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AFFIDAVIT CUM NO OBJECTION CERTIFICATE (To be executed by Registered Shareholder on Non-judicial Stamp Paper of Rs.10) I/we __________________________________ Son/Daughter/Wife of ______________________________________ do solemnly and sincerely swear and state as under:1. Shri

That undermentioned Certificate(s) is/are registered in my/our name in the That undermentioned Certificate(s) is/are registered in my/our name in the books of books of INDIAN ADITYA BIRLA NUVO LIMITED, Veraval. RAYON AND INDUSTRIES LIMITED, Veraval.

Certificate No.

Distinctive Nos.

No.of Shares

Folio No.


That the above Share Certificate(s) has/have been sold by me/us in the market through the broker __________________________ and received the payment for shares. I/we have executed the Transfer Deed(s) as transferor(s). That the said Share Certificate(s) along with Transfer Deed(s) has/have been lost/misplaced by _______________________ and the same is/are not in my/our possession. That I/we have no objection if the Company issue Duplicate Share Certificate(s) in lieu of the same and send the Certificate(s) directly to the purchaser/transferee after transfer in his/her/their name. Deponent(s) Signature: Name: Address:



VERIFICATION I/We solemnly verify that facts stated above are true and that nothing material has been cancealed by me/us. Deponent(s) Signature: Name: Address:

Note: This Affidavit should be verified in the presence of a First Class Magistrate or a Notary Public. In the event of verification in the presence of a Notary Public, the Affidavit should contain the notarial stamp.


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