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INDEMNITY BOND FOR ISSUE OF DUPLICATE SHARE CERTIFICATE

Date: ____________

I, Mr./Ms. XYZ, Son/Daughter/Wife of ________________________, residing at ____________________________________________, being a member of ABC Private Limited and holding Equity Shares in the Company as detailed below, do hereby solemnly affirm and declare as under:

That the original Share Certificate(s) in respect of the Equity Shares mentioned hereinbelow has/have been lost / misplaced / not traceable and the same is/are not in my possession.

Details of Lost Share Certificates

I further declare that:

1. The said Share Certificate(s) were not accompanied by any blank transfer deed duly signed by me.
2. I have not, nor has any person acting on my behalf, sold, transferred, pledged, assigned or otherwise parted with possession of the said shares or any interest therein.
3. I am the sole and absolute owner of the shares covered under the said Share Certificate(s).
4. In the event the original Share Certificate(s) is/are found at any time, I undertake to immediately surrender the same to the Company for cancellation.

I hereby request the Company to issue duplicate Share Certificate(s) in lieu of the original Share Certificate(s) reported lost.

In consideration of the Company issuing duplicate Share Certificate(s) at my request, I hereby indemnify and keep indemnified the Company, its Directors, Officers and employees against all losses, claims, damages, costs, charges and expenses which may arise or be incurred by the Company by reason of issuing such duplicate Share Certificate(s).

I further agree that the Company shall be entitled to recover such losses or expenses from me, my heirs, executors, administrators or my properties, as the case may be.

IN WITNESS WHEREOF, I have executed this Indemnity Bond on this ____ day of _________, 20.

Place: ____________

Signature of Shareholder

Name: Mr./Ms. XYZ

Witnesses

Witness No. 1
Name (in Block Letters): __________________________
Address: _______________________________________
Signature: _____________________

Witness No. 2
Name (in Block Letters): __________________________
Address: _______________________________________
Signature: _____________________