To

The Board of Directors,

Bank of India
Head Office: Star House, Bandra Kurla Complex,
Mumbai 400 051

Re: Application for Employee Stock Purchase Scheme (ESPS)

Employee ID (PF No.)

Name
Demat A/c. No. (as applicable) CDSL Client Id:
NSDL Client Id: DP ID:
Name of the Depository Participant
PAN No.
No. of Shares Applied
Through Branch: Name (Sol ID)
Amount Blocked @ ` 80/- Per Share `
Saving Bank A/c No.

I, _____________________________,S/O, W/O,D/O Shri _____________________________ Permanent Employee of Bank of

India, do hereby state that the above information is True and Correct and that I have read and understood the ESPS Scheme
bound by the scheme and confirm that:

(1) The ESPS Scheme is only for Permanent Staff members of the Bank and I am eligible to participate in the scheme and
that the Bank has the right to allot in full or part or reject my application without providing reasons thereof.

(2) By applying for the shares issued to me, I am authorizing the Bank to mark lien on my Saving Bank Account as per
details provided above and transfer the application money to the extent of shares to be allotted to me to BOI-ESPS
Account. I hereby undertake to make sufficient balance available in my Saving Bank Account for the purpose.
(3) The shares allotted to me will be credited to my Demat account as provided above and shall be under lock in period of one
year from the date of allotment.

(4) The Shares will be listed on National Stock Exchange of India Limited and BSE Limited, Stock Exchanges and Price of
Equity Shares can be affected by Market fluctuations.

Signature Date:

Mobile No.
Email id:

In case of any information or clarification, please contact Bank’s Registrar and Transfer Agents:

Bigshare Services Pvt. Ltd. 1st Floor, Bharat Tin Works Building, Opposite Vasant Oasis, Makwana Road, Marol, Andheri (East),
Mumbai-400 059 Phone: 022 62638200, 62638222, Email: Investor@Bigshareonline.com

For Office Use Number Dated Remarks

Shares Applied

Application Entered By

Application Verified By

Lien Marked (`)

(Reference No)

Signature and PF Number of Bank Official / Branch Manager and Stamp

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