(In Block Letters)
(To be submitted in duplicate)

Date ……………….

To,
The Secretary
Investor Service Cell
The Calcutta Stock Exchange Association Limited,
7, Lyons Range,
Calcutta-700 001.

May I/we request you to endorse the following complaint and arrange for quick redressal thereof

NAME : __________________________
ADDRESS : __________________________
__________________________
__________________________
__________________________ PHONE NO ________________
COMPANY NAME AND ADDRESS : _____________________________
_____________________________
_____________________________
_____________________________

REGISTRAR NAME AND ADDRESS: _____________________________
_____________________________

NATURE OF COMPLAINT
TYPE :- (Tick (ض ) appropriate term)
Non-receipt of :-

 Refund order/Allotment Advice
 Cancelled Stock Invest S.I.
 Duplicate RO for correct amount/After indemnity/After correction.
 Short Refund.

• Dividend :- Non-receipt of Dividend

• Shares :- Non-receipt of certificates in/after.

 Exchange of Allotment letter.

 Transfer/Endorsement/Bonus/Duplicate/Splitting.

• Debenture/Bond :- Non-receipt of

 Interest

 Redemption Amount/Interest Delayed on RA

• Miscellaneous :- Non-receipt of :

 Annual Report

 Brokerage/Commission Payment

 Interest on Delayed dividend

 Any other (specify)

PARTICULARS OF COMPLAINT :-
Folio/Certificate/Distinctive Nos/Application No./Application Form deposited In Bank
_____________________________________________________
_____________________________________________________

OTHER DETAILS (if any) :-
_____________________________________
_____________________________________
_____________________________________

In Case of REMINDERS only
CSEA Reference No :
_______________________________________
Date : _______________________________________

Yours faithfully,
(Signature)

Note :- 1) Separate Format for each Complaint / Company.
2) No Additional Enclosures required.
3) The 1^st reminder should be addressed so the CSEA only after 30 days from the receipt of the letter to the Exchange.In case we do not receive reply within 60 days from you, the complaint will be presumed as resolved.