S. No/
Section Name
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Field Name
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Instructions
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1
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Particulars of the applicant
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(a)
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Category of Applicant
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Select the radio button:
Individual
Others
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(b)
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First Name
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Enter the First Name of the applicant
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©
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Middle Name
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Enter Middle Name of the applicant
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(d)
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Last Name
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Enter the Last Name of the applicant
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(e)
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First Name
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Enter the First Name of the applicant
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(f)
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Middle Name
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Enter Middle Name of the applicant
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(g)
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Last Name
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Enter the Last Name of the applicant
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(h)
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Date of Birth
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(i)
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Name of entity
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In case ‘Other’ is selected in Category of applicant , then enter the Name of the Entity
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(j)
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Date of incorporation
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In case ‘Other’ is selected in Category of applicant , then enter the Date of incorporation of the entity
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(k)
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Address of the applicant
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Enter the address of the applicant
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Phone number
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Enter the valid phone number of the applicant
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(m)
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Aadhaar Number or Passport/OCI/PIO Card No. (in case of NRI/foreigners)
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Enter the valid Aadhaar Number/Passport/OCI/PIO Card.
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(n)
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PAN of applicant
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Enter valid PAN number of Applicant. PAN must be verified by clicking ‘Verify PAN Detail’. Applicant’s Name . Father’s Name and DOB should match with the information available in PAN
database.
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2
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Particulars of the Company from which the amount is due
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(a)
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Corporate Identification Number (CIN) of company
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This will be auto-Prefilled based on the CIN selected through Lookup service.
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(b)
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Name of the company /bank
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This field would be pre-filled on the basis of CIN selected in lookup service. There would be a SEARCH button enabled to search the CIN.
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(c)
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Address of the registered office of the company
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This will be auto-Prefilled based on the CIN selected through Lookup service
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(d)
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email ID of the company
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This will be auto-Prefilled based on the CIN selected through Lookup service.
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3
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Is it a case covered under rule 7 (8) & 7(9) of IEPF Rules, 2016
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Select the radio Button ‘Yes’ if the case is related to transmission. Or else select ‘No’.
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(a)
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Name of original security holder
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If Yes is selected in above, then enter the Name of original security holder.
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(b)
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Relation of claimant with security holder
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If Yes is selected above, then enter the relation of claimant with security holder
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(c )
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Number of Nominee/Legal heirs/Successors/ Administrator/ Others holders.
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If Yes is selected above, then enter the Number of Nominee/Legal heirs/Successors/ Administrator/ Others holders. Maximum 10 can be entered.
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Name of Beneficiary
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Enter the Name of Beneficiary depending on the number entered above.
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4
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Type of Claim
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Select the Radio Button:
Amount
Amount and Shares
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5
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Details of shares claimed
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This field would be enabled only when ‘Amount an shares’ is selected in field 4
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Number of Folio
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Enter the Number of folios. Maximum 15 can be entered. The number of blocks generated below would be equal to this number entered.
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Type of Holding
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Select from Drop down:
Physical
Demat
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Folio No./ Complete Demat account number from which transfer has been made to IEPF
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Enter the of the Folio No./ DP Id - Client ID - Account number
Maximum number of characters allowed for Folio No is 20 and for DP Id - Client ID - Account number is 60.
‘Folio No’ shall be entered if Physical is selected in ‘type of Holding’. ‘Account No’ shall be entered if Demat is selected in ‘type of Holding’
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Type of share
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Select from drop down:
Equity
Preference
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Number of shares
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Give the number of shares claimed
The number should be greater than zero
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6
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Details of amount claimed
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Number of claims
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Enter the number of claims to be filed
The limit for this is 15.The number of blocks generated below would be equal to this number entered.
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Type of claim
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Select the type of claim from drop down values.
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Type of Holding
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Select from Drop down:
Physical
Demat
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Folio No./ Complete Demat account number from which transfer has been made to IEPF
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Enter the of the Folio No./ DP Id - Client ID - Account number
Maximum number of characters allowed for Folio No is 20 and for DP Id - Client ID - Account number is 60.
‘Folio No’ shall be entered if Physical is selected in ‘type of Holding’. ‘Account No’ shall be entered if Demat is selected in ‘type of Holding’
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Amount of the claim
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Enter the amount of the claim
Both Principle and Interest field will be displayed when option 2,3 and 4 are selected in ‘Type of claim’ else only Principle field will be displayed.
Amount should be greater than Zero.
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Financial year to which it relates
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Select the Financial year range to which the claim relates
The year should be equal to or greater than year of incorporation of company and equal to or less than the system date
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Reason for non-receipt/ non-encashment of the instrument of payment
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Select the Reason for non-receipt/ non-encashment of the instrument of payment from below drop down values:
-Change in Address
-Death of original investor
-Loss of original Documents
-Others
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7
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Refund Account Details
Details of Bank account in which refund shall be credited
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(a)
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Bank account number
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Enter the Bank account number in which refund of dividend amount is to be made
The maximum number of characters that can be entered are 20
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Bank Name
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Give the bank name in which refund of dividend amount is to be made
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IFSC Code
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Give the IFSC code of the branch in which refund of dividend amount is to be made. Maximum 11 characters can be entered.
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Bank Branch
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Give the description of the bank branch in which refund of dividend amount is to be made
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Demat account number in which shares shall be credited
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Enter your Demat Account number
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Attachments
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1. Aadhaar Card of the claimant and if joint holders are there, copy of Aadhaar card of all joint holders
- Mandatory
2. Passport, OCI and PIO card in case of foreigners and NRI - Mandatory
3. Client Master List of De-mat A/c of the claimant - Mandatory
4. Proof of entitlement (Bonds/Debentures/Fixed Deposit receipts/Certificate of share/Interest warrant/Dividend warrant, Application No./Statement of transaction etc.) -
Mandatory
5. Optional Attachment – Optional
In case yes is selected in field 3 the below attachments are mandatory to attach
6. Notarised copy of death certificate.
7. Notarised succession certificate/Probate/Will
8. No Objection Certificate from other holder
9. Indemnity Bond for Transmission, duly notarized
10. Affidavit in form of surety
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OTP Validation
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Enter Mobile Number and e-Mail ID and click on Send OTP button.
Click on this button to send OTP to your mobile number and email ID.
Please note that separate OTPs will be sent to mobile number and email ID.
Further, please note that OTP can be successfully sent to the mobile number and email ID against one form and IP Address, for a maximum of 10 times in one day. OTP shall be valid for
a span of 30minutes.
For further chances, you may try with new form on next day.
Enter the OTP for Mobile Number and Email Id received on the mobile number and email id entered in the form.
Verify OTP Button: This button will be enabled after OTP for mobile number and email address are entered.
Please note that the OTPs must be verified before you Submit the form.
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Submit
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Click on the ‘Submit’ button to proceed for challan generation.
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Deca
