Request Proposal Form
Request Proposal Form
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
( Incorporated under Companies Act 1956 )
Regd. Office : Rohini Sector-17, New Delhi:110085
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 : ---------------------------------------------------------------------
Mobile No : ---------------------------------------------------------------------
6. Occupation :
7. Whether Income tax assessed ? : yes no (please tick)
If yes, please state the year : ....................................................................................
8. Income tax permanent account no :
9. Basic Documents
a) Enclose photo copy of PAN Card : Yes/No
(please tick)
c) Certificate of residential proof : Yes/No
10. Net Annual Income .....................................................................
11. Your relationship with Company's
Members / Promoters : 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 (2008-09)
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 1.1.2008) in case of individuals.
3. Company reserves the right to reject any application if the applicant has not furnished
correct information or not accompanied by appropriate Cheque/D.D.