Form for Informant’s Voluntary Information Disclosure to be submitted to the Board

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....datorily, remaining fields are mandatory I. PERSONAL INFORMATION OF THE INFORMANT A.INDIVIDUAL 1: Last Name:.....................   First Name:.....................   Title:.................. Address: City / State: PIN: Telephone (with State Code): Mobile: E-Mail address:   Employment Details*: Permanent Account Number, if available: II. LEGAL REPRESENTATIVE (where applicable) Last Name:.................. First Name:........................ Title:.................. Firm Name (if not self-employed): Contact address : City / State: PIN: Residence address:  City / State: PIN: Telephone (with State Code): Mobile: E-Mail address: Bar Cou....

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....e public; (iv) details of circumstances/evidence leading to possession of unpublished price sensitive information by the alleged violator(s); (v) details of insiders/suspects and their trades (i.e. purchase/sale and quantity purchased/sold) along with dates/period of trades.] 10. What facts or supporting material is your allegation based on?  ^5[Please include self-certified copies of all the relevant documents.] Please attach any additional documents to this form, if necessary. 11. Identify any documents or other information in your submission that you believe could reasonably be expected to reveal your identity and explain the basis for your belief that your identity would be revealed if the documents we....

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....ur knowledge and belief and not obtained from the categories of persons indicated in sub-regulation (2) and sub-regulation (6) of regulation 7G of the Securities and Exchange Board of India (Prohibition of Insider Trading) Regulations, 2015 and agree to indemnify the Board in case it is not so found. I/we fully understand that I/we may be subject to action under securities laws as well as Section 182 of the Indian Penal Code, 1860 (45 of 1860) and ineligible for Reward if, in my/our submission of information or in any other dealings with the Board, I/we knowingly and wilfully make any false, fictitious, or fraudulent statements or representations, or use any false writing or document knowing that the writing or document contains any false, ....