Application for Grant of Certificate of Registration

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.... Code................................ Telephone No. .................................. Telex No. ..................................... Fax No................................. (B) Address for Correspondence : Pin Code................................ Telephone No. ................................ Telex No. ................................ Fax No. ................................ (C) Address of Branch Offices : 2. Organisation structure (Organisation Chart separately showing functional responsibilities of Merchant Banking activities to be enclosed). 2.1 Objectives : (To be given in brief alongwith copy of Memorandum and Articles of Association). 2.2 Date and Place of Incorporation : Day Month/Year Place 2.3 Status of the Applicant : (e.g., limited company-Private/Public, unlimited company, ^11[body corporate,] ^12[limited liability partnership], ^13[****] others. If listed, names of Stock Exchanges and latest share price to be given). 2.4 Particulars of all Directors/Partners ^14[****]: Name Qualification Experience in Merchant Banking & Financial Services related areas Share in applicants firm/compa....

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................................................................................................................................................. 4.2 If the applicant is proposing to engage in Merchant Banking activities for the first time, the experience of key management personnel to be indicated. Name of Key Management Personnel Qualification Previous positions held Experience particularly in respect of merchant banking activities         4.2a If the applicant is proposing to engage in Merchant Banking activities for the first time, business plan of the company with projected volume of activities and income for which registration is sought to be specifically given. 4.3 Details of infrastructure including computing facilities, equity research and data base available with the applicant. 4.4 Any other information considered relevant to the nature of services rendered by the applicant. 5. Financial information. ^15[(Rs. in lakhs) 5.1 Capital Structure Year prior to the preceding year or current year Preceding year Current year   a) Paid-up capital b) Free reserves (excluding revaluati....

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....l paid up capital of the company 5.7 Name and address of the principal bankers of the applicant. 5.8 Name and address of the auditors. 6. Other information 6.1 Details of all settled and pending disputes: Nature of dispute Name of the party Pending/settled       6.2 Indictment or involvement in any economic offences by the applicant or any of the Directors, or key Managerial Personnel in the last three years. DECLARATION This Declaration must be signed by Two Directors ^16[or Two Partners] as the case may be. I/We hereby apply for registration. 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 registration. I/We declare that the information supplied in the application form is complete and correct. For and on behalf of ................................................................................................................................................. (Name of Applicant) Director/Partner ^17[****] Director/Partner Name in Block Letters Name in Block Letters ....

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....rities 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 "Certificate of Initial / Permanent Registration" were substituted for the words "Certificate of Registration" by the Securities and Exchange Board of India (Merchant Bankers) (Amendment) Regulations, 2011 w.e.f. 05-07-2011. 6 Figures "II/III/IV" omitted by the Securities and Exchange Board of India (Merchant Bankers) Regulations, 1997 w.e.f, 9-12-1997. 7 The words "3.Underwriting of Issue" and "4. Portfolio Management Service" shall be omitted by the Securities and Exchange Board of India (Merchant Bankers) (Amendment) Regulations, 1997 w.e.f, 9-12-1997. 8 Substituted 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 substitution, paragraph III as substituted by the Securities and Exchange Board of India (Merchant Bankers) Regulations, 2011 w.e.f. 05-07-2011 read as under: "This certificate of registration shall be valid from ..... to .... / for permanent, unless suspended o....