Indemnity Agreement
Indemnity Agreement
Indemnity Agreement
Dear Sir/Madam, I beg to inform you that the original Refund Order No.__________ for Rs.______ (Rupees __________________________________) dated _______ appears to have been lost, mislaid or accidentally destroyed with the result that the same has not been encashed by me. In consideration of the Bank issuing to me the duplicate Refund Order in lieu of the original Refund Order and making the payment of the same, I hereby agree to indemnify the Bank against all costs, expenses, loss and damages which may be incurred by the Bank in consequence of issuing a duplicate Refund Order and making payment thereof or in consequence of any claim which was made/may be made by or on behalf of any person holding the original Refund Order. The above indemnity shall cover the Bank its successors and assigns and its Directors and servants and officers and shareholders and their respective estates and effect are and shall from time to time and at all times hereafter kept safe and save harmless and indemnified against any claim arising out of the said Original Refund Order said to have been lost or miscarried against all action, losses, costs, charges, expenses and demands whatsoever the said Bank may suffer on account of the same. Bank Accounts Details: Name of the Bank Account No. Branch Name & Address. Dated this _______________________ day of ______________ 2007. Yours faithfully,
(Signature of 1st holder) (Signature of 2nd holder) (Signature of 3rd holder) 1. To be executed on Rs. 200/- stamp paper. In the alternative, you may affix special adhesive stamps of Rs. 200/- to the draft prior to its execution. 2. No court fee or postage stamps should be used in the execution of the Indemnity agreement.
UNDERTAKING From : To, Union Bank of India ________________ Share Application No.. Dear Sir/Madam, I / We are not in receipt of the original Refund Order No.__________ for Rs.______ (Rupees __________________________________) dated _______ and the same appears to have been lost, mislaid or accidentally destroyed with the result that the same has not been encashed by me/us. Hence I/we request you to issue a duplicate Refund Order in lieu of the original Refund Order and make the payment of the same. I/ We undertake that i/we shall reimburse all costs and expenses which you may have to incur for issuing the duplicate Refund Order. I / We also undertake to incur all the monetary loss which may have to be borne by you on account of issuance of the duplicate Refund Order. I /We shall be responsible for all the consequences of issuance of the duplicate Refund Order and all the claims and damages which may be incurred by the bank in this regard. This undertaking shall cover all the shareholders of the Bank at all times. Bank Accounts Details: Name of the Bank Account No. Branch Name & Address. Dated this _______________________ day of ______________ 2007. Yours faithfully, successors, assigns, Directors, employees and
(Signature of 1st holder) (Signature of 2nd holder) (Signature of 3rd holder) If the amount of original refund order is upto Rs. 5500/- investor can undertaking in the above format on a plain paper. furnished an
Address:____________________ ___________________________ Date :______________________ The Asstt. Vice President Data matics Financial Services Limited Dear Sir, Reg: Union Bank of India Shares. I hereby give following information for necessary action at your end:______________________________________________________________________ A. My particulars D-MAT FORM Client ID No. : ______________________ DP ID No. : ______________________ No. of shares : ______________________ PHYSICAL FORM Folio No. :__________________ No. of shares________________ Certificate Nos. : ____________ to____________ Distn. Nos. : _________________ to____________ ______________________________________________________________________ B. Subject (Please _ / whichever is applicable)
Fate of application Non-receipt of Dividend/Refund Order/Share certificate Name/Account No. etc. for correction. Change of address. New/present address is_____________________________ ______________________________ ______________________________ Revalidation of Refund Order/Dividend Warrant Issuance of Duplicate/New certificate in lieu of lost/damaged share certificate. Transfer/transmission of shares Others (Kindly specify)
C. Any other comment: Thanking you Yours faithfully, ____________________________ Signature (Name of shareholder/complainant)
Enclosures: __________________