To,
The Secretary,
____________________________________________ Co-operative Housing Society Ltd.
____________________________________________________________________
Subject : Application for issuance of a duplicate Share Certificate in lieu of the original, which has been lost.
Sir/Madam,
1. I/We, Shri/Smt./M/s. _________________________________________________, Member(s) of the Society holding Flat/Unit No. _______ in the building known as ____________________________, was/were the registered holder(s) of Share Certificate No. _______ for ______ fully paid-up shares of Rs. 50/- each, bearing distinctive numbers _______ to _______ (both inclusive).
2. I/We state that the said Share Certificate has been lost and, despite diligent search, could not be traced. I/We lodged a police complaint/non-cognizable complaint in this regard at ________________________ Police Station on __________, a copy whereof is enclosed.
3. I/We accordingly request that a duplicate Share Certificate, marked 'DUPLICATE', be issued to me/us in lieu of the original, in accordance with Rule 15(a) of the Bye-laws.
4. I/We enclose herewith an Indemnity Bond in the prescribed form, indemnifying the Society against any claim that may be made in respect of the said Share Certificate, together with a self-declaration/affidavit stating the circumstances of the loss.
Enclosures :
(1) Copy of the police complaint / non-cognizable complaint
(2) Indemnity Bond in the prescribed form
(3) Self-declaration/Affidavit regarding the circumstances of loss
Yours faithfully,
_________________________________
(Signature of Applicant/s)
Place : ______________
Date : ______________
Duplicate Share Certificate No. _______ (marked 'DUPLICATE' in lieu of original Certificate No. _______) issued on _______, entered in the Register of Share Certificates at Sr. No. _______.
Signature of Secretary : _________________________
