DECLARATION BY SIGNIFICANT BENEFICIAL OWNER
Form BEN-1 · Section 90(1) read with Rule 3 of the Companies (Significant Beneficial Owners) Rules, 2018
To,
The Board of Directors,
[Reporting Company Name]
CIN: [CIN]
I, [Individual Name], resident of [Address], PAN [PAN], do hereby declare that I am a Significant Beneficial Owner (SBO) in the above reporting company, holding, directly or indirectly, significant beneficial interest as under:
| Nature of Significant Beneficial Interest | Percentage of Holding | Date of Acquiring SBO Status |
|---|---|---|
| [Shares / Voting Rights / Dividend / Control] | [% (not less than 10%)] | [DD/MM/YYYY] |
The interest is held through the following member(s) of the reporting company: [Registered Member / Chain of Ownership]. I undertake to file a declaration of any change in my significant beneficial ownership within thirty days of such change.
Name: [Individual Name]
PAN: [PAN]
Date: [DD/MM/YYYY]