SHARE APPLICATION FORM

(For Allotment of Equity Shares in Beth Lifestyle Private Limited)

CIN: U36102KA2015PTC080368
Registered Office: Plot No 292 B, KIADB Industrial Area, Phase 2, Harohalli Hobli, Kanakapura Taluk, Bangalore Rural, Karnataka 562112, India

1. Applicant Details

Full Name

Father's/Spouse's Name

Date of Birth

Nationality

Occupation

Residential Address

Contact Number

Email ID

PAN

Aadhar

2. Share Application Details (1 Lot = 2000 Shares)

Number of Lots

Number of Shares Applied For

Face Value per Share (₹)

10

Premium per Share (₹)

240

Total Amount Payable (₹)

3. Payment Details

Bank Details for NEFT/RTGS Payment

Bank Name: Example Bank Ltd.

Branch: Main Branch, Mumbai

Account Name: XYZ Corporation

Account Number: 1234567890123456

IFSC Code: EXMP0001234

MICR Code: 400123456

Please use these details for NEFT/RTGS transactions and ensure the reference number (UTR) is provided below.

Choose Mode of Payment

NEFT

RTGS

Amount Paid (₹)

Reference No. (UTR)

Bank Name & Branch

Date

4. Declaration

I, the undersigned, hereby apply for the allotment of equity shares of BETH LIFESTYLE PRIVATE LIMITED (CIN U36102KA2015PTC080368) and agree to accept the same or a lesser number of shares that may be allotted to me, subject to the terms and conditions of the Company. I also agree to abide by the Memorandum and Articles of Association of the Company.

Place

Date