Template via bold kiln (www.boldkiln.com)
I, _______ , Son of _______, born on _______, residing at _______ (include city, PIN Code etc.), hereby confirm and verify that the particulars given in the Form DIN-1 are true and correct and also are in agreement with the documents being attached to Form DIN-1 and I am solely responsible for its accuracy.
I further confirm that
(i) The photograph and document attached to the Form DIN-1 belong to me. I further confirm that all required documents have been duly attested by me or duly attested by either Public Notary or a Gazetted Officer of a Government and are attached to the form DIN-1
(ii) I am not restrained/ disqualified/ removed of, for being appointed as director of a company under the provisions of Companies Act, 1956 including Section 203, 274, 284 and 388 (E) of the said Act or for being appointed as a designated partner of a limited liability partnership under the provisions of the Limited Liability Partnership Act, 2008 including section 5 of the said Act and
(iii) I have not been declared as proclaimed offender by any Economic Offence Court or Judicial Magistrate Court or High Court or any other Court and
(iv) I have not been already allotted a Director Identification Number (DIN) under Section 266B of the Companies Act, 1956 or a Designated Partner Identification Number (DPIN) under section 7 of the Limited Liability Partnership Act, 2008.
(v) _______ in practice has been authorised to digitally sign DIN application on my behalf.
(vi) The particulars of address provided in DIN-1 of the applicant and documents
attached as address proof are correct beyond all reasonable doubts.
(vii) I have not furnished any false information or suppressed any material information with view to obtain DIN. In case information provided is found to be false or suppressed or willful omission, I have no objection to de-activate and cancel the DIN allotted by the Central Government and I shall be liable for penal action u/s 628 of the Companies Act.
(viii) In case of DIN allotted by the Central Government has not been activated within 365 days from the date of allotment, I have no objection for cancelling/ Deactivating for cancelling/ deactivating the allotted DIN.