19 May 2011
SIR THE VERIFICATION OF APPLICANT AS ANNEXURE 2 POINT 1(a) AND 1(c) IS WRITTEN ALONG WITH PROOF AND IN CASE OF CHANGE OF NAME / IN THE DATE OF BIRTH, A COPY OF NOTIFICATION PUBLISHED IN THE GAZATTE
I AM UNABLE TO FIND OUT THE SUITABLE FORMAT IN THIS REGARD TO FILE DIN 4
I, ………………………. (name of the applicant), Son / Daughter* of ………………… (applicant’s father’s name), born on ………… (date of birth), resident of …………………… (present residential address of the applicant) hereby confirm and verify that the particulars given in the Form DIN – 4 are true and correct and also are in agreement with the documents being attached to the Form DIN – 4. (i) I have applied for change* of:- (a) Applicant Name (along with proof and in case of change of name, a copy of Notification published in the Gazette). (b) Nationality (along with proof). (c) Date of birth (along with proof and in case of change in the date of birth, copy of Notification published in the Gazette). (d) Income Tax Permanent Account Number (along with proof). (e) Voters Identity Card Number (along with proof) (f) Passport Number (along with proof) (g) Driving licence number (along with proof) (h) Permanent residential address (along with proof) (i) Present residential address (along with proof) I further confirm that: - i) The photograph and documents being attached to the Form DIN – 4 belong to me. I further confirm that all required documents have been duly issued by the respective government authority and are being attached to the Form DIN – 4 and ii) I am not restrained / disqualified / removed of, for being appointed as director of a company company under the provisions of Companies Act including Sections 203, 274, 284 and 388(E) of the said Act; and iii) I have not been declared as proclaimed offender by any Economic Offence Court or Judicial Magistrate Court or High Court or any other Court; and iv) I have not been already allotted a Director Identification Number (DIN) under section 266B of the Companies Act.
Signature (Name) *Note: Strike out whichever is not applicable