CS Vipul Goyal

Author has compiled format of Share Application form under Companies Act,2013 for ready Reference of our readers, Which is re-produced below and also link to download the same in word format is provided at the end of the Article:-

SHARE APPLICATION FORM

(Private & confidential, not for circulation)

To:

M/S: ABC PRIVATE LIMITED

202, Mumbai City MH 400056

Sir/Madam,

Sub: APPLICATION FOR PRIVATE PLACEMENT OF EQUITY SHARES OF RS.10/- EACH

Please refer to the offer document issued by you. Having read and understood the terms of offer and the instructions, apply for the allotment of equity shares to me/us. The application is an irrevocable offer by me/us. The amount payable on application as shown below is remitted. On allotment, please place my/our name(s) on the Register of shareholder(s). I/We bind myself/ourselves by the provisions as contained in the scheme.

In Figures In words

No. of shares.
Amount (Rs)
Date:

FOR OFFICE USE ONLY

Date of receipt of application

Sl. No:

I am/we are applying as (Tick) whichever is applicable

Cheque/Demand Draft drawn onCheque/ DD NoDateAmountIndividual ( ) Society/ Trust ( ) Mutual Fund ( ) Company ( ) Others ( )

APPLICANT’S NAME IN FULLName of father/ husbandSexAge
Sole /First
Second
Third
Nominee’s Name for sole/first applicant

Name (IN CAPITAL LETTERS): ……………………………………………………

Address : ………………………………………………………………………………………………………

…………………………………………………………………

Phone No:______________ Mobile No: __________Fax:__________ E-mail :__________________

ApplicantPANSPECIMENSIGNATURESSole/First

applicant

Sole/ FirstSecond applicant
SecondThird applicant
ThirdNominee

……………………………………………………………Tear Here……………………………………………………

Address for Correspondence:

M/s: ABC PRIVATE LIMITED

202, Mumbai City MH 400056

NAME/S:………………………………………….

CHEQUE/DEMAND DRAFT DRAWN ON………………………………………………………

CHEQUE / DD NO:……………DT:……………

AMOUNT RS.:………………………………

Please draw the Cheque/DD in favour of :M/S;  ABC PRIVATE LIMITED

Receiver’s

Stamp

 

Received on

Note: Cheques and Drafts are subject to realization.

Download Share Application Form under Companies Act, 2013 in word format

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