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                                <h1 class="title">Form Filing Assistance</h1>
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                                    <a title="Homepage" href="index.php"><i class="ti ti-home"></i>&nbsp;&nbsp;Home</a>
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                                <span class="ttm-bread-sep">&nbsp; | &nbsp;</span>
                                <span>Form Filing Assistance</span>  
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               <h2 class="text-white" >IEPF Form Filing Assistance</h2>
               <p class="mb-0"> &#9737;A flat fee-based IEPF Claim filing assistance provided by Recoversy for investments below Rs.2 lac.</p>
               
               <p style="color: white;"><b>Terms and Conditions:</b></p>
               <p class="mb-0"> &#9737;Recoversy is only providing form filing assistance for IEPF Claims and is not responsible in any way for the recovery of the investments from the IEPF Authority.</p>
               <p class="mb-0"> &#9737;The fee for IEPF Claim form filing assistance which is to be paid in advance is subject to the following conditions -</p>
               <p class="mb-0">&#9737;The recovery value of the investment should be less than Rs.3 lac</p>
               <p class="mb-0">&#9737;The following documents are to be provided from the investor end - </p>
                               <ul>
                <li> ♦&nbsp;<span style="color: white">Aadhaar card of the shareholder</span></li>
                <li>  ♦&nbsp;<span style="color: white">PAN card of the shareholder</span></li>
                <li>  ♦&nbsp;<span style="color:white">CML copy of the demat account of the shareholder</span></li>
                <li>  ♦&nbsp;<span style="color: white">Canceled cheque of the bank account linked with the demat account of the shareholder</span></li>
                <li>  ♦&nbsp;<span style="color: white">Proof of investment(share certificate)/entitlement letter from the company</span></li> 
                                </ul>
                                <p class="mb-0">&#9737;After the payment is completed, another form with the details required for form filing will be emailed to the email id mentioned.</p>
                                <p class="mb-0">&#9737;After receiving the documents, the filed forms along with the necessary instruction will be emailed within 7 working days.
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                                    <h2 class="title">Unclaimed Investment Details </h2>
                                   
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                             <form id="ttm-contactform" class="ttm-contactform wrap-form clearfix" method="post" action="#">
                                <div class="row">
                                    <div class="col-md-12">
                                        <label style="font-weight:500; font-size:18px;">Full Name as per PAN card * 
                                            </label>
                                        
                                    </div>
                                    <div class="col-md-4">
                                        <label>
                                            <span class="text-input">
                                                <input name="your-name" type="text" value="" placeholder="First" required="required">
                                            </span>
                                            </label>
                                        
                                    </div>
                                    <div class="col-md-4">
                                        <label style="font-weight:500; font-size:18px;">
                                          
                                            <span class="text-input">
                                                <input name="text" type="text" value="" placeholder="Middle" required="required">
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                                        </label>
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                                        <label style="font-weight:500; font-size:18px;">
                                            <span class="text-input">
                                                <input name="text" type="text" value="" placeholder="Last" required="required">
                                            </span>
                                        </label>
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                                     <div class="col-md-6">
                                        <label style="font-weight:500; font-size:18px;">
                                          
                                            <span class="text-input">
                                                <input name="text" type="Email" value="" placeholder="Email" required="required">
                                            </span>
                                            <p style="font-size:10px;"> Please make sure the email is accessible at all times as the same would be used for OTP generation and further communication from the IEPF Authority</p>
                                        </label>
                                    </div>
                                      <div class="form-group col-md-6">
                                      <label for="inputState">Phone*
                                      <select id="inputState" class="form-control">
                                        <option selected> 91+123456789</option> 
                                        <option>91+00000000</option>
                                      </select>
                                     
                                      </label>
                                    </div>
                                    
                                    <div class="col-md-6">
                                        <label style="font-weight:500; font-size:18px;">
                                          
                                            <span class="text-input">
                                                <input name="text" type="text" value="" placeholder="Unique id" required="required">
                                            </span>
                                            <p style="font-size:10px;"> Kindly provide with the unique id which you may have found on our search portal.</p>
                                        </label>
                                    </div>
                                       <div class="col-md-6">
                                        <label style="font-weight:500; font-size:18px;">
                                          
                                            <span class="text-input">
                                                <input name="text" type="text" value="" placeholder="Recovery Value INR*" required="required">
                                            </span>
                                            <p style="font-size:10px;"> Kindly provide the current market value of your investment to be recovered. Do not value below Rs.3 lac would only be considered for IEPF Claim filing assistance service</p>
                                        </label>
                                    </div>
                                     <div class="col-md-12">
                                        <label style="font-weight:500; font-size:18px;">
                                          Address *
                                            <span class="text-input">
                                                <input name="text" type="text" value="" placeholder="Steet Address" required="required">
                                            </span>
                                        </label>
                                    </div>
                                      <div class="col-md-6">
                                        <label style="font-weight:500; font-size:18px;">
                                          
                                            <span class="text-input">
                                                <input name="text" type="text" value="" placeholder="City" required="required">
                                            </span>
                                        </label>
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                                    <div class="col-md-6">
                                        <label style="font-weight:500; font-size:18px;">
                                          
                                            <span class="text-input">
                                                <input name="text" type="text" value="" placeholder="State/Region/Province" required="required">
                                            </span>
                                        </label>
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                                      <div class="col-md-6">
                                        <label style="font-weight:500; font-size:18px;">
                                          
                                            <span class="text-input">
                                                <input name="text" type="text" value="" placeholder="Postal / Zip Code" required="required">
                                            </span>
                                        </label>
                                    </div>
                                    <!--<div class="col-md-6">-->
                                    <div class="form-group col-md-6">
                                      <label for="inputState">Country</label>
                                      <select id="inputState" class="form-control">
                                        <option selected>Choose...</option> 
                                        <option>...</option>
                                      </select>
                                    </div>
                                    <div class="col-12">
                                        <p>Kindly provide the current address as per Aadhaar card of the 1st holder.</p>
                                    </div>
                                   
                                    
                                     <div class="col-md-6">
                                        <label style="font-weight:500; font-size:18px;">
                                          Fee Payment including GST *
                                            <span class="text-input">
                                                <input name="text" type="Email" value="" placeholder="10,000" required="required">
                                            </span>
                                        </label>
                                    </div>
                                    <div class="col-12">
                                        <p>Once the details are verified at our end and payment is confirmed, you would receive another form which needs to be filled for successful IEPF Claim form filing.</p>
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                                         <input name="submit" type="submit" id="submit" class="submit ttm-btn ttm-btn-size-md ttm-btn-shape-square ttm-btn-bgcolor-darkgrey btn-block" value="Submit">
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                                <!--        <textarea name="message" cols="40" rows="3" placeholder="Message" required="required"></textarea>-->
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