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1 TEXT OF THE POSTAL BALLOT FORM on 28th July 2009, 3:18 pm

amuca007


TEXT OF THE POSTAL BALLOT FORM
XYZ LIMITED
Registered Office
Postal Ballot Form
1. Name(s) of shareholder(s) : ……………………………. (in block letters)
(including joint holders, if any) : …………………………….
2. Registered address of the sole/first : ……………………………. named shareholder
3. Registered folio No./DP ID No./Client : ……………………………. ID No.* (* Applicable to investors holding shares in dematerialized form)
4. Number of shares held : …………………………….
5. I/We hereby exercise my/our vote in respect of the ordinary/special resolution to be passed through postal ballot for the business stated in the notice of the company by sending my/our assent or dissent to the said resolution by placing the tick (9) mark at the appropriate box below.
Item No. No. of shares I/We assent to I/We dissent to the the resolution resolution
Place:
Date:
(Signature of the shareholder)
Instructions:—
1. A member desiring to exercise vote by postal ballot may complete this Postal Ballot Form and send it to the company in the attached self-addressed envelope. Postage will be borne and paid by the company. However, envelopes containing postal ballots, if sent by courier at the expenses of the registered shareholder will also be accepted.
2. The self-addressed envelope bears the address of the scrutiniser appointed by the Board of directors of the company.
3. This form should be completed and signed by the shareholder. In case of joint holding, this form should be completed and signed (as per the specimen signature registered with the company) by the first named shareholder and in his absence, by the next named shareholder.
4. Unsigned Postal Ballot Form will be rejected.
5. Duly completed Postal Ballot Form should reach the company not later than the close of working hours on ….......... (day) …............ (date). Postal Ballot Form received after this date will be strictly treated as if the reply from the member has not been received.
6. Voting rights shall be reckoned on the paid up value of shares registered in the name of the shareholders on the date of despatch of the notice.
Specimen of Board resolutions which can be p_______________s by circulation

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