Share Application form-Model

<Name for the company>
<Registered Office>
SHARE APPLICATION FORM
The Board of Directors <name of the company>
Dear Sirs
Sub	:	Application for allotment of  <>  equity shares of rs. 10/- each fully paid up for cash at par.
Ref	:
We hereby irrevocable apply to allotment to us equity/convertible preference shares as stated below:
We enclose herewith a Cheque for sum of Rs. <>  (Rupees <> only) towards the application money for Equity shares of Rs. 10/- each of the Company fully paid up for cash at par.
We agree to accept the equity shares applied for or such lesser number as may be allocated to us, subject to terms of the Memorandum and Articles of Association of the Company. I/We will sign all such other documents and do all such other acts, if any, necessary on my/our part to enable me / us to be registered as the holder(s) of the above said shares which may be allocated to me/us. I/We hereby authorise you to place my/our name(s) on the Register of members of the company as the holders of the equity shares that may be so allocated and to register my/our address as given below. I/We confirm that I am/ we are Indian National(s) resident in India and I am / We are not applying for the said shares as nominee(s) of any person(s) of resident outside India or Foreign National.
No. of shares applied for			:
Cheque/DD. No.Date			:
Amount			:
Name of bank			:
Our / My Particulars are as under
Name in full			:
Father’s Name			:
Address			:
Status			:
Occupation			:
PAN no			:
Signature
<place>						First holder
<date>						Second holder
FOR OFFICE USE ONLY
No. of Shares applied			:
Date of Receipt			:
No. of share allotted			:
Date of Allotment			:
Allotment No.			:
Share Certificate No			:
Distinctive No.			:
ACKNOWLEDGEMENT
Received from Mr. <name>, R/o  <address> , sum of Rs. <>/- (Rs.  <>  only) towards <>  equity shares of Rs. <>/- each fully paid up for cash at par.
Cheque/DD. No and date			:
Amount			:
Bank			:
						For <  >
<place>						<name>
<date>						<designation>