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Form ISR-4 – Request for issue of Duplicate Certificate and other Service Requests

Information to be provided to RTA by Members holding Securities in Physical form

The Securities and Exchange Board of India (‘SEBI’) vide its circular dated November 03, 2021 and December 14, 2021 has prescribed mandatory provisions for “Common and Simplified Norms for processing Investor’s Service request by RTAs and norms for furnishing PAN, KYC details and Nomination”. Further, it has made mandatory for the Members holding securities in physical form to furnish PAN, KYC details and Nomination to the Registrar and Transfer Agent (‘RTA’) of the Company. In case of failure to provide required documents and details as per the aforesaid SEBI circular, all folios of such Members shall be frozen on or after April 01, 2023 by the RTA. Click here for SEBI Circulars:

https://www.sebi.gov.in/legal/circulars/nov-2021/common-and-simplified-norms-for-processing-investor-s-service-request-by-rtas-and-norms-for-furnishing-pan-kyc-details-and-nomination_53787.html

and

https://www.sebi.gov.in/legal/circulars/dec-2021/clarifications-with-respect-to-
circular-dated-november-03-2021-on-common-and-simplified-norms-for-processing-
investor-s-service-request-by-rtas-and-norms-for-furnishing-pan-kyc-details-
_54602.html

In view of the above circulars, Members of the Company holding securities in physical form are required to provide following documents / details to RTA:

  • PAN
  • Nomination (for all eligible folios) in Form No. SH-13 or ‘Declaration to Opt-out’ in Form ISR-3. Any cancellation or change in nomination shall be provided in Form No. SH-14;
  • Contact details including Address with PIN code, Mobile Number and E-mail address;
  • Bank Account details including Bank Name and Branch, Bank account number and IFS code;
  • Specimen signature.

The Members can submit the above documents/details through following modes:

  1. In Person Verification: by producing the originals to the authorised person of the RTA, who will retain copy(ies).
  2. In hard copy: by sending self-attested photocopy(ies) with date of the relevant document at the below mentioned address of the RTA.

PURVA SHAREGISTRY (INDIA) PRIVATE LTD
9, Shiv Shakti Industrial Estates, J R Boricha Marg,
Lower Parel,
Mumbai -400011.
Email: support@purvashare.com
Phone No: 91-22-2301-2518/6761
Through e-mail address already registered with the RTA: with e-sign of scanned copies of documents.

Sr. No. Form Purpose
1 Form ISR-1 Request for registering PAN, KYC details or changes/updations there of (only for securities held in physical form)
2. Form ISR-2 Confirmation of Signature of Securities Holder by the Banker
3. Form ISR-3 Declaration for Opting-out of Nomination by Holders of Physical Securities
4. Form SH-13 Nomination Form
5. Form SH-14 Cancellation or Variation of Nomination

The above mentioned forms referred to in SEBI circulars are attached herewith.