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Transmission Affidavit

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FORMAT OF AFFIDAVIT FOR TRANSMISSION OF SHARES WITHOUT PRODUCING PROBATE /

SUCCESSION CERTIFICATE / LETTERS OF ADMINISTRATION


(Please type this Affidavit after carefully reading the notes mentioned below the format)

AFFIDAVIT

I, __________, son/daughter/spouse of _________ aged ___, an Indian Inhabitant / NRI presently residing at
__________________, do hereby solemnly affirm and declare as under:

1.That Shri/Smt. (Name of the deceased), the deceased, was holding _____ equity shares in (the name of the
company) covered under Folio No. _______ and Share Certificate No(s). ___________, bearing Distinctive
Nos. ________ to __________ of the face value of Rs.__/- each.

Folio No. Certificate Nos. Distinctive Nos. Shares covered in each certificate

2.Shri./Smt. (name of the deceased) expired intestate on (date of death) at (place of death) leaving behind
him/her the following legal heirs :

Sr. No. Name of the heir Age Relation with the deceased

1.
2.
3.

3.The abovementioned shares were separate and self acquired property of the deceased. According to the law
of Intestate Succession applicable to him/her by which he/she was governed at the time of his/her death, the
person(s) mentioned hereinabove is/are the only heir(s) of the deceased. They are entitled to inherit
solely/jointly the aforesaid shares covered under Folio No. ______ held by the deceased.

4.That the Late Shri/Smt. (name of the deceased) has left no other heir than these in paragraph 2 above and the
person(s) mentioned therein is/are only his/her legal heir(s).

5.I have already executed indemnity bond for transmitting the aforesaid shares held by the deceased in my
name without production of Succession Certificate / Probate of Will / Letter of Administration ( LoA )
OR
I have already, alongwith name of other applicant(s), executed indemnity bond for transmitting the
aforesaid shares held by the deceased in our name without production of Succession Certificate / Probate of
Will / Letter of Administration ( LoA ).

6.I therefore request the (Name of the Company) to transmit the above shares in my / our name.

I am executing this declaration to be submitted to the concerned authorities of the Company.

LIIPL/Transmission/Affidavit/Version No. 1.0 18/11/2013 Page 1 of 2


VERIFICATION
I hereby state that whatever is stated herein above are true to the best of my knowledge.

Solemnly affirmed at ________ )

On this ____ day of ______ 20... ) (Signature of the Applicant/s)


Deponent

Identified by me Before Me

Advocate S.E.O./ Oaths Commissioner/Notary

NOTES:
1.Affidavit should be on Non-judicial stamp paper of Rs. 100/-, or duly Franked and duly attested and
affirmed by Notary
2.Please fill up the details as per the documents you are annexing. Please do not just type this format as it
is.
3.It should be executed by the Applicant(s)
4.Maximum of only three legal heirs can apply for transmission.

LIIPL/Transmission/Affidavit/Version No. 1.0 18/11/2013 Page 2 of 2

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