PLEASE READ INSTRUCTIONS BEFORE COMPLETING THIS FORM

INDEMNITY CUM AFFIDAVIT

ON STAMP PAPER OF RS 300/TO BE NOTARISED

This Indemnity cum Affidavit is executed at ___________ this ____ day of ________, by :
(1) Mr ______________ Age: ____ years, Occupation: ____, residing at ____________________
(hereinafter referred to as Indemnifier 1)
(2) Mr ______________ Age: ____ years, Occupation: ____, residing at ____________________
(hereinafter referred to as Indemnifier 2)
(3) Mr ______________ Age: ____ years, Occupation: ____, residing at ____________________
(hereinafter referred to as Indemnifier 3)
(4) Mr ______________ Age: ____ years, Occupation: ____, residing at ____________________
(hereinafter referred to as Indemnifier 4)
(5) Mr ______________ Age: ____ years, Occupation: ____, residing at ____________________
(hereinafter referred to as Indemnifier 5)
3

(hereinafter, collectively referred to as Indemnifiers).

IN FAVOUR OF
th

CROMPTON GREAVES LIMITED, a Company having its Registered Office at 6 Floor CG House Dr
Annie Besant Road, Worli, Mumbai 400 030, hereinafter called the Indemnity Holder.
The expressions, Indemnifier, Indemnifiers and Indemnity Holder(s) shall, unless it be repugnant to
the context or meaning thereof, be deemed to mean and include their respective successors and assigns.
The abovementioned Indemnifiers do solemnly affirm and declare as follows:
(1) The following shares of Crompton Greaves Limited are registered in the name of Late
_______________:
Folio No

No of
Shares(Face
Value per
share
Rs___)

Certificate
No(s)

Indemnifiers will be all heirs and two sureties

Distinctive No(s)
From

To

(2) Mr/Ms. __________ died without leaving a will (intestate) and though due and diligent search has
been made for his / her will, no such will has been found so far
4
OR
(2) Mr/Ms. __________ died leaving his last will and testament dated ______ in respect of which no
probate/letter of administration/succession certificate had been obtained.
(3) Under the personal law, applicable to the deceased, the following become his sole legal heirs and
are entitled to inherit jointly the aforesaid shares.
a. Mrs ......................................... Wife
b. Mr .......................................... Son
c. Ms .......................................... Daughter
(4) The above mentioned shares were the separate and self acquired property of the deceased.
(5) Indemnifier 1, Indemnifier 2*, Indemnifier 3* are the legal heirs and do hereby give consent for the
transfer of these shares into the name of ......................................... (hereinafter referred to as
Beneficiaries) and to pay to them the arrears of dividend , if any and also issue in bonus shares, on
the said shares, without insisting on production of legal representation to the estate of the deceased
shareholder.
(6) The following information may be relied upon for processing the transmission formalities:
1. Full Name and address of the deceased member:
2. Nature of shareholding single / joint:
3. Date of death of the deceased as per English Calendar:
4. Present market value of shares held in the Company:
5. Name of the person in whose custody the share
certificates are presently available and reasons therefor:
6. No of shares held by the deceased in other companies:
Name of Co

No of shares

..........................

.......................

..........................

.......................

7. Particulars of the property (movable & immovable) of

the deceased other than shares:
8. Particulars of the debts of the deceased. Please state
the amount and nature of debts:
9. Full details of surviving legal heirs:
Name Address

Relationship
with the Deceased

Age

Marital Status

Guardian details

(i)
(ii)
(iii)
(iv)
10. Law by which the deceased was governed
(If Hindu or Mohammaden state the school of Law):
11. Heirs of the deceased in according with the aforesaid law:
4

Strike out whichever is not applicable

Indicate in case of minor children of the deceased. Please mention name, address, whether natural guardian or
appointed under Guardian And Wards Act.
5

12. In case deceased was member of Hindu Undivided

Family(HUF), full details of surviving legal members:
Name

Address

Relationship with the Deceased

Age

Marital Status

(i)
(ii)
(iii)

13. Specify whether deceased was "Karta" of the HUF:

14. Specify whether the shares in the Company were part of
his personal estate or part of HUF property:
15. Particulars of the Beneficiaries:
Name

Fathers /
Husbands
Name

Address

Occupation

Relationship
Age
with the Deceased

Marital
Status

(i)
(ii)
(iii)

16. Residential Status of the Beneficiaries

: Resident / Non Resident

17. Names of Indemnifiers who are acting as sureties:

18. Any other information to support the
: ....................................................
Beneficiaries claim to the shares of the
....................................................
deceased member
.....................................................
(7) In consideration of the Company transferring the abovementioned shares as requested at Clause (5)
all the Indemnifiers hereby undertake jointly and severally that:
(i) they themselves and their heirs, executors and administrators respectively, will at all times and
from time to time save, defend, keep harmless and indemnify the Company, its successors,
assignees and the Directors thereof and their respective heirs, executors, administrators, estates
and effects from and against all actions, causes, suits, proceedings, accounts, claims, demands,
and all losses, damages, costs, charges, liabilities, expenses and sums of money incurred in
respect thereof, whatsoever on account of the Company, at their request, transferring the
abovementioned and also Bonus shares to the Beneficiaries and paying arrears of dividend on
the said shares, without insisting on the production of legal representation to the estate of the
deceased shareholder.
(ii) the determination by the Indemnity Holders of the extent of any and all such losses, damages,
claims, penalties, proceedings, costs and all other liabilities, shall be binding on all the
Indemnifiers, without questioning the reasonableness, validity or otherwise of any payments
made by the Indemnity Holders, in response to a claim that has been made by the Indemnity
Holders;
(iii) In case, the Indemnifiers fail to defend, settle or mitigate the claim, the Indemnity Holders shall
have full rights to defend, pay or settle said claim on the Indemnifiers behalf, without notice to
Indemnifiers, and notwithstanding any direction on the contrary by the Indemnifiers, with full
rights to recourse against the Indemnifiers for all fees, costs, expenses and payments made or
agreed to be paid to discharge the claims.
(iv) Upon default, the Indemnifiers further agree to pay all reasonable attorneys fees necessary to
enforce this Agreement.
(v) This Agreement shall be unlimited as to amount or duration.

(vi) This Indemnity is in addition to and not in derogation of any other Indemnity/Guarantee and/or
Security which the Indemnifiers may have executed in favor of the Indemnity Holders or which
Indemnity Holders may at any time hold.
(vii) that this Indemnity cum Affidavit shall ensure upon and also be enforceable jointly and severally
against all the Indemnifiers and all their respective legal heirs, representatives, successors and
assigns, for all times in future.
(8) In consideration of the Company transferring the abovementioned shares as requested at Clause (5)
the Indemnifiers hereby declare and agree that in the event of their failure to compensate the
Indemnity Holders as per Clause (7) above, the Company can have a lien in general on all
shares/debentures or other securities which the Indemnifiers may be holding presently or in the
future and also the dividend. interest declared or payable on the shares/debentures or other
securities.

VERIFICATION
We, the Indemnifiers abovenamed, do hereby verify that the statements mentioned in the above
paragraphs are true to the best of our knowledge and belief and that nothing material has been concealed.
Verified at ................................. on this ..............day of .............20
IN WITNESS WHEREOF the Indemnifiers have hereunto set and subscribed their hands to this document
the day and year hereinabove mentioned.
Name

Address

Signature

Phone No

Email Id

Bank
7
Details

Heir 1
Heir 2
Heir 3
Surety No 1
Surety No 2
Witness for Heir 1
Witness for Heir 2
Witness for Heir 3
Witness for Surety
No 1
Witness for Surety
No 2

BEFORE ME
(Signature & Stamp of
Notary Public)

Please take care that sureties and witness are not the same individuals. Further sureties should be in
addition to the heirs
7
Name of Bank, Branch and Account No. to be filled in

SURETY DETAILS
8
SURETY NO 1
(Private & Confidential)

1. Name in Full :
2. Permanent Residential Address :
3. Phone no :
4. E-Mail Id :
5. Age :
6. Employment :
(i) Place of employment
(ii) Name of employer
(iii) Annual salary and other emoluments
7. Details of immovable property owned
(absolutely in your name, not as member of
HUF) within municipal limits*
(i) Situation
(ii) Valuation
(iii) Annual rent realized
(please specify whether the immovable property
consists of houses or mere lands)
8. Nature and value of business*
(In your own name & not as partner)
(i) Annual turnover
(ii) Annual Profits

Date:

(Signature of the Surety)

Note: Reply if applicable, otherwise kindly write NOT APPLICABLE against the relevant Column.

Sureties should be different to the shareholders and witnesses

SURETY DETAILS
9
SURETY NO 2
(Private & Confidential)

1. Name in Full :
2. Permanent Residential Address :
3. Phone no :
4. E-Mail Id :
5. Age :
6. Employment :
(iv) Place of employment
(v) Name of employer
(vi) Annual salary and other emoluments
7. Details of immovable property owned
(absolutely in your name, not as member of
HUF) within municipal limits*
(iv) Situation
(v) Valuation
(vi) Annual rent realized
(please specify whether the immovable property
consists of houses or mere lands)
8. Nature and value of business*
(In your own name & not as partner)
(iii) Annual turnover
(iv) Annual Profits

Date:

(Signature of the Surety)

Note: Reply if applicable, otherwise kindly write NOT APPLICABLE against the relevant Column.

Sureties should be different to the shareholders and witnesses

INSTRUCTIONS
1. The Company has provided procedures for transmission of shares
Transmission without legal documents
This is permissible only if the market value of the shares is upto Rs 2.5 lacs. In terms of Article 57 of
Articles of Association of the Company, the Board of Directors is competent to permit a transmission
of shares without insisting on legal Documents upto a specified limit. This has been fixed at Rs 2.5
Lacs. However the Company may not choose to offer this privilege in certain doubtful cases, and may
insist on completion of full legal formalities for claiming the shares of the deceased shareholder,
which includes production of the Probate or Letters of Administration or Succession Certificate.
The documents to be submitted for this purpose are:
Indemnity Bond cum Affidavit on stamp paper of Rs 300/ Original share certificates
Death certificate attested by a Bank Manager
Surety details form for two sureties
Copy of Will, where available
In case shares are to be transmitted in favour of a particular heir, the balance heirs are requested to
provide No Objection Certificates.

2. Kindly execute the Indemnity Cum Affidavit For Duplicate Issue on a Non-judicial stamp paper of
Rs. 300/- or affix special adhesive stamps or frank the form for the same amount.
3. The stamp paper must be purchased in the name of the first Legal Heir.
4. In case adhesive stamps are used, the same must be cancelled by the issuing authority.
5. The Indemnity Cum Affidavit must be signed by all the heirs alongwith two Surety(ies). The
execution date on the form must be subsequent to the date of the stamping.
6. The duly executed Indemnity Cum Affidavit must be notarized by a Notary Public under his/her
official seal.
7. The heirs cannot be sureties. These must be separate individuals of good financial standing.
8. Witnesses must be other than heirs or the sureties.
9. In case of NRI shareholders, the Indemnity Cum Affidavit can be executed on plain paper and a
demand draft towards the stamping amount may be issued in favour of M/S Datamatics Financial
Services Limited, Mumbai, the Companys Registrar & Share Transfer Agent for addressing the
Regulatory formalities. The duly executed Indemnity Cum Affidavit must be notarized by the
Consulate/Embassy other Authorities permitted under local laws to issue oaths.
10. Thumb Impression (Left Hand only) will be accepted only if it is attested by a Bank Manager of a
Nationalised Bank or a Share Broker having SEBI Registration Number or a Notary Public.