To M/s. XYZ and Company Ltd ……….

Sir

I have paid a sum of rupees …….. towards the price of …….. shares out of the recent issue of shares made
by you and you have allotted to me …….. shares by your letter of Allotment No ……… dated . ……. received
by me.
You have now requested me to return the said letter of allotment in exchange of the share certificate for
the said shares.

I have informed you that the said letter o ]’allotment is lost or misplaced and by your letter dated …….. you
have agreed to issue the Share Certificate in respect of the said …….. shares against my indemnifying you
for any loss your may suffer or incur on account of any claim made against you by any body else on the
strength of the said allotment letter.

I have therefore to state that 1 hereby agree to indemnify you and keep you indemnified against all loss.
costs, charges and expenses which you may suffer or incur on account of any body making a claim to the
said shares issued to me on the strength of the said allotment letter above mentioned.

Yours faithfully,