KANNUR INTERNATIONAL AIRPORT

EQUITY SHARE APPLICATION FORM

I submit the following details for applying ……………..number of shares of

Kannur International Airport Ltd., Kannur.

1. PARTICULARS OF FIRST APPLICANT

Name

Date of Birth

E-mail id

Telephone (R)

Telephone (M)

Name of Father

PAN No./Pass
Port No./
Norka No.

2. GENERAL INFORMATION
Status
Contact Details
(Indian Address)

Overseas
Address

3. NOMINATION DETAILS
Name of the
Nominee
Relationship

Address of
Nominee

Date of Birth
 4. INVESTMENT AND PAYMENT DETAILS (DD ENCLOSED)

No. of Shares
Applied
DD Amount
(25%)
DD No. & Date

Drawn on Bank
& Branch
Investment
Amount (Rs. in
Figures) 25%
Investment in
Amount (Rs. in
words) 25%

SIGNATURE

Place :

Date: