NHC FOODS LIMITED_1201090030649333_1734500276

APPLICATION ON PLAIN PAPER ASBA
CAF Number: 18978
1 Name of Company NHC FOODS LIMITED

2 Name and address of the Eligible Equity Shareholder Name of Sole / First Applicant: KHARE HARISH SUHAS
including joint holders (in the same order and as per Address: 145 2ND MAIN ROAD
specimen recorded with our Company or the Depository) 3RD CROSS
RAMACHANDRAPURAM BANGALOR, BENGALURU-560021
3 Contact Details of the Sole/ First Applicant Phone (with STD code)/ Mobile:
Email address:
4 PAN Sole/First Account Holder GRWPS2872D
Second Joint Account Holder
Third Joint Account Holder
5 Investor classification (Please tick) Resident Non-Resident
6 Registered Folio Number (in case of Eligible Equity 1201090030649333

Shareholders who hold Equity Shares in physical form as on
Record Date) / DP and Client ID;
7 Except for Applications on behalf of the Central or State
Government, the residents of Sikkim and the officials
appointed by the courts, PAN of the Eligible Equity
Shareholder and for each Eligible Equity Shareholder in case
of joint names, irrespective of the total value of the Equity
Shares applied for pursuant to this Issue
8 Number of Equity Shares held as on Record Date 10570
9 Number of Equity Shares entitled to as per Rights 42280
Entitlement
10 Number of Equity Shares applied for as per the Rights
Entitlement (A)
11 Number of additional Equity Shares applied for, if any
(applicable only if entire Rights Entitlements have been
applied for) (B)
12 Total number of Equity Shares applied for (A+B)
13 Total amount paid at the rate of Rs 1.00 per Equity Share
14 Details of the ASBA Account such as the SCSB account
number, name, address and branch of the relevant SCSB
15 In case of non-resident Eligible Equity Shareholders making
an application with an Indian address, details of the
NRE/FCNR/NRO account such as the account number,
name, address and branch of the SCSB with which the
account is maintained;
16 Authorization to the Designated Branch of the SCSB to block
an amount equivalent to the Application Money in the ASBA
Account
17 Signature of the Eligible Equity Shareholder (in case of joint
holders, to appear in the same sequence and order as they
appear in the records of the SCSB)
All such Eligible Equity Shareholders are deemed to have accepted the following:
“I/ We understand that neither the Rights Entitlement nor the Equity Shares have been, or will be, registered under the United States Securities Act of
1933, as amended (the “US Securities Act”) or any United States state securities laws, and may not be offered, sold, resold or otherwise transferred
within the United States or to the territories or possessions thereof (the “United States”) except in a transaction exempt from, or not subject to, the
registration requirements of the US Securities Act. I/ we understand the offering to which this application relates is not, and under no circumstances is to
be construed as, an offering of any Equity Shares or Rights Entitlement for sale in the United States, or as a solicitation therein of an offer to buy any of
the said Equity Shares or Rights Entitlement in the United States. Accordingly, I/ we understand that this application should not be forwarded to or
transmitted in or to the United States at any time. I/ we understand that none of the Company, the Registrar, the Lead Managers or any other person
acting on behalf of the Company will accept subscriptions from any person, or the agent of any person, who appears to be, or who we, the Registrar, the
Lead Managers or any other person acting on behalf of the Company has reason to believe is in the United States, or if such person is outside India and
the United States, such person is not a corporate shareholder, or is ineligible to participate in the Issue under the securities laws of their jurisdiction. I/
We will not offer, sell or otherwise transfer any of the Equity Shares which may be acquired by us in any jurisdiction or under any circumstances in which
such offer or sale is not authorized or to any person to whom it is unlawful to make such offer, sale or invitation except under circumstances that will
result in compliance with any applicable laws or regulations. We satisfy, and each account for which we are acting satisfies, all suitability standards for
investors in investments of the type subscribed for herein imposed by the jurisdiction of our residence.
I/ We understand and agree that the Rights Entitlement and Equity Shares may not be reoffered, resold, pledged or otherwise transferred except in an
offshore transaction in compliance with Regulation S under the US Securities Act ("Regulation S"), or otherwise pursuant to an exemption from, or in a
transaction not subject to, the registration requirements of the US Securities Act. I/We (i) am/are, and the person, if any, for whose account I/we am/are
acquiring such Rights Entitlement, and/or the Equity Shares, is/are outside the United States, and (ii) is/are acquiring the Rights Entitlement and/or the
Equity Shares in an offshore transaction meeting the requirements of Regulation S.
I/ We acknowledge that the Company, the Lead Managers, their affiliates and others will rely upon the truth and accuracy of the foregoing
representations and agreements.
I/ We acknowledge that Our Company, the Lead Managers and the Registrar shall not be responsible if the Applications are not uploaded by SCSB or
funds are not blocked in the Investors’ ASBA Accounts on or before the Issue Closing Date”.
Signature by the Applicant: ___________________________
Date:
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NHC FOODS LIMITED_1201090030649333_1734500276

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APPLICATION ON PLAIN PAPER ASBA

CAF Number: 18978

1 Name of Company NHC FOODS LIMITED

Second Joint Account Holder

Third Joint Account Holder

5 Investor classification (Please tick) Resident Non-Resident

6 Registered Folio Number (in case of Eligible Equity 1201090030649333

Signature by the Applicant: ___________________________

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