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  INVESTOR COMPLAINT FORM (Use separate form for each company or complaint) (Please select the appropriate item in the Nature of Complaint) All fields marked (*) are to be mandatorily filled in Note: 1. If your complaint relates to multi-level marketing scheme or a scheme falling under the Price Chit and Money Circulation Schemes (Banning) Act, 1978, including a company carrying on chit fund business, please lodge your complaint with the Ministry of Finance, Department of Economic Affairs, Government of India. 2. If your complaint relates to termination of services, non-payment of salary, terminal benefits etc. (service-related matters), the complaint should be filed with the Ministry of Labour & Employment, Government of India. 3. In case, your complaint / grievance relates to Non-Banking Finance Company (NBFC) or Residuary Non-Banking Company (RNBC) registered with RBI, please lodge your complaint with Reserve Bank of India (RBI). 4. In case, your complaint is against any company having any collective investment scheme, the complaint should be filed with SEBI only. 5. If your complaint is against intermediaries registered with SEBI, such as stock brokers, depository participants, mutual funds, you should file your complaint with SEBI only. 6. If your complaint / grievance relates to issue and transfer of securities and non-payment of dividend in respect of listed companies and also the companies which intend to get their securities listed on any recognized stock exchange, you may file such complaints either with Securities and Exchange Board of India (SEBI) (under the Department of Economic Affairs) or with the Ministry of Corporate Affairs (MCA). 7. In case of other companies, all complaints should be filed with MCA. 8. In case of Chit Fund Companies, complaints be Lodged with the Registrar of Chit Funds of the Concerned State. 9. In case of real estate companies, complaints be lodged with the Ministry of Urban Development and Housing, GOI. 10. If your complaint relates to disputes concerning title of properties or in the nature of commercial disputes, you should take up the matter with the Court/Tribunal of appropriate jurisdiction.  Dear Sir/Madam, Kindly take up the matter with the company for immediate redressal of my complaint, particulars of which are as under : *Complaint against Unlimited Liability companyUnlisted public limited companyListed companyPrivate limited company Section 25 company Other CompaniesLimited Liability Partnership ( LLP) *Nature of business Commercial and industrial companyNon-Banking Financial ActivityReal estate company/ Bonds OthersNetwork marketing/ Multilevel marketing companyGold bonds Plantation company Housing finance company Nidhi company Chit fund companyProducer company 11. If your complaint relates to misuse of digital signature (resulting in alleged filling of form 32 or form 2 etc.), you should file your complaint with the appropriate police authority, as prescribed in Information Technology Act, 2000.12. If your complaint relates to deficiencies in products or services of a company, you should file your complaint before the Consumer Court of appropriate jurisdiction or the Ministry of Consumer Affairs, Government of India, Krishi Bhawan,New Delhi.  (ii) Complaint relating to debentures or bonds Non- receipt of Redemption amountNon- receipt of Duplicate debenture/bonds certificateNon receipt of certificate after splittingNon receipt of certificate after endorsementNon receipt of notice for call moneyNon- receipt of offer for rights debentures/bondsNon- receipt of debenture application moneyNon- receipt of interest on delayed payments Non receipt of debenture/bonds certificates after initial allotment Non receipt of certificate after exchange of allotment letter Non receipt of certificate after transmissionNon receipt of certificate after transfer Non receipt of interestAny other (specify) Non-receipt of Annual Report Non-receipt of registration of change in addressNon-receipt of interest on delayed refund relating to other securitiesNon-receipt of payment as per Company Law Board (CLB) order Non-receipt of Pre-matured payments Non-receipt of interest Non-receipt of matured amountNon-receipt of interest on delayed paymentNon- receipt of share application moneyNon- receipt of notice for call money Non-receipt of Bonus shares Non- receipt of certificate after Consolidation Non- receipt of offer for rights shares Non- receipt of certificate after splitting Non- receipt of certificate after Conversion Non- receipt of certificate after transmissionNon- receipt of certificate after transferNon- receipt of Duplicate Share certificateNon- receipt of Dividend warrant /interim dividend warrantNon- receipt of certificate after EndorsementNon- receipt of certificate after initial allotment (iii) Complaint relating to fixed deposits(iv) Miscellaneous Complaints(v)*Status of complainant InvestorShareholderCreditorEmployeeOthersDeposit Holder (i) Complaint relating to shares3. Nature of Complaint  5. (a) *  Corporate Identity Number (CIN)/ Limited Liability Partnership Identification Number (LLPIN) (b) Global Location Number (GLN) of the company(c) Name of the company /LLP(d) Address of the registered office of the company/LLP 6. (a) Particulars of the shares or debenture or fixed deposits or other security (Fill in the details in respect of shares certificates or debenture certificates or fixed deposits receipt or application form or other security (h) * Phone(j) * Email ID(g) * Country(f) * ISO Country Code(i) Fax 4. Name and address of investor /other stakeholder (a) * Name(b) * AddressLine ILine II(c) * City(d) * State(e) * Pin codePre-fill
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