Form DIR-4 
Verification of applicant for application for DIN 
(Affidavit) 
[Pursuant to section 153 and rule 9(3)(a)(iv) of Companies (Appointment and Qualification of Directors) Rules, 2014] 
I,……………. , Son of ………………, born on ……………, resident of ……………………………………….. hereby confirm and verify that the particulars given in the Form DIR-3 are true and also are in agreement with the documents being attached to the Form DIR-3. 
I hereby confirm and declare that 
1. The photograph and documents being attached to the Form DIR-3 belong to me. I further confirm that all required documents have been duly certified by the respective government authority and are being attached to the Form DIR-3, and 
2. I am not restrained, disqualified, removed of, for being appointed as director  of  a  company  under  the  provisions  of  the  Companies  Act,  2013 including sections 164 and 169, and 
3.
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
4. I have not been already allotted a Director Identification Number (DIN) under section 154 of the Companies Act, 2013, and 5. I shall be liable under section 448 of the Act and under the relevant provisions of the Indian Penal Code, 1860 and any other law as applicable, if any statement in this application is found to be false or any material fact is found to have been omitted. 
*Note: strike out whichever is not applicable.
Signature:
(Applicant’s Name)