J&K Bank

J&K

Bank

Dated: _____________

THE SENIOR MANAGER

KARVY FINTECH PVT. LTD.

UNIT: JAMMU & KASHMIR BANK LTD. KARVY

SELENIUM TOWER B, PLOT 31-32,

GACHIBOWLI, FINANCIAL DISTRICT,

NANAKRAMGUDA, HYDERABAD - 500 032

Ph. No.: 040-67161508, 67161509

Photograph to

be attested by

Branch Head.

Subject: Address & Signature Verification.

Dear Sir,

This is to confirm that Mr./ Ms. _______________________________________________________________

S/D/W/O: ________________________________________________________________________________________

Address: ______________________________________________________________________________________

has a Saving/ Current Account with us bearing No.

The signature of the said Account Holder, as recorded with us, is verified below at “A” and the date of

opening of the Account is: ________________ .

“A”

Y

o

u

r

s

f

a

i

t

h

f

u

l

y

Branch Head

(Seal & Signature with Code No.)

Signature Verified

Branch Head

Signature

DECLARATION OF LOSS OF SHARE CERTIFICATE

Form to be filled in by a person or persons applying for duplicate certificate(s) in respect of shares for which original

certificate(s) is/are lost.

1. Full name and address of the shareholder

2. Number of shares held by the

Shareholder

3. Distinctive numbers of the

shares in respect of which

certificate(s) is/are lost

4. When were the share certificates lost or

found to be missing?

5. Full statement of the circumstance of loss

of the share certificate(s)

6. Were any signed transfer form attached

to the missing share certificate(s)?

If so, give full particulars

7. Were the shares sold, mortgaged,

pledged or otherwise disposed of either

by the shareholder, applicant or by any

other person?

If so, give full particulars

8. Was diligent search made for the Missing

certificate(s)?

The Jammu and Kashmir Bank Ltd.

Board Secretariat

Corporate Headquarters,

M. A. Road, Srinagar - 190 001

Tel: (0194) 2481930-35 Fax: (0194) 2481928

Visit us at: www.jkbank.net

CIN:L65110JK1938SGC000048

ACKNOWLEDGMENT

Receipt No. _____________

Name of the Shareholder: ________________________

Case: _______________________________

Folio No./Client ID : __________

Certificate No. : ____________

Distinctive No's : __________________________

Number of Shares: __________

Date of receipt of Documents : _____________

Signature of Shareholder

FORM –A

AFFIDAVIT

[For issuance of duplicate securities]

This affidavit is to be executed in the presence of a Public Notary

I/We, ______________________________Son/daughter of ________________________________

residing at ______________________________________________________________________, having

Permanent Account No (s)_____________________________do hereby solemnly affirm and state on oath

as follows.

1. That I/We, _________________________________________ (“all the shareholders ”) hold the following

__________________(number of) securities under Folio no.___________ of Jammu & Kashmir Bank Ltd. in

my/ our name as single holder / joint holder:

S.No

Company Name

Folio No.

No. of

securities

held

Security

Certificate

No.

Distinctive Nos.

From

To

1.

2.

3.

4.

5.

2. I/We_____________________________________________________________further swear / solemnly

declare that I/ we am/are applying for issue of duplicate certificate(s) to me/us on the ground that the original

security(ies) certificate(s) has/have been misplaced / not found by me/us, despite a diligent search made by

me/us in that behalf.

3. I/We_____________________________________________________________ further swear /solemnly

declare that the said securities are not sold or pledged or deposited by way of security to any

person/company.

4. I/We_____________________________________________________________hereby further swear /

solemnly declare that if, after the duplicate share certificate(s) is / are issued to us as aforesaid, the original

security(ies) certificate(s) is / are at any time subsequently, found, recovered or traced by us or by anyone on

our behalf, then, we unconditionally undertake not to deal with the said original share certificate(s) in any

manner whatsoever (whether by physical transfer or dematerialization or as security or pledge) and further

unconditionally undertake to promptly surrender the original share certificate(s) to

the Registrar and Transfer Agent / Company, for cancellation.

5. I/We __________________________________________________________am/are making the above

solemn declaration on oath with full knowledge of the fact that in the event the original security (ies)

certificate(s) issued is /are found, recovered and traced by me/us and instead of surrendering the same is /

are dealt with by me/us as aforesaid, the Company will be at liberty to adopt civil and / or criminal proceedings

against me/us for my/our failure to promptly surrender the original security (ies) certificate(s), for cancellation

and for breach of my/our solemn declaration and undertaking not to deal with the original security (ies)

certificate(s) in any manner whatsoever as aforesaid at my/our entire risk as to cost and consequences.

Signature of all deponents

_____________________

VERIFICATION

We hereby solemnly affirm and state that what is stated herein above is true to our knowledge and

nothing has been concealed therein and that we are competent to contract and entitled to rights and

benefits of the above mentioned securities.

Deponent(s) (1) ______________(2) __________________(3) ____________________

Solemnly affirmed at Signature of the

Deponent(s): _________________________

Signed before me

Place: __________________________

Date : __________________________

--------------------------------------------------

Signature of Notary with Official Seal of Notary & Regn. No.

Form-B

INDEMNITY

[For issuance of duplicate securities]

This indemnity is to be executed in the presence of a Public Notary /Gazetted Officer

I/We,__________________________ Son / daughter / spouse / of______________________

residing at______________________ having Permanent Account No (s)________________do

hereby solemnly affirm and state on oath as follows.

1. That I/we, am/are the sole/joint holder/s of the Securities in following folios. I/We request you to

issue duplicate certificate(s) for securities, as detailed below in my/our name(s):

S No.

Name of the

Company

Certificate No.**

Distinctive No.**

Folio

No. **

No. and Face

value of securities

held

1.

2.

**In case of non-availability of Certificate Nos./Distinctive Nos./ Folio nos., security holder shall obtain the same

from RTA.

2. That the above securities were acquired by me/us for valuable consideration out of my/our own

investment/funds against allotment in Public Issue/allotment in Right Issue or acquired from the

market/through inheritance in the year(s) ………….

3. I/We hereby jointly and severely agree and undertake to indemnify and keep indemnified, saved,

defended, harmless, the aforesaid (Name of the Company/RTA) and its successors and assigns

for all time hereafter against all losses, costs, claims, actions, demands, risks, charges, expenses,

damages, etc., whatsoever which you may suffer and/or incur by reason of your, at my/our

request, issuing the said Duplicate Securities as herein above mentioned, to the undersigned.

IN WITNESS WHEREOF the said

1) Mr. /Ms. _______________________ 2) Mr. /Ms. ______________________________

________________________________ ______________________________________

Signature __________________________ Signature _____________________________

have hereunto set their respective hands and seals this day of _________________________

signature of All holder(s)/Applicant(s)

_________________________________

Signed before me

At: _____________________

On:_____________________

Signature of Notary / JMFC

Official stamp & seal of the Notary Magistrate/ Notary & Regn. No.:

Address of First holder / Applicant :

Code:

Contact No

Email ID

Date

FOR OFFICE USE ONLY

Signature Checked By:

1 | P a g e

Form ISR – 1

(see SEBI circular No. SEBI/HO/MIRSD/MIRSD_RTAMB/P/CIR/2021/655 dated November 03, 2021 on Common

and Simplified Norms for processing investor’s service request by RTAs and norms for furnishing PAN, KYC

details and Nomination)

REQUEST FOR REGISTERING PAN, KYC DETAILS OR CHANGES / UPDATION THEREOF

[For Securities (Shares / Debentures / Bonds, etc.) of listed companies held in physical form]

Date:___ /___ /______

A. I / We request you to Register / Change / Update the following (Tick  relevant box)

󠄀 PAN

󠄀 Bank details

󠄀 Signature

󠄀 Mobile number

󠄀 E-mail ID

󠄀 Address

B. Security Details:

Name of the Issuer Company

Folio No.:

Name(s) of the Security holder(s)

as per the Certificate(s)

1.

2.

3.

Number & Face value of

securities

Distinctive number of securities

(Optional)

From To

C. I / We are submitting documents as per Table below (tick as relevant, refer to the

instructions):



Document /

Information

/ Details

Instruction / Remark

1

PAN of (all) the (joint) holder(s)

PAN

Whether it

is Valid

(linked to

Aadhaar):

 Yes No

󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀,󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀

󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀

PAN shall be valid only if it is linked to Aadhaar by March 31, 2022*

For Exemptions / Clarifications on PAN, please refer to Objection Memo in page

4

2

Demat

Account

Number

󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀 󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀

Also provide Client Master List (CML) of your Demat Account, provided by the

Depository Participant.

2 | P a g e

3

Proof of

Address of

the first

holder

Any one of the documents, only if there is change in the address;

󠄀 Client Master List (CML) of your Demat Account, provided by DP.

󠄀 Valid Passport/ Registered Lease or Sale Agreement of Residence / Driving

License / Flat Maintenance bill.

󠄀 Utility bills like Telephone Bill (only land line), Electricity bill or Gas bill -

Not more than 3 months old.

󠄀 Identity card / document with address, issued by any of the following:

Central/State Government and its Departments, Statutory / Regulatory

Authorities, Public Sector Undertakings, Scheduled Commercial Banks, Public

Financial Institutions.

󠄀 For FII / sub account, Power of Attorney given by FII / sub-account to the

Custodians (which are duly notarized and / or apostilled or consularised) that

gives the registered address should be taken.

󠄀 The proof of address in the name of the spouse

4

Bank details

Account Number: _________________________________

Bank Name: _____________________________________

Branch Name: ___________________________________

IFS Code: _______________________________________

Provide the following:

󠄀 original cancelled cheque with name of security holder printed on it or Bank

Passbook or Bank Statement attested by the Bank #

5

E-mail

address

___________________________________________#

6

Mobile

______________________________ #

* or any date as may be specified by the CBDT (DP: Depository Participant)

# In case it is not provided, the details available in the CML will be updated in the folio

Authorization: I / We authorise you (RTA) to update the above PAN and KYC details in my / our folio (s)

_________, ________,(use Separate Annexure if extra space is required) in which I / We are the holder(s)

(strike off what is not applicable).

Declaration: All the above facts stated are true and correct.

Holder 1

Holder 2

Holder 3

Signature



Name



Full address



 󠄀󠄀󠄀󠄀󠄀󠄀

󠄀󠄀󠄀󠄀󠄀󠄀

Form ISR – 2

(see circular No. SEBI/HO/MIRSD/MIRSD_RTAMB/P/CIR/2021/655 dated November 03, 2021 on Common and

Simplified Norms for processing investor’s service request by RTAs and norms for furnishing PAN, KYC details

and Nomination)

Confirmation of Signature of securities holder by the Banker

1. Bank Name and Branch

2. Bank contact details

Postal Address

Phone number

E-mail address

3. Bank Account number

4. Account opening date

5. Account holder(s) name(s)

1)

2)

3)

6. Latest photograph of the account holder(s)

7. Account holder(s) details as per Bank Records

a) Address

b) Phone number

c) Email address

d) Signature(s)

1) 2) 3)

Signature verified as recorded with the Bank

Seal of the Bank

(Signature)

Place:

Name of the Bank Manager

Employee Code

Date:

E-mail address

1

st

Holder

2

nd

Holder

3

rd

Holder

Form ISR - 3

Declaration Form for Opting-out of Nomination

by holders of physical securities in Listed Companies

(see SEBI circular No. SEBI/HO/MIRSD/MIRSD_RTAMB/P/CIR/2021/655 dated November 03, 2021 on Common

and Simplified Norms for processing investor’s service request by RTAs and norms for furnishing PAN, KYC

details and Nomination)

[Under Section 72 r/w Section 24 (1) (a) of Companies Act, 2013 r/w Section 11(1) and 11B

of SEBI Act, 1992 and Clause C in Schedule VII and Regulation 101 of SEBI (Listing Obligations

and Disclosure Requirements) Regulations, 2015)]

Name of the Company :

Registered Address of the Company:

I / we ……………………… the holder(s) of the securities particulars of which are given

hereunder, do not wish to nominate any person(s) in whom shall vest, all the rights in

respect of such securities in the event of my /our death.

PARTICULARS OF THE SECURITIES (in respect of which nomination is being opted out)

Nature of

Securities

Folio No.

No. of

Securities

Certificate No.

Distinctive No.

I/ we understand the issues involved in non-appointment of nominee(s) and further are

aware that in case of my / our death, my / our legal heir(s) / representative(s) are required

to furnish the requisite documents / details, including, Will or documents issued by the

Court like Decree or Succession Certificate or Letter of Administration / Probate of Will or

any other document as may be prescribed by the competent authority, for claiming my / our

aforesaid securities.

Name(s) and Address of Security holders(s) Signature(s)

Sole / First Holder Name

Second Holder Name

Third Holder Name

Name and Address of Witness

Signature

Page | 1

Form ISR-4

(see circular No. SEBI/HO/MIRSD/MIRSD_RTAMB/P/CIR/2022/8 dated January 25, 2022 on Issuance of

Securities in dematerialized form in case of Investor Service Requests)

Request for issue of Duplicate Certificate and other Service Requests

(for Securities - Shares / Debentures / Bonds, etc., held in physical form)

Date:___ /___ /______

A. Mandatory Documents / details required for processing all service request:

I / We are submitting the following documents / details and undertake to request the

Depository Participant to dematerialize my / our securities within 120 days from the date

of issuance of Letter of Confirmation, received from the RTA/Issuer Company (tick as

relevant, refer to the instructions):

 Demat Account No. (If available):    �� 

��

Provide Client Master List (CML) of your Demat Account from the Depository Participant*

 Provide the following details, if they are not already available with the RTA (see SEBI

circular dated November 03, 2021 in this regard)

PAN

Specimen Signature

Nomination / Declaration to Opt-out

* (Your address, e-mail address, mobile number and bank details shall be updated in your

folio from the information available in your CML). You can authorize the RTA to update the

above details for all your folios. In this regard, please refer to and use Form ISR-1 in SEBI

circular dated November 03, 2021.

B. I / We request you for the following (tick  relevant box)

� Issue of Duplicate certificate

�Claim from Unclaimed Suspense

Account

� Replacement / Renewal / Exchange of

securities certificate

� Endorsement

� Sub-division / Splitting of securities

certificate

� Consolidation of Folios

� Consolidation of Securities certificate

� Transmission

� Transposition (Mention the new order of holders here)

C. I / We are enclosing certificate(s) as detailed below**:

Name of the Issuer Company

Folio Number

Page | 2

Name(s) of the security

holder(s) as per the

certificate(s)

1.

2.

3.

Certificate numbers

Distinctive numbers

Number & Face value of

securities

** Wherever applicable / whichever details are available

D. Document / details required for specific service request:

I. � Duplicate securities certificate

II. � Claim from Unclaimed Suspense Account

Securities claimed

(in numbers)

(in words)

III. � Replacement / Renewal / Exchange of securities certificate

(that is defaced, mutilated, torn, decrepit, worn out or where the page on the

reverse is fully utilized)

IV. � Endorsement

V. � Sub-division / Splitting of securities certificate

VI. � Consolidation of securities certificate/Folios

VII. � Transmission

VIII. � Transposition

Provide / attach original securities certificate(s) for request for item numbers III to VIII above.

Declaration: All the above facts stated are true and correct to best of my / our knowledge and

belief.

Security Holder 1 / Claimant

Security Holder 2

Security Holder 3

Signature



Name



Full

address



�� ��

��

Form No. SH-13

NOMINATION FORM

[Pursuant to section 72 of the Companies Act, 2013 and rule 19(1) of the Companies

(Share Capital and Debentures) Rules 2014]

To

The Jammu & Kashmir Bank Ltd:

Corporate Headquarters, M. A. Road,

Srinagar – 190001

I/We .............................................................................................................................

............................................................. the holder(s) of the securities particulars of

which are given hereunder wish to make nomination and do hereby nominate the following

persons in whom shall vest, all the rights in respect of such securities in the event of my/our death.

(1) PARTICULARS OF THE SECURITIES (in respect of which nomination is being made)

Nature of

securities

Folio No.

No. of

securities

Certificate

No.

Distinctive

No.

(2) PARTICULARS OF NOMINEE/S —

(a) Name: ..............................................................................................................

(b) Signature of Nominee: .............................................................................................

(c) Date of Birth: ....................................................................................................

(d) Father's/Mother's/Spouse's name: ......................................................................

(e) Occupation: ....................................................................................................

(f) Nationality: ....................................................................................................

(g) Address: ................................................................................................................

(h) E-mail id: ..............................................................................................................

(i) Relationship with the security holder: ........................................................................

(3) IN CASE NOMINEE IS A MINOR—

(a) Date of birth: ....................................................................................................

(b) Date of attaining majority: ................................................................................

(c) Name of guardian: ..........................................................................................

(d) Signature of guardian: ..........................................................................................

(e) Address of guardian: ..........................................................................................

(4) PARTICULARS OF NOMINEE IN CASE MINOR NOMINEE DIES BEFORE ATTAINING

AGE OF MAJORITY—

a) Name: ..............................................................................................................

b) Signature of Nominee: ..............................................................................................

c) Date of birth: ....................................................................................................

d) Father's/Mother's/Spouse's name: ......................................................................

e) Occupation: ....................................................................................................

f) Nationality: ....................................................................................................

g) Address: ..................................................................................................................

h) E-mail id: ..............................................................................................................

i) Relationship with the security holder: ..........................................................................

j) Relationship with the minor nominee: .........................................................................

Security Holder (s): Witness:

Signature: .............................................. Signature: ...........................

Name: ......................................................... Name: .................................

Address: ..................................................... Address: ..............................

..................................................................... ............................................

.................................................................... ...........................................

INSTRUCTIONS:

1. In case you are holding physical shares, the duly filled-in form be sent to Company

Secretary, The Jammu and Kashmir Bank Limited, Board Secretariat, Corporate

Headquarters, M.A. Road, Srinagar - 190001 or to our Share Transfer Agent: Karvy

Fintech Pvt. Ltd. Unit: J&K Bank Ltd, Karvy Selenium Tower B, Plot No. 31 – 32,

Gachibowli Financial District, Nanakramguda Hyderabad - 500 032 TEL:- (040) - 67161508,

67161509. In Case you are holding shares in Dematerialised form, the duly filled-in form

be sent to the Depository Participant where you are having Demat Account.

2. Please use separate form for each folio. Nomination is applicable to the folio, irrespective

of the number of shares registered under the folio. Only one nomination per folio per

instance would be entertained

3. The nomination can be made by individuals only applying / holding share(s) on their own

behalf singly or jointly upto two persons. Non-Individuals including society, trust, body

Corporate, partnership firm, karta of Hindu undivided family, holder of power of

attorney, cannot nominate. If the shares are held jointly, all joint holders will sign the

nomination form

4. A minor can be nominated by a holder of share(s) and in that event the name and address

of the guardian shall be given by the holder.

5. The nominee shall not be a trust, society, body Corporate, karta of Hindu undivided

family or a power of attorney holder. A nonresident Indian can be a nominee on

Repatriable basis (subject to the Reserve Bank of India's approval as applicable).

6. Nomination stands rescinded upon transfer of share(s) or on receipt of Form No. SH-14

(cancellation or variation of Nomination).

7. Transfer of shares in favour of a nominee shall be a valid discharge by a Company against

the legal heirs.

8. The form must be complete in all respects and duly witnessed. Incomplete form is not a

valid nomination

9. Subject to rules and regulations as applicable from time to time.