DECLARATION AND VERIFICATION BY APPLICANT FOR DIRECTOR IDENTIFICATION NUMBER
Form DIR-4 (Verification) · Sections 153 & 154 read with Rule 9 of the Companies (Appointment and Qualification of Directors) Rules, 2014
I, [Applicant Name], son/daughter/wife of [Relation Name], resident of [Full Residential Address], holding PAN [PAN], do hereby declare and verify that:
- I have not been allotted any Director Identification Number (DIN) earlier and I have applied for only one DIN.
- The particulars given in the application for allotment of DIN, including my name, date of birth, address, nationality and identity/address proof, are true, correct and complete to the best of my knowledge and belief and nothing material has been concealed therefrom.
- I have attached self-attested copies of the documentary proof of identity and residence as required.
I understand that furnishing false or incorrect information renders me liable to penalty and action under the Companies Act, 2013.
Signature of Applicant: __________________
Name: [Applicant Name]
PAN: [PAN]
Name: [Applicant Name]
PAN: [PAN]
Place: [Place]
Date: [DD/MM/YYYY]
Date: [DD/MM/YYYY]