Companies (Declaration of Beneficial Interest in Shares) Rules, 1975

FORM III : Form of return to be filed with the Registrar pursuant to sub-section (4) of section 187C of the Companies Act, 1956 (1 of 1956)

Name of the Company __________	Registration No. of the Company __________
Address of its Registered Office __________	Nominal Capital __________

Sl . No.	Particulars of shares in respect of which the person whose name is entered in the register of numbers of the company as a holder thereof does not hold the beneficial interest in such shares		Particulars of persons in whose names the above shares have been registered as holders in the register of members		Particulars of persons who hold a beneficial interest in such shares		Nature of the beneficial interest	Dates of declarations under sub-sections (1), (2) and (30 received in respect of the said shares together with names of declarant	Dates of receipt of the said declarations by the company
1	2		3		4		5	6	7
No. of shares	Distinctive Nos. of shares		Name and Nationality		Name and Nationality
	Kind of shares		Address		Address
	Face value of shares		Father’s/ Husband’s name		Father’s/ Husband’s name
	Paid-up value of shares		Date of entry of name in register		Occupation

Date _________

___________________________________

Signature of person signing on behalf of the company

Foot Note

1. Published vide Notification No. GSR 53(E), dated 20th. February, 1975.