FORMS

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.... then 'Not applicable' should be specified. 3. Information which needs to be supplied in more details may be written on separate sheets which should be attached to the application form. 4. Original copy of form duly signed should be submitted for registration. PART I GENERAL INFORMATION 1. Applicant's details : 1.1 Name of the Applicant : 1.2Address of the Applicant : Pin Code: ................ Telephone No. : ...... : Telex No. : .............. Fax No.: ............ 1.3 Address of the applicant for correspondence : Pin Code: ................ Telephone No. : ...... : Telex No. : .............. Fax No. :............ : 1.4 Address of Branch Offices (in India) of the Applicant, if any : 1.5 Whether any other application und....

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....mention the details of electronic office equipment, typewriters, telecommunication equipment, furniture and fixtures, other communication facilities, etc.) : 4. Business plan (for three years) 4.1 History, major achievements and present activity : 5. Financial information : 5.1 Capital structure (Rs. in lakh) : Current year Last year Previous year Second year Third year (a) Paid-up capital (b) Free reserves (excluding revaluation reserves) (c) Total (a) + (b) (d) Loans (details) (e) Net profit: (i) General (ii) Specific Note : In case of partnership or proprietary concerns, please indicate capital minus drawings. 5.2 Deployment of resources : (a) Fixed assets : (b) Plant and machinery and office equipment : (c) I....

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....d with any company and reasons for the same Declaration THIS DECLARATION MUST BE SIGNED BY THE PRINCIPAL OFFICER/S: I/We hereby apply for grant of certificate of registration by the Board. I/We warrant that I/we will carry out my/our duties in accordance with the Act, Rules and Regulations. I/We warrant that I/we have truthfully and fully answered the questions above and provided all the information which might reasonably be considered relevant for the purposes of my/our grant of certificate for registration and I/we will promptly notify the Board of any changes in the information during the period that my/our registration is being considered and if my/our registration is accepted, thereafter. I/We understand that misleading or attempt....

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....on 3A/Regulation 8A" were substituted for the words "Regulation 3" by the SEBI (Underwriters) (Amendment) Regulations, 2011, w.e.f. 5-7-2011. 2 Substituted for the words "Application for Grant of Initial/ Permanent Registration" by the Securities and Exchange Board of India (Change In Conditions Of Registration Of Certain Intermediaries) (Amendment) Regulations, 2016 w.e.f. 08-12-2016. Prior to this the words "Application for Grant of Initial/ Permanent Registration" shall be substituted with the words" substituted the words "Application for registration as underwriter", by the SEBI (Underwriters) (Amendment) Regulations, 2011, w.e.f. 5-7-2011. 3 Substituted for "Regulation 8" by the SEBI (Underwriters) (Amendment) Regulations, 2011, w.e.....