To REQUEST FOR CHANGE OF ORGANIZATION NAME VENDOR CODE: LARSEN & TOUBRO LIMITED, KH ECC Division, HQ,SSC Vendor Payments, — Mount Poonamallee Road, : Manapakkam,Chennai-600 089. Formerly Organization known as (Old name): New name of the Organization: Effective date of new name I Register office / Permanent address with PIN Code Phone Number Email: LTT TET T TT Tt yy Please tick the type of Organization subsequent to name change. ml Sole Proprietorship _[Please attach a self attested copy of VAT Registration Centficate or Bank passbook] Partnership Firm {Please attach a copy of partnership deed duly verified by the public notary] Private Limited Company [Please attach a copy of Certificate of Incorporation issued by Registrar of Companies duly attested by Company Secretary (Or any Senior Official] Public Limited Company [Please attach a copy of Certificate of Incorporation issued by Registrar of Companies duly attested by Company Secretary or any Senior Official] [P.0]Others, please specify (Attach required copies of documents) Permanent Account Number (PAN) : I [Please attach 2 copy of PAN card] Detalls of Bank account after name change for effecting Electronic payment Bank Name: Bank Account no. (Please attach a copy of cancelled Cheque.) Bank Address: ae (Complete postal address) NEFT Code Ts (Please obtain from your bank) | | | Contact No of Bank STD Code Phone No Payment Communication e-mail Id sniseannno Place: Date: (Name & Signature by Authorized Signatory with Seal) Please contact us at mybill@Intece.com & myeft@Intecc.com for any further clarifications. Ph : 044-22526616,6617,6662,6671,6672,6673,6674 & 6675. Fax: 044-22526059. For Office Use: LTF Bill discounting Yes No Bank Guarantee status an No (Revision: 3)