail Pre-fill 14 THE GAZETTE OF INDIA: EXTRAORDINARY [PART II-SEC. 3(i)] (b) Name of the company (c) Address of registered office of the company (d) Email id of the company 3. Is it a case covered under rule 7 (8) & 7(9) of IEPF Rules, 2016 Yes (a) Name of original security holder No NNN (b) Relation of claimant with security holder (c) Number of Nominee/Legal heirs/Successors/ Administrator/ Others holders. Name of Beneficiary i. ii. ii. 4. Type of Claim 5. O Amount O Amount and Shares Details of shares claimed (More than one Folio for one company can be added) Number of Folio Type of holding Folio No./ Type of share Number of shares Complete Demat Account Number from which transfer has been made to IEPF 6. Claim Details *Number of claims Folio No. Demat A/c No [भाग II –खण्ड 3 ( i ) ] भारत का राजपत्र : असाधाà¤....