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Repurchase Redemption Form

This document is a Repurchase/Redemption Request Form for securities issued by Groww Invest Tech Private Limited. It includes sections for participant details, account information, number of securities to be repurchased, and signatures for authorization. The form also contains an acknowledgment section for the receipt of the request by the depository participant.

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arabindasadhukhan2018
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36 views1 page

Repurchase Redemption Form

This document is a Repurchase/Redemption Request Form for securities issued by Groww Invest Tech Private Limited. It includes sections for participant details, account information, number of securities to be repurchased, and signatures for authorization. The form also contains an acknowledgment section for the receipt of the request by the depository participant.

Uploaded by

arabindasadhukhan2018
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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GROWW INVEST TECH PRIVATE LIMITED

Correspondence Address: 1st Floor, Obeya Tulip, Regent Insignia, No. 414/8, 4th Block, Koramangala,
Bengaluru 560034 | SEBI Registration Number: IN-DP-417-2019 | CDSL DP:12088700

Annexure 9.2

REPURCHASE / REDEMPTION REQUEST FORM

Participant Name
Depository Participant ID 1 2 0 8 8 7 0 0
RFN DATE

I/We offer the below mentioned securities for repurchase/ redemption and declare that my/our account be debited
the number of securities to the extent of my/ our repurchase/ redemption request and proceeds be paid to me/us
cheque/ bank draft. I/We hereby declare that the below mentioned person(s) are the beneficial owners of the
security mentioned.

Account Number 1 2 0 8 8 7 0
Account Holder Name

No. of Securities to be Repurchased/Redeemed(in figures)


in words
(integers)
and
(Fractions)
Name of the security
Name of the issuing Company
Face Value
ISIN

Specimen Signature(s) Name Signature

First/ Sole Holder ____________________________ ______________

Second Holder ____________________________ ______________

Third Holder ____________________________ ______________

Participant Authorization

Received the above mentioned securities for repurchase/ redemption from


Account No. 1 2 0 8 8 7 0 0
ISIN
Date D D M M Y Y Y Y
Name of the first
Holder

The application form is verified with the details of the beneficial owner’s account and certified that the application form is in
order. The account has sufficient balance to accept the repurchase/ redemption request. It is also certified that the beneficial
owner’s signatures are verified and found in order.

The other details of the beneficial owners as extracted from the records are enclosed.

Forwarded by – Name

Signature Seal

======================================================

Acknowledgement
Participants Name Address and ID

We hereby acknowledge the receipt of repurchase/ redemption request for ___________ no. of securities of
______________________ (security details) from _______________________________ (Name) holding a/c no. ___________

_______________________________ _____________________ ___________________


Depository Participant’s Signature Seal Date

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