Application For Nomination of Shares "Q"
Application For Nomination of Shares "Q"
I/we being the nominee in respect of the under mentioned shares of the Bank allotted to
the Late Shri / Smt. VIJAY MARUTIRAO BANGADE hereby agree to accept and hold
the said shares in my/our name(s) and also agree to pay all calls/arrears due on the said
shares and agree to be registered as member (S) in the Register of Member of the Bank
subject to the provision of the Memorandum & Articles of Association of the Bank.
Full Name of the Company
: BANK OF MAHARASHTRA
: 345696701 TO 345696800
Date of Death
: 30-03-2015
I/We undertake that in case there is any claim from any third party arising out of
transmitting the said securities in my/our names. I/we/our respective heirs, executors and
administrators defend and keep harmless and indemnify Bank OF Maharashtra from and
against any actions, causes, suits, proceedings, accounts, claims and demand whatsoever
on account of the said securities.
I/We declare that information given above is true and correct to my/our knowledge and
that I/we am/are the only nominee(s) in respect of the shares of the Bank allotted to the
deceased above named.
SIGNED & DELIVERED by me/us this -19 October 2015
Signature of Witness
Signature(s) of the nominee(s)
Full Name & Address of the Witness : RUTURAJ VIJAY BANGADE
2367 C Ward, Sonya Maruti Chowk,
Shaniwar Peth, Kolhapur 416 002
Particulars of the nominee(s) :
Shri/ Smt./ Kum.
Occupation Full Address
Fathers / Husbands Name
-----------------------------------------------------------------------------------------------------------MADHURI VIJAY
2367 C Ward,
VIJAY MARUTIRAO
BANGADE
Sonya Maruti Chowk,
BANGADE
Shaniwar Peth,
Kolhapur 416 002
AFFIDAVIT
(On non Judicial stamp paper of Rs.100/- )
Date. ___________
________________________
Signature(s) of the applicant(s)
Signed in presence
Address of
Magistrate /
Notary
Regn. No.