PLEDGE/HYPOTHECATION FORM

ZUARI INVESTMENTS LIMITED
Corporate Office: F-Block, IInd Floor, International Trade Tower, Nehru Place,
New Delhi 110019 (India) Tel.: 91-11-46581300 Fax: 91-11-6413391

DP ID: IN301055 Serial No. PHI-3/_______
Date:   Please tick in any one of the boxes as may be applicable Execution Date:  
Create the pledge/hypothecation
Close the pledge/hypothecation
Invoke the pledge/hypothecation
Confirm the creation of pledge/hypothecation
Confirm the Closure of pledge/hypothecation
Confirm the invocation of hypothecation
Date   Instruction Type Pledge/Hypothecation  
Client Id                 Counterparty Pledgor/Pledgee Client Id                
Client Name   Counter Party Pledgor/Pledgee Name  
Agreement No. (as provided by pledgee)   Counter Party Pledgor/Pledgee DP Id  
Closure Date   Counter Party Pledgor/Pledgee DP Name  
Sr. No.

ISIN

Security Name

Reasons & release date for locked-in security (if any)

Quantity (Refer Instruction No.2

Pledge Order No. (Refer Instruction No.3)

Reasons for rejections (if any) (To be filled in at the time of confirmation)

             
             
             
             
             
             

 

 

 

 

Accepted By

 

 

 

 

Entered By

 

 

 

 

Verified & Released By

 

 

 

 

Authorised Signatory(ies)
Instructions: 1) To be submitted in duplicate for acknowledgement. 2) Pledge Quantity Closure Quantity or the Invoked Quantity to be mentioned as the case may be. 3) Pledge Order No. to be filled in by the client (except at the time of creation of the pledge to be filled in by the Participant). 4) Locked-in securities can not be invoked before the lock-in release date.

Regd. Office: Jaikisaan Bhawan, Zuarinagar, Goa - 403 726 (India)