A statutory disclosure form submitted by a director under Section 164(1) or 164(2) and Rule 14(1) of the Companies (Appointment and Qualification of Directors) Rules, 2014, confirming whether or not they have incurred any disqualifications from holding office as a director across current and former company directorships.

FORM 'DIR-8'

Intimation by Director

[Pursuant to Section 164(1) or 164(2) and Rule 14(1) of Companies (Appointment and Qualification of Directors) Rules, 2014]

Registration No. of Company: [CIN/Registration No.]

Nominal Capital Rs.: [Amount]

Paid-up Capital Rs.: [Amount]

Name of Company: [Name of Company]

Address of its Registered Office: [Registered Office Address]

To

The Board of Directors of [Name of Company]

I, [Name of Director], [wife/husband/son/daughter] of [Name of Relative], resident of [Residential Address], Director in the Company hereby give notice that I am/was a director in the following Companies during the last three years:-

I further confirm that I have not incurred disqualification under section 164(1) or section 164(2) of the Companies Act, 2013 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.

[Alternatively, where applicable: I further confirm that I have incurred disqualification – (A) under section 164(1) on the following ground(s) in the previous financial year; or (B) under section 164(2) of the Companies Act, 2013 in the following company(s) in the previous financial year, and that I, at present stand disqualified from being a director – details to be provided in the table below.]

Date: [DD.MM.YYYY]                                                                              Signature: ______________

Place: [City]                                                                                                [Name of Director]