Name of the Target Company

Name of acquirer(s) alongwith PAC { Referred together as "acquirers " hereinafter}

Shareholding details

Before the said proposed Acquisition  

After the said proposed Acquisition

No of shares 

% (shares / voting rights)

No of shares 

% (shares / voting rights)

Share holding / voting rights of acquirer(s) in target company before and after the proposed acquisition

Paid up capital of the target company before and after the proposed acquisition

Type of acquisition (By way of public /rights/inter-se-transfer)

In case, the acquisition is by way of inter-se transfer as per regulations, disclose names of transferors and their share holding in T.C before transfer

No and % of shares / voting rights of T.C proposed to be acquired through the acquisition.

Acquisition price per share

Date of proposed acquisition

Signature of the acquirer/ Authorised Signatory

Place :

Date :