FORM 2B
(See rules 4 CCC and 5D)
Nomination Form
(To be filled in by individual applying singly or jointly)
I/We______________________________________________ and ___________________________________________
the holders of shares/debentures/fixed deposit bearing Folio no./Receipt no.______________________________________ of
M/s Chambal Fertilisers and Chemicals Ltd. wish to make a nomination and do hereby nominate the following persons in whom all rights of transfer and/or amount payable in respect of shares/debentures/deposits shall vest in the event of my/our death.

Name and Address of Nominee

Name __________________________________________________________________________________________

Address ________________________________________________________________________________________

Date of Birth* ____________________________________________________________________________________
(* to be furnished in case the nominee is a minor)
** The nominee is a minor whose guardian is (Name and Address) _____________________________________________

________________________________________________________________________________________________
(** To be deleted if not applicable)

Signature __________________________________      Signature __________________________________

Name __________________________________          Name ____________________________________

Address __________________________________      Address ___________________________________

_________________________________________      ___________________________________________

Date __________________________________           Date _______________________________________

Signature of two witnesses                                                             @delete whichever is not applicable
Name and Address
Signature with date
1.


  
2.


  
Instructions:

1. The Nomination can be made by individuals only applying/holding shares/debentures on their own behalf single or jointly upto two persons. Non-individuals including society, trust, body corporate, partnership firm, Karta of Hindu Undivided Family, holder of power of attorney cannot nominate. If the shares are held jointly, all joint holders will sign the nomination form.
2. A minor can be nominated by a holder of shares/debentures/deposits and in that event, the name and address of the Guardian shall be given by the holder.
3. The nominee shall not be a trust, society, body corporate, partnership firm, Karta of Hindu Undivided Family or a power of attorney holder. A Non-Resident-Indian can be a nominee on re-patriable basis.
4. Nomination stands rescinded upon transfer of shares/debentures or repayment/renewal of deposits made.
5. Transfer of shares/debentures in favour of a nominee and repayment of amount of deposit to nominee shall be valid discharge by a company against the legal heir.