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[To be published in the Gazette of India, Extraordinary, Part II, Section 3, Sub-
Section (i)]
Government of India
Notification
New Delhi, 21 s t August, 2018
(i) in the proviso to rule 12A, for the words and numbers "DIR-3 KYC on or
before 3 1 s t August, 2018, the words and numbers "DIR-3 KYC on or before
15 th September, 2018 " shall be substituted.
(ii) in the Annexure, for Form No.DIR-3 KYC, the following Form shall be
substituted:-
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iAr-AH-4 ^H^RT
Note-
(b) Name
SPassport number
*
Line I
Line II
ik
City
*
State Pin code
Country
*
Line I
Line II
*
City
Country
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1. r
Proof of permanent address Attach
Remove attachment
Verification
I, hereby confirm and verify that the particulars given in the Form herein above are true and also are in agreement with
the documents being attached to this form.
(i) The documents being attached to the Form DIR-3KYC belong to me. I further confirm that all required
documents have been duly issued by the respective government authority and are being attached to the
Form DIR-3 KYC and
(ii) I further confirm that the Mobile No and email ID belong personally t o me and
(iii) I have not been declared as proclaimed offender by any Economic Offence Court or Judicial Magistrate
Court or High Court or any other Court, and
(iv) I have no other allotted DIN other than DIN in which changes are intimated under section 154 of the
Companies Act,2013 or a Designated Partner Identification Number under section 7 of the Limited Liability
Partnership Act, 2008.
(v) I shall be liable under section 448 of the Act and under relevant provisions of the Indian Penal Code, 1860
and any other law as applicable, if any statement in this application is found to be false or any material fact
is found to be have been omitted.
Certification
I declare that I have been duly engaged for the purpose of certification/verification of this form. It is hereby certified
that:
* I have satisfied myself about the identity of the applicant and his address based on the perusal of the
original of the attached document.
Note: In case where the applicant is residing outside India the particulars have to be verified from the
documents dulv attested by the attesting authority as prescribed.
" I have verified and attested the documents of the applicant based on the Originals documents produced
before me.
* I have gone through the provisions of The Companies Act, 2013 and rules thereunder for the subject
matter of this form and matters incidental thereto and I have verified the above particulars (including
attachment(s)) fi om the original records maintained by the Company/applicant which is subject matter of
this form and found them to be true, cor rect and complete and no information material to this form has
been suppressed.
'Category
"Membership Number
Check Form
Note: Attention is drawn to provisions of Section 448 and 449 which provide for punishment
for false statement / certificate and punishment for false evidence respectively.
This e-Form has been taken on file maintained by the register of companies through electronic mode and on
the basis of statement of correctness given by the Director and professional.
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