We are fast growing company with a wide range of Pharmaceutical Products
Request Proposal form -To be filled by Promoter's Friends/Relatives for subscribing Shares of the Company .
Request Proposal for the inclusion of the name as Promoter/Director in the register
of the Company as required under the MINISTRY OF CORPORATE AFFAIRS
ORISCON BIOTECH (I) PVT LTD
Regd. Office : Plot No: C- 80, Ganesh Nagar, Pandav Nagar Complex, New Delhi -110092, INDIA
Corporate Office: Plot No: C-31/32, G-3, Ganesh Nagar, Pandav Nagar Complex, New Delhi -110092
Phone No: 011- 22486954 Website : www.orisconbiotech.com
( Please read terms and conditions and eligibility criteria carefully before filling up the form. Additional sheets may be enclosed in case the space provided under any of the columns is insufficient)
1. Name of the applicant
2. Father's name
3. State whether you are : (a) Individual ( b ) HUF
4. Address
a) Present .......................................................................................................
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b) Permanent ....................................................................................................
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5. Telephone No .....................................................................................................
6. Mobile No .....................................................................................................
7. Whether Income tax assessed ? : yes no ( please tick )
If yes , please state the year : ....................................................................
8. Income tax permanent account no : ....................................................................
9. Basic Documents to be Provided
a) Enclose photo copy of PAN Card : Yes / No ( please tick )
c) Certificate of residential proof : Yes/No
11. Your relationship with Company's : ( Members / Promoters ) or ( Friends/Relatives ) (please tick)
12. Details of the amount enclosed along with this application :
(a) Amount Rs : ----------------------------------------------------------
(b) Cheque/D.D. No : ----------------------------------- Date ----------
DECLARATION:
I/We certify that all information furnished above is true to the best of my/our knowledge and belief. I/We shall abide by such terms and conditions that the Company may impose for allotment of SHARE and inclusion of my name in the register of the company as a Member/Promoter. I want to subscribe Ten Thousand Share of the company " ORISCON BIOTECH INDIA PRIVATE LIMITED" on terms and conditions as stated in the AGM's REPORT (2010-11)
Date:
Place:
(Signature of the applicant)
Eligibility conditions
1. Applicants must preferably be an Indian national & a relatives / Friends of PROMOTERS.
2. Applicant must have attained the age of 18 years (on 1.1.2012) in case of individuals.
3. Company reserves the right to reject any application if the applicant has not furnished the
correct information or not accompanied by appropriate Cheque / D.D.