Form 13: Nomination Form

To,
The Secretary,
____________________________________________ Co-operative Housing Society Ltd.
____________________________________________________________________

Sir/Madam,

1. I, Shri/Smt./M/s. _________________________________________________, Member/Joint Member (strike out whichever is not applicable) of the Society, holding Share Certificate No. _______ for _______ fully paid-up shares in respect of Flat/Unit No. _______ in the building known as ____________________________, hereby nominate the following person(s) under Section 154B-13 of the Act and Rule 106C-8:

Name(s) of Nominee(s)
_________________________________________________

Address(es) _________________________________________________

Relationship_________________________________________________

Proportion of devolution (if more than one nominee; equal share if left blank)

_________________________________________________

2. This nomination is made for the purpose of admission of the nominee as a Provisional Member upon my death, pending final settlement of my legal heirs, and I confirm that this nomination does not by itself confer any ownership, title or beneficial interest in the flat/unit upon the nominee.

3. I confirm that the above nominee(s) is/are not, to my knowledge, an Associate Member or Provisional Member of the Society, and that this nomination is made by me as a full Member/Joint Member.

4. I understand that no fee is payable for this nomination if it is my first nomination, and that a fee of Rs. 100/- is payable for any subsequent nomination, revocation or variation.

Yours faithfully,

_________________________________

(Signature of Nominator)

Place : ______________
Date : ______________

Witnesses:
1. Name & Address : _________________________________ Signature : _______________

2. Name & Address : _________________________________ Signature : _______________

Signature of Secretary : _________________________