Undertaking by Applicant

(Applicant Name) hereby undertake that the details mentioned in the application form are true & correct to the best of my knowledge & belief. I hereby authorize "Utech lndia Ltd" to process/enroll and download my digital signature on my behalf.

Signature of Applicant

Date & Place

Undertaking by Proposer

(Name of Proposer) undertake that I have submitted the correct details for iApplicant Name), my client mentioned in the application form to get Digital Signature Certificate as required. lD & Address Proof attached with application form are duly and truly certified & attested by me.
I also

hereby authorized by applicant to take & Use Digital Signature certificate.

Signature of Proposer with Stamp

Date & Place

Utech lndia Ltd I Class 2 | Class 3 | DGFT Digital Signature Certificateswww,utechindia.com

Enrollment Request No:

Used IDr

?rt?ltr aoNSuLtANCY SXtlvrCEs

CFRTIFYING *lJTI-]ORITY

TATA CONSULTANCY SERVICES LIMITED - CERTIFYING AIJTHORI'EV K.D.K SOFTWARE (INDIA) PVT, I.TD. - REGISTERING AUTFIORITY REQUEST FORM FOR CLASS-2 CERTIFICATE - (Jser Type - Individual

T,&YA

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Instructions: Items marked with * are mandatory,

Validity of
GENDER

DSC

I
*

Narne * (Full Name) E.MAIL ADDRESS

I'""

e'montns

l v"u."

zv."r"

(Mandatory - a valid and active email ID that is accessed frequently)

Residential Address x

City* Country*
Documents Chck List ldentity and Residence
Ph. NO* lvlobiie No*
TCS-CA for ID & Add

* (Attsted Copies of following docs must be provided to

proof)

ldentity
Drivins Licenso
Bank Passbook with Phot6

lo Card lssued by covt. Residance

LatestTelephone Bill
Latest BankStatement Latest Electricity Bill

Drivinq License

Instructions

A I subscribers are advised to read Certiflcate Practice Statement of CA. The Certillcate shall be downloaded onto same Computer/ Hardware which used durinq Enroltment. The Cert ficaie must not be shared wilh olhers or used by them on your behalf. If you loose Key Pair, you shall inforrn RA Adminisirator and appty for Revocation of Certificate. After placing the online request following things should not be carried out unlil successful installation of Certificate a) Fo.rnatting of Computer b) Deleiion of User Ac@unt c) Up gradation of IE or Windows OS Application form must be submitted in person, incomplete forms are liable to reject.

Applicanl Declaration RA Dectararion I hereby confim lhat I have rcad and understood lhe .bovell hereby confirm lhal I hav recerved and ve.ilied the documenls inf L, .o \ d1d i l {olow r'e abole -srucio-s fo'ootar-9 andls,bn eo oytt-e subsc.oer Ls 19 _1 og ra Srq-alu' Celfcare. I
Date