AI Drafter 
TaxTMI 
TaxTMI 
Application Form for Grant of Certificate of Registration as Foreign Venture Capital Investor (FVCI)
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....b) Date of Commencement of Business 4. Place and Country of Incorporation/ Establishment/ Formation: Particulars Details a) Place b) Country c) ISD Country Code 5. Legal form of the applicant and the law under which it is incorporated, established or registered: 6. Legal Entity Identifier & Tax Residency Certificate details: Particulars Details a) Legal Entity Identifier (LEI), if applicable b) Tax Residency Certificate (TRC) No. c) Country of Tax Residency + Add (Add rows at b) and c) in case of Multiple Tax Residency details) 7. Address & Communication Details 7.1. Registered Address of the Applicant: Flat/ Room/ Door/ Block No. Name of Premises/Building/ village Road/ Street/Lane/ Post Office Area/ Locality/ Taluka/ Sub-Division Tow....
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....e FVCI applicants on the basis of multiple parameters such as home jurisdiction, type of entity, nature of business etc. __We declare that there is no natural person/individual who are ultimately holding > ___% beneficial ownership directly/indirectly into the entity as well as on controlling basis for companies, Trust & General Partner / Limited Partnership structure. We therefore provide details of the senior managing official of the FVCI as under. The list of beneficial owners as per materiality threshold for controlling ownership interest and / or on control basis is provided as under: __ The list of beneficial owners as per materiality threshold for controlling ownership interest and / or on control basis is provided as under: S. No Name & Address of the Beneficial Owner (Natural Person) Date of Birth Tax Residency Jurisdiction Nationality Whether acting alone or together, or through one or more natural person as group with their name & address Beneficial Owner (BO) Group Percentage Shareholding / Capital....
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....stablished outside India or any other entity incorporated or established outside India If any other entity or investment vehicle, please give details: 13. Type of entity: Please select one of the below options: 1) Private Company (R) 2) Public Company (U) 3) Body Corporate (D) 4) Financial Institution (S) 5) Non-Government Organisation (N) 6) Charitable Organisation (C) 14. Documents submitted as Proof of Identity (POI) and Proof of Address (POA) for KYC: Particulars Details a) Proof of identity (POI) b) Proof of Address (POA) 15. Whether the applicant or the applicant's authorized signatories/ Promoters/ Partners/ Trustees/ Whole Time Directors/Office bearer is a) A politically exposed person Yes/No ....
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....perations or the registration, has been revoked, temporarily or permanently or any regulatory actions that have resulted in temporary or permanent suspension of investment related operations in jurisdiction where the applicant is operating and has a bearing on obtaining FVCI registration for investing in India? Yes/No If yes, please mention details briefly in below box. For more details, enclose Annexure. Declaration and Undertaking: We_______________________________________, the applicant, in the capacity of _________________, do hereby declare that what is stated in the aforesaid application form (including the enclosed documents/annexures) is complete and true to the best of our information and belief. We undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, we are aware that we may be held liable for it. We hereby apply for registr....
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....ctions/ directives as may be issued by Securities and Exchange Board of India, Reserve Bank of India or any other authority from time to time under provisions of the Act or any other applicable law. 4. We authorize custodian to operate the account through Power of Attorney (PoA) and not to receive credits automatically into our account. 5. We authorize custodian to send statement of account in electronic form and we will ensure the confidentiality of the password of the email, as applicable 6. We authorize custodian to maintain appropriate house account details on depository platforms for the purpose of collection of monetary corporate benefits and any other similar activities on our behalf. B: Additional information 1. If segregated portfolio is maintained for each sub-funds or share classes/ equivalent structures of the applicant, names of such sub-funds or share classes/ equivalent structures that intend to invest in India. Sr. No. Name of sub-funds or share classes/ equivalent structures that intend to invest in India (BO declaration at point ....
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.... OR __ Details of entities holding >= ------% of ownership/ entitlement through shares/units, economic benefit participation etc. including cumulative direct / indirect holding held through single or multiple entities are provided as under: Name of Beneficial owner Direct / Indirect Stake Names of the entity(ies) through which the stake in the FVCI is held indirectly Country of Incorporation / Nationality Percentage stake held in the applicant Individual /Non- Individual b) Beneficial Ownership by Control: __ We declare that there is no entity who controls through means like voting rights, agreements, arrangements, etc. OR __ Details of controlling entity is provided as under: Name of Beneficial owner Method of Control (Give Details including names of the intermediate structures, if any, through which control is exercised ) Country of Incorporation / Nationality Percentage control on the applicant, if applicable Individual/Non- Individual Da....
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....may also be given for that office. 2. Please indicate whether the applicant belongs to any one or more of the following categories: Pension Fund, Mutual Fund, Investment Trust, Investment company, Investment trust, Investment partnership, Asset Management Company, Investment manager, Investment Management Company, Endowment fund, University fund, Charitable institutions or any other investment vehicle incorporated and established outside India 3.(a) The date and place of incorporation of the applicant. (Details of statute under which incorporated). (b) Brief description of the principal activities of the applicant and the year of commencement of such activities. (c) Brief description of the group, if any, to which the applicant belongs. 4. Whether any of the following documents are submitted? i. Copy of certificate of registration with home regulator; or ii. Copy of income tax return filed in the home country; or iii. Copy of bankers certificate fair track record of the applicant 5. Please also state whether there has been any instance of violation or non-adherence to the securities laws, code of ethics/conduct, code of business rules, for which the ap....
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....firm commitment letter(s) required to be furnished under paragraph 10 of this Form.] For and on behalf of _______________________________________ ____________________________________ (Name of the applicant) Authorised Signatory ___________________ ___________________ ______________________________________ (Name) (Signature) Date: Place: Note: 1. Securities and Exchange Board of India (SEBI) reserves the right to call for any further information from the applicant regarding his application. 2. Applications, superscribed "Application for Registration of Foreign Venture Capital Investors", should be submitted in duplicate, in sealed envelopes, at Securities and Exchange Board of India's office. Documents to be enclosed with the application: a. Documents to suppo....