3.
Name
No of shares Allotted
Type of shares
Address
City
State
4.
Name
No of shares Allotted
Type of shares
Address
City
State
5.
Name
No of shares Allotted
Type of shares
Address
City
State
6.
Name
No of shares Allotted
Type of shares
Address
City
State
_________________________
___________________________
Signature of Director
Signature of Director
_________________________
___________________________
Name of Director
Name of Director
& Tel. No.
& Tel. No.
Note:
If there is insufficient space in the form to provide the information required, please attach a separate sheet containing the information
required in the prescribed format.
SECTION C – Shareholder of the Company after this allotment.
1.
Name
No of shares
Type of shares
Address
City
State