Nomination Form

To,

Open Text Corporation India Private Limited / Open Text Technologies India Private
Limited / GXS India Technology Center Pvt Ltd
Manisha Kumari
I, _______________________________________________________________________hereby
nominate the person mentioned below to receive the Full and Final Settlement payable in the event
of my death

Name of the Nominee: Jay Prakash Singh

Nominee Relationship with employee: Father
Date of Birth of Nominee (DD-MM -YYYY): 25-May-1968

If Nominee is minor, please share the name and address of the Guardian who may receive the
amount
Name of Guardian:______________________________________________________ (Full Name)
Address of Guardian:______________________________________________________________
_______________________________________________________________________________

Nominee / Guardian Bank Details:

Bank Account Number: 07611530008991

Bank Name: HDFC BANK
IFSC Code: HDFC0000761
Name as per Bank details JAY PRAKASH SINGH

Date: 23-mar-2023 Employee Signature