To,
The Secretary,
____________________________________________ Co-operative Housing Society Ltd.
____________________________________________________________________
Subject : Application for issuance of a duplicate Share Certificate in lieu of the original, which is damaged/defaced/torn/mutilated/laminated.
Sir/Madam,
1. I/We, Shri/Smt./M/s. _________________________________________________, Member(s) of the Society holding Flat/Unit No. _______ in the building known as ____________________________, am/are 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 become damaged/defaced/torn/mutilated/laminated (strike out whichever is not applicable) due to ________________________________________________, and is accordingly no longer fit for retention in its present condition.
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 Bye-law No. 15(b), and enclose herewith the original Share Certificate for surrender and cancellation.
4. I/We enclose herewith an Indemnity Bond in the prescribed form and a Self-declaration/Affidavit regarding the circumstance of loss to be made.
Enclosures :
(1) Original Share Certificate (damaged/defaced/torn/mutilated/laminated) — for surrender and cancellation
(2) Indemnity Bond in the prescribed form
(3) Self-declaration/Affidavit regarding circumstance of loss to be made
Yours faithfully,
_________________________________
(Signature of Applicant/s)
Place : ______________
Date : ______________
Original Share Certificate No. _______ surrendered and cancelled on _______. Duplicate Share Certificate No. _______ (marked 'DUPLICATE') issued on _______, entered in the Register of Share Certificates at Sr. No. _______.
Signature of Secretary : _________________________
