CORPORATE HIGHLIGHTS :

HOW TO APPLY :

Market leaders in Calcium supplements and some other formulations. q The Company is ranked 27th largest pharmaceutical company, one of the fastest growing company in top 50 pharma companies in India as per March 2012 MAT data of ORG-IMS q Govt. recognised R & D set up. q Plants set up as per WHO GMP standards. q ISO 9001-2000 certified Company. qCollaborations with internationally renowned organisations. q Recognised Export House. q Recipient of the President’s Export Award, Forbes Asia Best under Billion Company Award & Frost & Sullivan Market Leadership Award for SHELCAL, India’s Most Admired Nutrition and Nutarceutical Company of the year 2012 q GDR’s listed on the Luxembourg Stock Exchange.

The application for Fixed Deposits must be made in the prescribed form and lodged either at the Registered Office of the Company at the address given above or at any of the branches of Bajaj Capital Ltd. mentioned below and should be accompanied by an ‘A/C PAYEE’ cheque/demand draft drawn in favour of “ELDER PHARMACEUTICALS LIMITED - F.D. ACCOUNT” payable at Mumbai.All future correspondence in connection with the Fixed Deposit should be addressed to the company at the address mentioned above.

APPLICATION FORMS ARE ACCEPTED AND AVAILABLE AT THE FIXED DEPOSIT DEPARTMENT OF THE COMPANY AT ‘ELDER HOUSE’, C-9, DALIA INDUSTRIAL ESTATE, OFF VEERA DESAI ROAD, ANDHERI (WEST), MUMBAI 400 05,

AND AT THE BELOW MENTIONED BRANCHES OF BAJAJ CAPITAL LTD., MANAGERS TO THE FIXED DEPOSIT SCHEMES. THE FIXED DEPOSIT APPLICATION FORMS CAN ALSO BE DOWNLOADED FROM COMPANY’S WEBSITE

NAMELY WWW.ELDERINDIA.COM.

qInterest compounded quarterly and warrants dispatched in advance every year.

qNomination facility available.

qIn-house processing and prompt service.

SCHEME HIGHLIGHTS :

Pharmaceuticals Limited

CUMULATIVE SCHEMES

Regd. Office : Elder House, C-9, Dalia Industrial Estate, Off Veera Desai Road,Andheri (West), Mumbai 400 053. Tel.: 2673 0058 Fax : 267300051

E-mail : elderfd@elderindia.com

FIXED DEPOSIT SCHEMES

Period

* Rate ofInterest

p.a.MinimumAmount ofDeposit (`.)

AmountPayable on

Maturity (`.)

NON-CUMULATIVE SCHEMES

QUARTERLY INCOME

12 Months 9.50% 25,000/- 27,461/- 9.84%24 Months 10.50% 25,000/- 30,758/- 11.52%36 Months 11.50% 25,000/- 35,128/- 13.50%

Period

MinimumAmount ofDeposit (`.)

EffectiveYieldp.a.

12 Months 9.50% 25,000/-

24 Months 10.50% 25,000/-

36 Months 11.50% 25,000/-

* Rate ofInterest

p.a.

BAJAJ CAPITAL LTD.

*Senior Citizens, Employees & Shareholders will get 0.50% additional interest on all the Fixed Deposit Schemes.

Nehru Place Bajaj House, 97, Nehru Place, New Delhi - 110 019; Ph: 41693000, Call Centre: 011-39881010 Agartala: 1st Floor, Oriental Bank of Commerce, Near Rabindra Bhawan, Tripura (West)-Ph:

9206044376 Agra Shop No. 110, Ground Floor, Block No. 27/2/4,Sanjay Palace, Near Hotel Panchrattan Agra - 282002. Ph: (0562), 6457307 - 8 Ahmedabad 2-L,'Akik' Opp Lions Hall, Mithakhali Six Raod, Near

Nalanda Hotel, Ellisbridge, Ahmedabad - 380006. Ph 30072782-86, 32919929, 65419400, 64500170 - 74 Ajmer Ground Flr, Shop No-12, Ajmer Tower, Kutchery Road, Ajmer Ph: (0145) , 6451231 - 32

Allahabad Shop No. F-5 Indira Bhawan, Civil Lines, Allahabad-211001, Ph:(0532) 6452481 - 82 Asansol 1st Floor, 76, G T Road Near Bangha Panchil, Asansol-713303. Ph: 0341-2216180. Bangalore Unit

104-107, First Floor, A Wing, Mittal Towers, M.G. Road, Bangalore-560001. Ph: 25594999, 65471121 - 23. Call Centre: 39881010 Begusarai Hotel Blue Diamond, near Alka Cinema Opp. BRTS, Begusarai-

851117. Ph:9931630362 Bhagalpur 2nd Floor, Chandralok Complex Near Ghantaghar Bhagalpur-812001. Ph:, 9234300737 Bhopal Shop No. 6, First Floor, Jyoti Cinema Complex, M.P. Nagar, Zone1, Bhopal-

462011 Ph: (0755) 2571342, 4229297, 6459550, 6459552 Bhubaneswar Plot No. 1/A, Ground Floor, Station Square, Kharvel Nagar, Bhubneswar - 751001. Ph:0674-, 6451257, 6451269 Chennai: Wellington

Plaza, 3rd Floor, 90, Anna Salai, Chennai - 600002. Ph: 23451234, 64588300 - 03 Fax: 23451222 Call Centre: 39881010 Cochin F-2, 1st Floor, N.J.K Thripthy Building Opp. to Medical Trust Hospital, S.A.Road,

Valanjambalam, Cochin - 682 016 Phone Number: 0484-2370053, 56 & 59 . Coimbatore Zonal Office No.575, D. B. Road, First Floor (Near Head Post Office), R.S.Puram, Coimbatore-641002. Ph: 0422-

2540257/1892, 6470136 - 38 Dehradun 15, Rohini Plaza, 11-E Rajpur Road, Dehradun-248001. Ph: (0135), 6452648 - 49 Erode Aanoor Amman Complex, No. 58, Veerapathra Street, Sathy Road, Erode-

638003. Ph: 4020420, 6451855 - 56 Faridabad 5R/1 Ground Floor, B. K. Chowk, Near HDFC Bank, Faridabad - 121001 Ph: 6466566, 6466564 Ghaziabad G-5, Ansals Satyam Building, Raj Nagar, District

Centre, Ghaziabad-201002, Ph: 6493211, 6494070 Gorakhpur AD Tower, Ground Floor, Bank Road, Gorakhpur- 273001. Ph: 9935523688, (0551), 6453025 - 26 Gurgaon - Sec 14 102, AKD Tower, Upper

Ground Floor, Near HUDA Office, Sector-14, Gurgaon-122001. Ph. 124- 6468101, 6468102 Guwahati Room No.102, 1st Floor, Dunfur Apartment, R G Baruah Road, Guwahati -781024 Ph: 9207045530 - 31

Hyderabad #3-6-522, 2nd & 3rd Floor, Opp: KFC Restaurant, Main Road, Himayathnagar, Hyderabad-500001. Ph: 64631421 - 23 Call Centre: 040 - 44555555 Indore Shop No. 3, City Plaza, M.G. Road near

Regal Cinema, Indore- 452001 Ph.: (0731) 6452014, 6452024 Jaipur G-3, Anukampa Tower, Opp. Sangam Tower, Church Road (M. I. Road) Jaipur-302001 Ph:01416503342 Jamshedpur Shop No. 53, 2nd

Floor, Kamani Business Centre Bishtupur, Jamshedpur-831001. Ph:0657-, 6457603, 6457627 Jalgaon Plot No 18/19,2nd Floor, Dhake Corporate Center, Dhake Colony, Above ICICI Bank LTD, Jalgaon-425 001.

9422745091, Jamnagar 116,1st Floor, Manek Centre, Near Income Tax Office, P. N. Marg, Jamnagar, Gujarat - 361008, Tel - 0288-2663373 / 0288-6450105, Kanpur 106, Ratan Esquire, 14/144, Chunni Ganj,

Kanpur 208001. Ph.:(0512) , 6451763 - 64 Karur Chella Chambers, 1st floor, #74, Covai Road, Karur - 639002 Phone Number : 04324-241415 & 241416 Kochi Rubicon Building, S.A. Road, South Over

Bridge, Valanjambalam, Kochi-682016. Ph: 0484 -2356848/2356849/4119111, 6452565 - 66, 6452568 Kolkata 10C, Hungerfort Street, Ground Floor, Kolkata-700017. Ph:40034039 Call Centre: 44400444

Kottayam Skyline Citadel Building, Opp: Plantation Corporation, Ground Floor, Kanjikuzhy, K.K. Road, Kottayam-686004. Ph: 3293519, 6451737, 6452249, 51 Ludhiana Ground Floor, SCO-137, Feroze Gandhi

Market, Ludhiana-144001, Punjab. Ph: 0161-6451629, 0161-6451630, 09316921166 Lucknow 5, Commerce House, Habibullah Compound, 11, M.G. Marg, Hazratganj, Lucknow: 226001 Ph: (522), 6565568

- 69 Madurai Shop D, 1st Floor, A. R. Plaza, 16, 17, North Veli Street, Madura I- 625020. Ph: 2345863/4378999, 6461023 - 25 Mangalore Essel Towers, Shop No. BS4, Bunts Hostel Circle, Mangalore- 575003.

Ph: 4251787, 6451217 -18 Meerut G-43, Ganga Plaza, Near Begum Bridge, Meerut Cantt Ph: (95121), 6451510 - 11 Mumbai: Agra Bldg, Gr.Floor, 7/9 Oak Lane,Fort, Mumbai- 400023. Ph - 022 - 66376999 /

22654979 Call Center: 60000006 Corporate Office: 003, Ground Floor, Peninsula Tower, Peninsula Corporate Park, Lower Parel, Mumbai-400013. Ph.022 - 40099999/ 66104950 - 59 Nagpur Shop No 5,

Pushpakunja Commercial Complex, Central Bazar Road, Ramdas Peth, Nagpur-440 010 Tel: 0712-6618576 / 77 Nashik G-13, Suyojit Sankul, Tilak Wadi, Sharanpur Road, Nashik-422 002. Ph: 95253-2580314-

6,6576003 - 05 Noida Sec-29, A-2, Brahmputra Commercial Complex, Near Rail Reservation Centre, Sec. 29, Noida-201301 Ph: (95120), 6494074 - 75, 6493213 Palakkad S.S. Complex, 1st Floor, College

Road, Near Head Post Office, Palakkad-678001, Ph: 2545579, 6452240 - 41 Patna Ashiana Plaza, 1st Floor, Flat No. 106B, Budha Marg, Patna - 800001. Ph: 0612-, 6451056 - 59, 61 - 63 Peelamedu 184,

Avinashi Road, Opp. Varadaraja Mills, Peelamedu, Coimbatore-641004. Ph: 4364368/4364378, 6471258 - 59 Pondicherry No.127/A, 100 feet road, Nadesan Towers, First floor, Natesan Nagar, Pondicherry -

605001. Ph: 0413 - 2204911, 2204912, 6452334 - 35 Pune Subhash Nagar shop no. 6, Sanas Plaza, 1302, Subhash Nagar, Bazirao road, Pune-411022. Ph 24493355/56, 65009460 - 62 Rajkot Prathibha

Complex, Near Jayesh Publicity, Moti Tanki Chowk, Rajkot - 360001 Ph - 0281 -3043588, 3043688, 6450135 - 37 Salem No. 22, "Swarnambigai Plaza", Omalur Main Road, Salem-636009. Ph: 2441180/

4041180, 6452565 - 66 Sonepat Ground Flr, Opp. Old Civil Hospital, Railway Road Sonepat-131001, Ph: (95130) 6451297, 6451256 Secunderabad Shop No.10, First Floor, Minerva Complex, 94 S. D. Road,

Secunderabad-500003. Ph: 27721033/0725, 64631428 - 29 Surat L-4 Gr Flr, Vishwakarma Chambers, Majura Gated Crossing Road, Ring Road, Surat - 395002 Ph - 0261 - 2475700 , 2463572, 6450421 - 22

Thrissur VIII/78/9, Bharatha Kshemam Building, Next to SBI ATM, College Road, East Fort, Thrissur-680005. Ph: 329439, 6451571/72, 6451533, 6451570 Tirunelveli Shop No.1, First Floor, K.S. Arcade, Nr

Byepass Roundtana, Tirunelveli-627001. Ph:4000502, 6451060 - 61 Trichy Thillai Nagar Swati Arcade, 73/1-f, 1st Floor, Salai Road, Thillai Nagar, Trichy - 620018. Ph: 2763744/4020503, 6452094 - 95 Trichy

Thiruverambur No.48/5-B, Selvi Complex, Thanjavur Main Road (Near Malai Kovil Bus Stop) Thiruverambur, Trichy-620013. Ph: 2511339, 6452096 - 97 Trivandrum Edamala Plaza, TC1 4 / 9 9 9 ,

Vazahuthacadu, Vel layambalam Road, Vazahuthacadu, Sasthamangalam Post, Trivandrum-695010. Ph: 2735112, 6450176 - 78 Vaishali Shop No. 4, 1st Floor, Lajwanti Plaza, Sector-4, Main Market, Vaishali,

Ghaziabad. Ph: 6493212, 6494072 Varanasi D-58/53-54, 1st Floor, Shiva Complex, Rath Yatra Crossing, Varanasi - 221010 Ph: (0542) 6451059 - 60 Vadodara 129 Siddharth Complex, R C Dutt Road,

Vadodara - 390007. Ph 0265 - 3088162 -65, 6450181 - 82 Vijayawada Kalyan Complex, 39-1-89, 1st Floor, Beside O.B.C. Bank, Temple Street, M.G. Road, Labbipet, Vijayawada-520010. Ph: 6538181,

2492245, 6460112 - 13 Visakhapatanam No.10-1-125, 1st Floor, Asilmetta Junction,Beside Prasad Labs, Visakhapatanam-530003 Ph No: 2598214, 2505957, 2506292

thRate of Interest of fixed deposit receipts effective from 6 October, 2012

Tax exemption form attached : ̈ 15H ̈ 15G

Particulars of other deposits, if any, with the Company

FDR No (s) ......................................... for `. ....................

APPLICATION FORM FOR FIXED DEPOSITS

CUMULATIVE SCHEMES

NON-CUMULATIVE SCHEMES

** SIGNATURE (S) OF THE APPLICANT(S)

QUARTERLY INCOME

Regd. Office : Elder House, C-9, Dalia Industrial Estate,Off Veera Desai Road, Andheri (West), Mumbai 400 053.

Tel.: 66485 329 Fax : 26730051 E-mail : elderfd@elderindia.com

(Please write in block letters and tick ( ) the appropriate box)

Dear Sirs,

I/We, the undersigned hereby apply for a Fixed Deposit with your Company as per details given below :

Fresh Deposit / Renewal (Please cancel whichever is not applicable)

Amount of Deposit ̀ . ........................................../- (Rupees .......................................................................................................................................................)

Paid by Cheque / Demand Draft / Matured FDR No. .................................... dated / due on ................................................ drawn on .............................................

...................................................................................................... Branch ..................................................................................................................................

Applicant’s Name in full : (In Block Letters)

(1) Mr. /Ms ................................................................................................................................................................................................................................

(Guardian in case of Minor)................................................................................................................Minor’s Date of Birth .....................................................

(2) Mr. /Ms .................................................................................................................................................................................................................................

(3) Mr. /Ms ................................................................................................................................................................................................................................

Address : (In Block Letters) ............................................................................................................................................................................................................

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

............................................................ Pin Tel. No. E-mail. ..........................................

Pharmaceuticals Limited

¨ ¨

¨

¨

¨

¨

¨

¨

¨ ¨

¨

¨

¨

¨¨ ¨ ¨12 Months 24 Months 36 Months

Resident Individual Minor

H.U.F.

Charitable Institution

Shareholder Folio No. .....................

DP ID .............................................

Either or Survivor

Employee

Public Senior Citizen

First named Depositor

Any one or Survivor

Client ID ..................................

Domestic Company

¨ ¨ ¨12 Months 24 Months 36 Months

STATUS :

CATEGORY :

DEPOSIT REPAYABLE TO :

Pay in Slip No./Date

Previous FDR No.

FDR No

Details of Bank Account (To be suffixed with the Payee’s name)

Name of the Bank : ...........................................................................

Branch : ............................................................................................

BROKER’S NAME : ....................................................................

BROKER’S CODE NO. : ..........................................................

Renewal/Realisation Date

Previous FDR Amt.

Document No. Folio No.

Cheque Amount (`)

New FDR Amt. (`.)

(1) Sole/First Applicant ........................................................................................

(2) Second Applicant ..........................................................................................

(3) Third Applicant .............................................................................................

TO BE FILLED IN BY THE APPLICANT Date :

Received from Mr/Ms ................................................................................................................................................................. (Name of the First / Sole Applicant)

For Fixed Deposit together with * Cheque / Demand Draft / FDR No. ................................................ Dated ....................................... Drawn on ...............................

............................................................................................................................................................................ (Name of Bank) for ̀ .......................................

* (Subject to Realisation)

ACKNOWLEDGEMENT

For ELDER PHARMACEUTICALS LIMITED

Authorised Signatory

Nomination Form

I/We _______________________________ hereby nominate the following person to receive the amount due to me, on my death.

Nominee's Name: ______________________________________________________________________________________________________

Guardian's Name (other than applicant)*_____________________________ Date of Birth * _________ Relationship________________________

Address of the Nominee / Guardian : _______________________________________________________________________________________

________________________________________________________(Signature of Nominee/Guardian*)(*in case the nominee is a minor ) Signature of Depositor(s)

I / We have read the terms and conditions printed on this form, and agree to abide by the same.

I/ We also declare that the first named depositor is the beneficial owner of the deposit and is to be treated as the payee for the purpose of deduction of tax under Section 194-A of the Income Tax Act 1961.I am /We are resident(s) of India and am/are not placing this deposit as a Nominee(s) of any Non-Resident.

FOR OFFICE USE ONLY

(mandatory)(mandatory)

A/c No. :

IFSC Code :

MICR Code :

(PAN is mandatory)

(PAN of the second depositor)

PAN No.:of the first depositor

I/We hereby declare that the amount shown above is not being deposited out of the funds acquired by me/us by borrowing or by accepting deposit from any other person.

BAJAJ CAPITAL LIMITED

(`. in lacs)

Liabilities (Continued) As at As at31.03.2012 31.03.2011

Unsecured Loans 27769.91 17715.14Current Liabilities & Provisions 23987.75 20543.82Deferred Tax Liability 183.33 348.16

Total 171433.93 149979.54

(`. in lacs)

Assets As at As at31.03.2012 31.03.2011

Fixed Assets 50761.26 47577.24Capital Work in Progress 19100.83 9302.72Investments 2109.31 1087.47Current Assets 65699.88 67099.77Loans & Advances 33762.65 24912.34

Total 171433.93 149979.54

H) Brief particulars of Contingent Liabilities not provided for.

(`. in lacs)

As at As at31.03.2012 31.03.2011

a) Letters of Credit 3308.91 3242.89b) Bank Guarantees 9689.04 342.55c) Corporate Guarantee to subsidiary 16034.65 8673.47

Disputed Liability in respect of

d) Income Tax 268.58 268.58e) Sales Tax 36.21 17.56

f) Customs duty 25.00 25.00

g) Excise duty 492.62 -

Total 29855.01 12570.05

As at31.03.2012

(`. in lacs)

I) The Amount which the Company can raise under Companies(Acceptance of Deposits) Rules, 1975, as amended till date

a) 10% of the aggregate Paid-up Share Capital 6096.94& free reserves of the Company from Shareholders, Directors etc.

b) 25% of the aggregate Paid-up Share Capital 15242.34and free reserves of the Company from others.

Total 21339.28

J) The Deposits actually held as on 31.03.2012 12855.31

K) The Company has no overdue deposits other thanunclaimed deposits amounting to : 104.50

a) The company has not defaulted in any repayment of deposits or part thereof or any interest there upon to any small Depositors.

b) No small depositor has waived any interest accured on deposit.

L) The Company hereby declares that

a) It has complied with the provisions of the Companies(Acceptance of Deposits) Rules, 1975, as amended till date;

b) Compliance with these rules does not imply that repayment of deposits is guaranteed by the Central Government; and

c) The deposits accepted by the Company are unsecured and rank pari passu with other unsecured liabilities.

d) The acceptance of Deposits is subject to the terms and conditions as indicated in the form of application for deposits available at the Registered Office of the Company and with the Managers to the Fixed Deposit Scheme viz. Bajaj Capital Ltd., Bajaj House, 97, Nehru Place, New Delhi - 110 019.

M) The Scheme/annexed with in this advertisement shall come into force from the date this advertisement has been duly approved by the Board of Directors at its

th meeting held on 28 September, 2012.

N) A copy of this advertisement signed by a majority of the Directors has been filed with rdthe Registrar of Companies, Maharashtra, Mumbai on 3 October, 2012.

Previous years figures have been regrouped / rearranged wherever necessary.

Pharmaceuticals LimitedRegd. Office : Elder House, C-9, Dalia Industrial Estate, Off Veera Desai Road, Andheri (W), Mumbai 400 053. Tel.: 2673 0058 Fax : 26730051 E-mail : elderfd@elderindia.com

Particulars as per the Companies (Acceptance of Deposits) Rules, 1975, as amended till date, are as under :

A) Name of the Company : ELDER PHARMACEUTICALS LTD.

B) Date of Incorporation : 2nd April, 1983

C) Business carried : Manufacture and Sale ofon by the Company Pharmaceutical Bulk Drugs &

Formulations.

The Company has Zonal Sales offices at Mumbai, Delhi, Kolkata & Chennai and

factories at Navi Mumbai & Patalganga in Maharasthra, Selaqui & Langha Road in Uttarakhand and Paonta Sahib in Himachal Pradesh. The Company also has C & F Agents/Sales Depots all over

India.

D) Brief particulars of the : The Company is managed by theManagement of the Company Managing Director, Joint Managing

Director and Executive Director under the supervision and control of the

Board of Directors of the Company.

E) Names, Addresses & Occupation of the Directors :

Name Address Occupation

11, Anjali, 1st Floor, IndustrialistManaging Director Behind Radio Club,

Colaba, Mumbai - 400 005.

11, Anjali, 1st Floor, IndustrialistJoint Managing Director Behind Radio Club,

Colaba, Mumbai - 400 005.

502,Khaibar Apt, ServiceExecutive Director Prof Alemida Road,

Bandra (w),Mumbai - 400 050.

C-6-1, Lloyds Garden, CompanyAppa Saheb Marathe Marg, DirectorPrabhadevi, Mumbai - 400 025.

707, Ansal Chambers II, ManagementBhikaji Cama Place, ConsultantNew Delhi - 110 006.

B-231, Vikasini CHS, Sector-8B, FinancialCBD Belapur, ConsultantNavi Mumbai - 400 614.

27, Belvedere,B.D. Road, Opp Legal AdvisorAmerican Consulate Mumbai-400026

122, Buena Vista, Gen. J. Bhosle MedicalMarg, Mumbai - 400 021. Practitioner

28, South Road, IndustrialistAllahabad - 211 001.

Via Cariginal Pacca, Service24, Rome, Italy

1186, CECILIA, 22nd Cross, Financial14th Main, Sector III, ConsultantHSR Layout, Bangalore 560 034

F) Profits & Dividend (`. in lacs)

Year ended Profit before Profit after Dividend31st March Tax Tax

2012 10351.12 8415.95 30%2011 8906.95 7140.12 30%2010 6467.99 5539.16 30%

G) Summarised financial position of the Company as appearing in the two latest audited Balance Sheets immediately preceding the date of this advertisement.

(`. in lacs)

Liabilities As at As at31.03.2012 31.03.2011

Share Capital 2056.66 2056.66Reserves & Surplus 42044.39 33980.56Share Premium A/c 25074.56 25074.56Secured Loans 50317.33 50260.64

Mr. Jagdish Saxena

Mr. Alok Saxena

Mr. Yusuf Karim Khan

Dr. R. Srinivasan

Dr. J. S. Juneja

Dr. Sailendra Narain

Mr. Urvashi Saxena

Dr. S. Jayaram

Mr. Saleem I. Shervani

Mr. Edoardo Carlo Richter

Mr. Michael Bastain

FIXED DEPOSIT SCHEMES

By order of the BoardJagdish Saxena

Managing Director

FORM 2 B(see rules 4CCC and 5D

(To be filled by individual applying singly or jointly)(if jointly, only upto two persons)

I/We .............................................................................and........................................................................................................... the

holders of Shares/Debentures/Deposit Receipt Receipt bearing number(s) ........................................... of M/s. ELDER PHARMACEUTICALS

LIMITED wish to make a nomination and do hereby nominate the following person in whom all rights of transfer and for amount payable in

respect of shares / debentures / deposits shall vest in the event of my/our death.

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

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

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

Date of Birth : * .............................................

Name and Address :

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

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

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

NOMINATION FORM

Name and Address of Nominee

* (to be furnished in case the nominee is a minor)

** The nominee is a minor whose guardian is

* (to be deleted if not applicable)

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

of Sole Depositor of Joint Depositor

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

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

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

Date : ..................................... Date : ....................................

Name and Address

1.

2.

Instructions :

1. The nomination can be made by individuals only applying/holding/shares/debentures on their own behalf singly or jointly up to 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.

2. A minor can be nominated by a holder of shares/debentures/deposits and in that event the name and address of the Guardian shall be given by the holder.

3. The nominee shall not be a society, trust, body corporate, partnership firm, Karta of Hindu Undivided Family, power of Attorney holder. A non-resident Indian can be a nominee on re-patriable basis.

4. Nomination stands rescinded upon transfer of shares/debenture or repayment/renewal of deposits made.

5. Transfer of shares/debenture in favour of a nominee and repayment of amount of deposit to nominee shall be valid discharge by a Company against the legal heir.

Signature of two witnesses Signature with Date