HINDUSTAN PETROLEUM CORPORATION LIMITED
(A GOVERNMENT OF INDIA ENTERPRISE)
Registered Office : 17, Jamshedji Tata Road, Churchgate, Mumbai 400 020
Website: www.hindustanpetroleum.com

Instructions:
1. Please read the instructions carefully before filling in the form
2. Shareholders can download/ print this form, fill in the details, sign it and send it to the
Company / Registrar by post / courier for further handling.
SHAREHOLDING IN PHYSICAL FORM SHAREHOLDING IN DEMAT FORM
To
INTIME SPECTRUM REGISTRY LTD
UNIT: HINDUSTAN PETROLEUM CORP. LTD.
C-13, PANNALAL SILK MILLS COMPOUND,
L.B.S. MARG, BHANDUP (W),
MUMBAI - 400 078
To be sent to
Your Depository Participant (DP)
Dear Sir,
SUB.: CHANGE OF ADDRESS
Folio No(s)._________________________________
DP ID________________ CL. ID_______________
I refer to my shareholding at above mentioned Folio No. / DP ID & Cl.ID number and write to
inform the change in my address as given below :-
OLD ADDRESS NEW ADDRESS
PIN
PIN
I request you to kindly change the above address in your records under intimation to me.
Thanking you,
Name of the Sole/First
Holder Signature :
Second Holder Signature :
Third Holder Signature :
Note : The signature(s) should match with the signature already on the record.