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Form No. IEPF-4

Statement of shares transferred and information of shares & unclaimed or unpaid dividend not transferred to the IEPF

[Pursuant to rule 6(5),6(8), 6A(5), 6A(8) and 6(3) of the Investor Education and Protection Fund Authority (Accounting, Audit, Transfer and Refund) Rules, 2016] and Section 124 of the Companies Act 2013]

Refer instruction kit for filing the form

Form No. IEPF-4

Statement of shares transferred and information of shares & unclaimed or unpaid dividend not transferred to the IEPF

[Pursuant to rule 6(5),6(8), 6A(5), 6A(8) and 6(3) of the Investor Education and Protection Fund Authority (Accounting, Audit, Transfer and Refund) Rules, 2016] and Section 124 of the Companies Act 2013]

Refer instruction kit for filing the form

  • Entity's Details
  • Attachment & Declaration
  • Review & Submit

All fields marked in * are mandatory

Entity's details

OR

Fund details

Details of shares and dividend not transferred to IEPF account

Attachments

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          Declaration

          I have been authorised by the Board of directors’ resolution number*

          Dated*

          to sign and submit this form.

          To the best of my knowledge and belief, I declare that all the requirements of Companies Act, 2013 and the rules made thereunder in respect of the subject matter of this form and matters incidental thereto have been complied with. I also declare that all the information given herein above is true, correct and complete including the attachments to this form and nothing material has been suppressed.   

          *  To be digitally signed by

          *  Designation

          ( Director/Manager/ Company Secretary/CFO/CEO/Managing Director/Authorised person of the bank)

          *  DIN of the director or Managing Director; or Income-tax permanent account number

          of the manager or CEO or CFO or Authorized person of the bank; 

          or Membership number of the secretary

          Note: Attention is drawn to provisions of Section 448 and 449 of the Companies Act, 2013 which provide for punishment for false statement / certificate and punishment for false evidence respectively

          This eForm has been taken on file maintained by IEPF Authority through electronic mode and on the basis of statement of correctness given by the company/bank

          For office use only:

          e-Form Service request number (SRN)

          e-Form filing date

          You have successfully submitted the form. Your Service Request Number is {srn}

          To proceed further with the process you need to affix the DSC of the authorised Company representative on the pdf of the generated form. To download the pdf Click Download PDF

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