Intimation by Director under Section 274(1)(g) (from DD-A)

FORM ‘DD-A’

Companies (Disqualification of Directors under section 274(1)(g) of the Companies Act, 1956) Rules, 2003

Intimation by Director

[Pursuant to Section 274(1)(g)]

CIN of the company	:
Nominal Capital	:
Paid-up Capital	:
Name of Company	:
Address of its Registered Office	:

To The Board of Directors

Dear Sirs

I <          >  son/daughter/wife of <                                           > resident of  <                                               > director/managing director/manager in the company hereby give notice that I am/was a director in the following companies during the last 3 years:-

Name of the Company	Date of Appointment	Date of Cessation

I further confirm that I have not incurred disqualification under section 274(1)(g) of the Companies Act, 1956 in any of the above companies, in the previous financial year, and that I, at present, stand free from any disqualification from being a director.

Or

I further confirm that I have incurred disqualifications under section 274(1)(g) of the Companies Act, 1956 in the following company(s) in the previous financial year, and that I, at present stand disqualified from being a director.

Name of the Company	Date of Appointment	Date of Cessation

Signature

(Full Name)

Dated this _________ day of _________