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Revocation Request Form

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To,
Xtratrust CA

Date

(Ex. DD/MM/YYYY)

Please Note

  • Please fill the form as per the details in the DSC issued to you
  • In case of organization DSC, an additional authorization from the Authorized signatory of the Organization would be required granting to revoke the DSC.

Section 1 - Product Confirmation

Section 2 - Reason for Revocation

Section 3 - Declaration of Subscriber

  1. I understand that section 71 of the IT act stipulates that if anyone makes a misreprentation or suppresses any material fact from the CCA or CA for obtaining any DSC, such person shall be punishable with imprisonment up to 2 years or with fine up to one lakh rupees or with both.
  2. I have read and understood XtraTrust CPS & the Subscriber Agreement and will unconditionally abide by the provisions mentioned in it
(Ex. DD/MM/YYYY)

Section 4 - Authorization Letter

To,
XtraTrust CA

I hereby request for the revocation of the Digital Signature Certificate bearing Application ID issued on for period of year's to (subscriber name) with registered Mobile Number & Email Id on behalf of (organization name)

Section 5 - To Be Filled by XtraTrust Assessment Executive (AE)

Name

Date (Ex. DD/MM/YYYY)

Place

Designation

Revocation Date & Time (Ex. DD/MM/YYYY HH:MM)

AE Sign

Download
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*
836966

Disclaimer

  • I understand that Section 71 of the IT act stipulates that if anyone makes a misrepresentation or suppresses any material fact from the CCA or CA for obtaining any DSC, such person shall be punishable with imprisonment up to 2 years or with fine up to one lakh rupees or with both.
  • I have read & understood XtraTrust CPS & the Subscriber Agreement and will unconditionally abide by all the provisions mentioned in it.
  • I agree that the revocation request is communicated to authorized person and/or subscriber.