Bse Complaint Format
INVESTOR COMPLAINT FORM AGAINST COMPANY
(Please state details in CAPITAL letters and submit in duplicate)
Date :
Bombay Stock Exchange Limited
$ (Please send the form to the appropriate office of BSE as stated in the notes at the bottom)
Dear Sir/s,
Please do the needful, in respect of my complaint below :
Name and Address of Investor :Name of Investor : ______
Address : ______
______
City : ______Pin Code : ______
Tele. No. : ______Mobile No. : ______e-mail id : ______
Name of the Company :
Nature of Complaint : (Please tick whichever is appropriate)
Non-receipt of
□ Allotment Letter / Refund Order
□ Certificate - Endorsed / Transfer / Duplicate / Bonus / Rights
□ Interest / Dividend (Specify Period)
□ Credit of securities with DP
□ Redemption Amount
□ Others (Specify)
Particulars of Complaint : (Please provide maximum details)
In case of Transfer / Others In case of IPO / New Issue
Folio No. : ______Application No. : ______
Certificate No.:______Client ID : ______
Distinctive No/s.: ______DP ID : ______
DRN No. ______No. of Share/s ______
No. of Share/s ______
In case, Complainant desires to send reminder *:BSE’s Letter Ref. No. : ______Date : ______
Yours faithfully,
Signature of the Investor
Notes :-
$ / Regional Centres / States and Union Territories covered by the CentresDELHI : BSE Investor Service Centre,
Floor 7, Mercantile House, Kasturba Gandhi Marg,
New Delhi – 110 001. / Delhi, Haryana, Uttar Pradesh, Uttaranchal, Himachal Pradesh, Punjab, Jammu & Kashmir, Chandigarh, Rajasthan
KOLKATA : BSE Investor Service Centre,
1st Floor, Kishore Bhabhan, 17, R. N. Mukherjee Road,
Kolkata – 700 001 / West Bengal, Bihar, Jharkhand, Orissa, Assam, Arunachal Pradesh, Mizoram, Manipur, Sikkim, Meghalaya, Nagaland, Tripura, Chhattisgarh
CHENNAI : BSE Investor Service Centre
4th floor, Exchange Building No. 11, Second Line Beach, Chennai – 600 001 / Andhra Pradesh, Karnataka, Kerala, Tamilnadu, Andaman & Nicobar, Lakshadweep, Pondicherry.
MUMBAI : 25th Floor, P. J. Towers, Dalal Street, Fort, Mumbai – 400 001 Tel no. 22721234/33 / Maharashtra, Gujarat, Goa, Daman & Diu, Dadra & Nagar Haveli, Madhya Pradesh
- Please provide full details in the Form with required enclosures.
- Please use separate forms for each company, in case of complaints against more than one Company.
- Your Contact No. / Fax / Email will be useful for early response.
- Please lodge complaint/s relating to Fixed Deposit / Plantation Company, with the Department of Company Affairs., Government of India, “A” Wing, 5th
Floor, Shastri Bhavan, R. P. Road, New Delhi -
- Please visit our website www.bseindia.com.
- Toll Free No. : 1800226663 (For Investors residing outside Mumbai)
*Please quote BSE’s Letter Reference No. and date, in reminder, which may be sent after 30 days from the date of BSE’s letter.