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.... ^4[****] Table 4: Details of sales personnel or approved user who has passed any certification programme Sl. No. Name Date of test Percentage Certificate No.           Other details: 1. Please furnish a copy of the memorandum and articles of association or the partnership deed, as the case may be. 2. ^5[****] 3. If the applicant intends to clear and settle his trades through a clearing member, the applicant is required to furnish the name and details of the clearing member along with a copy of MoU/ agreement/ contract with them for the same. 4. Whether the application is accompanied by a requisite fee as per Schedule V of the Regulations as applicable to the applicant. Undertaking: 5. Whether the applicant or its director or partners, any time convicted of any economic offence? If so, furnish the details. 6. Whether the applicant or its directors or partners, declared insolvent or declared defaulter by any exchange? If so, furnish details. 7. Whether the applicant or its directors or partners at any time subjected to any proceedings or penalty by the Board under SEBI Act or any of the regulations ....

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....  6. Fax Number(s), Phone Number(s) of office and residence and email address   7. Form of Organization-Sole proprietorship, partnership, corporate body, financial institution ^10[,others (please specify)]   8. Net worth along with supporting document   ^11[9. PAN of the applicant]   Table 2: Details of proprietor/ partners/ directors Sl.No Names Age PAN Educational Qualifications Experience in derivatives trading or securities market, as applicable ^12[***] Other details: 1. Please furnish a copy of the memorandum and articles of association or the partnership deed, as the case may be. 2. Whether the application is accompanied by a requisite fee as per Schedule V of the Regulations as applicable to the applicant. Undertakings: 3. Whether the applicant or its director or partners, any time convicted of any economic offence? If so, furnish the details. 4. Whether the applicant or its directors or partners, declared insolvent or declared defaulter by any exchange? If so, furnish details. 5. Whether the applicant or its directors or partners at any time subjected to any proceeding....

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....e Securities and Exchange Board of India Act, 1992, read with the rules and regulations made thereunder, the Board hereby grants a certificate of registration to...................as a Sub-broker subject to the rules and in accordance with the regulations. Registration number allotted is as under: ...................................................................................................................................... ................................................. This certificate shall be valid till it is suspended or cancelled in accordance with the regulations. Date:............... By Order For and on behalf of Securities and Exchange Board of India     ************ NOTES:- 1 Substituted by the SEBI (Stock Brokers and Sub-brokers) (Second Amdt.) Regulations,2013 w.e.f 27.09.2013 2 Inserted by the SEBI (Stock Brokers and Sub-Brokers) (Amendment) Regulations, 2014 w.e.f. 08.10.2014. 3 Inserted by the SEBI (Stock Brokers and Sub-Brokers) (Amendment) Regulations, 2014 w.e.f. 08.10.2014 4 Table 3omitted by the SEBI (Stock Brokers and Sub-Brokers) (Amendment) Regulations, 2014 w.e.f. 08.10.2014. 5 Omi....

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....x, phone number of offices and residential numbers. Also indicate the number of employees. Office Address Phone No. Telex No. Fax No. Residential Phone Nos. of proprietor, partners, directors, etc. 8. Number of branch offices and their location with phone, telex and fax numbers. I certify that the information given in this application form is true to the best of my/our knowledge and belief. Recommendation letter from the stock broker to whom I/we am/are affiliated and two references, including one from the banker as required are enclosed. ............................... Date.................... Signature Recommendation of the Stock Exchange This is to certify that...............is a ^13[recognised] sub-broker affiliated to...............member broker of this Exchange. The application is recommended/not recommended for registration by the Board. Authorised Signatory Signature .............................. Stock Exchange FORM C Securities and Exchange Board of India (Stock Brokers & Sub-brokers) Regulations, 1992 Recommendation Letter to be given by the Member with whom the Sub-broker is Affiliated: To The.................Stoc....