Account No. : ---------------------------
No. of Shares: ---------------------------

FORM 2B
[See rules 4CCC and 5D of Companies (Central Govt's) General Rules & Forms]
N O M I N A T I O N   F O R M
(To be filled in by individual(s) applying singly or jointly)

I/We----------------------------------------------------- and --------------------------------------- and ------------------------------------------------------------------- the holders of Equity Shares bearing No(s). ----------------------------------------------------------- of -------------------------- Limited wish to make a nomination and do hereby nominate the following person(s) in whom all rights of transfer and/or amount payable  in respect of Shares shall vest in the event of my / our death.

Name, Address and Signature of Nominee

Name        : ---------------------------------------------------------------------------------------------------

Address     :---------------------------------------------------------------------------------------------------

                  ---------------------------------------------------------------------------------------------------

Signature   : --------------------------------------------------------------------------------------------------

Date of Birth* : ----------------------------------------------------------------------------------------------

(*To be furnished in case the nominee is a minor)

** The Nominee is a minor whose guardian is

Name               :--------------------------------------------------------------------------------------------

Address           :--------------------------------------------------------------------------------------------

                        --------------------------------------------------------------------------------------------

Signature         : -------------------------------------------------------------------------------------------

(**To be deleted if not applicable)

Name, Address and Signature of Holder(s)

1. Name              : ----------------------------------------------------------------------------------------

Address              : ----------------------------------------------------------------------------------------

Signature            : ----------------------------------------------------------------------------------------

Date                   : ----------------------------------------------------------------------------------------

2. Name              : ----------------------------------------------------------------------------------------

Address              : ----------------------------------------------------------------------------------------

Signature            : ----------------------------------------------------------------------------------------

Date                   : ----------------------------------------------------------------------------------------

3. Name              : ---------------------------------------------------------------------------------------

Address              : ---------------------------------------------------------------------------------------

Signature            : ---------------------------------------------------------------------------------------

Name, Address and Signature of two Witnesses
Name and Address                                                     Signature with date

                1.

                2.

Instructions

1 The Nomination can be made by individuals only holding shares on their own behalf singly or jointly. Non- individuals including society, trust, body corporate, partnership firm, Karta of Hindu Undivided Family, power of attorney holder cannot nominate. If the shares are held jointly, all joint holders are required to sign the Nomination Form. Space is provided as a specimen, if there are more joint holders more sheets can be added for signatures of holders of shares and witnesses.

2. A minor can be nominated by a holder of shares and in that event, the holder shall give the name, addess and signature of the guardian.

3. The nominee shall not be a society, trust, body corporate, partnership firm, Karta of Hindu Undivided Family or a power of attorney holder. A non-resident Indian can be a nominee on repatriable basis.

4. Nomination stands rescinded upon transfer of shares.

5. Transfer of shares in favour of a nominee shall be a valid discharge by the Company against the legal heir.

6 The Nomination Form shall be filed in duplicate with the Company/ Registrar & Share Transfer Agent who will return one copy thereof to the shareholder duly acknowledged.

FOR OFFICE USE ONLY