SCHEDULE I
FORM A
SECURITIES AND EXCHANGE BOARD OF INDIA
(REGISTRARS TO THE ISSUE AND SHARE TRANSFER AGENTS) REGULATIONS, 1993
(Regulation 3)
APPLICATION FOR REGISTRATION AS
REGISTRARS TO ISSUE OR TRANSFER AGENTS OR BOTH.
NAME OF THE APPLICANT :
(Whether proprietary concern / firm / association of persons /body of persons / body corporate)
INSTRUCTION:
1. APPLICANT MUST SUBMIT A COMPELTED APPLICATION FORM TOGETHER WITH SUPPORTING DOCUMENTS TO THE SECURITIES AND EXCHANGE BOARD OF INDIA.
2. ALL COLUMNS OF THE APPLICATION SHOULD BE FILLED IN. IN CASE A COLUMN IS NOT RELEVANT OR NOT APPLICABLE, THIS 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.
PART - I
GENERAL INFORMATION
APPLICANTS DETAILS
1.1 Name of the Applicant : _
Pin Code :_ Fax No.:
(b) __
(c) __
(d) __
1.6 Whether any other application under Securities and Exchange Board of India Act, 1992 has been made for grant of Certificate, if so, details thereof:
2. ORGANISATION STRUCTURE :
2.1 Objective of the organisation
(attach the extracts from relevant documents like, Partnership deed, Charter, Memorandum of Association, and Articles of Association in support of objectives of the organisation.)
2.2 Date and Place of Incorporation / Establishment of the organisation of the applicant.
Day Month Year Place
2.3 Status of the applicant (specify whether proprietory, partnership, association of persons, body of individuals, limited company - public / private, others. If listed, name of the stock exchange and latest share price: - high & low)
2.4 Organisation Chart stating the functional responsibility at various levels.
2.5 Particulars of all Proprietors / Partners / Mangers / Officers / Directors:-
[Name, Qualification, Experience, Date of Appointment, Other directorship (Name & Date of Appointment), Previous positions held.]
2.6 Number of employees
(General and for specific Intermediaries activity)
2.7 Name and activities of associate companies / concerns carrying out on activities of a registrar to issue or share transfer agent.
Name Address / Phone nos Type of activity Status
2.8 In case the applicant is a body corporate, please give list of major shareholders (holding 5% or more voting rights) and percentage of their shareholdings.
3.0 DETAILS OF INFRASTRUCTURAL FACILITIES
3.1 Office Space (mention the extent of area available)
3.2 Office Equipment (mention the details of electronic office equipment, typewriters, telecommunications equipment etc.)
3.3 Whether Data Processing capacity facility is available. (a) In house or (b) outside please give details
3.4 Computer facility :
(a) Hardware Configuration
(b) Software Environment
4. BUSINESS PLAN (FOR THREE YEARS)
(a) History, Major achievements and present acitivity
(b) Projected Profitablity (Next three years)
(Physical targets, Modus Operandi to achieve targets, Resultant Income)
5.0 FINANCIAL INFORMATION
5.1 Capital structure (Rs. In lakhs)
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Current Year
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Subsequent second year (estimated)
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Subsequent third year (estimated)
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(a) Paid up Capital
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(b) Free reserves (excluding revaluation reserves)
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(c) Total (a) + (b)
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(d) Loans (Details)
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Note : In case of partnership or proprietory concerns, please indicate capital minus drawings.
5.2 Deployment of Resources
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Current Year
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Subsequent second year (estimated)
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Subsequent third year (estimated)
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(a) Fixed Assets
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(b) Plant & Machinery And office equipment
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(c) Investment (Details Should be given separately)
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(d) Others
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5.3 Net Profit for the last three financial years (Rs. In lakhs)
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First Year
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Second Year
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Third year
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5.4 Estimated profit from various sources Rs. In lakhs)
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Current Year
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Subsequent second year (estimated)
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Subsequent third year
(estimated)
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In the case of body corporate, please enclose three years of audited annual accounts and where unaudited reports are submitted, give reasons.
Name and Address of Principal Bankers
Name and Address of the Auditors (Internal, External & Tax auditor, if any).
(As applicable)
6.0 OTHER INFORMATION
6.1 Details of all pending disputes:
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Nature of dispute
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Name of the party
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Names & Places of Court / Tribunal where disputes are pending
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6.2 Indictment of involvement in any offence relating to moral turpitude / economic offenses in the last three years.
6.3 Any significant awards or recognition, collective grievances against the services rendered by the company.
6.4 Any other information considered relevant to the nature of services rendered by the company.
6.5 Name of two references.
(For applicants other than institutions & corporate bodies)
Part II
7. BUSINESS INFORMATION
7.1 Describe present activities and proposed activity in case of new organisation.
7.2 Existing / proposed facilities for redressal of Investor Grievances.
(Furnish number and type of complaints received, follow-up with the companies, average time taken in resolving the complaints and overall system of handling complaints.)
7.3 Enclose a copy of typical contract entered with a person making the issue or share transfer agent.
7.4 Details of facilities for processing of application, collection and despatch of documents, refund orders, allotment letters, space for safe custody of refund orders, certificates, reconciliation with the collecting banks.
8. EXPERIENCE
8.1 Experience in handling the activities during the last three years (Name of the corporate body, particulars of issues handled, size of issues etc.) for :
(a) Registrars to Issue
(b) Share Transfer Agents
8.2 Experience in other financial services (period, area, commencement of activity).
DECLARATION
THIS DECLARATION MUST BE SIGNED BY PRINCIPAL OFFICER / SOLE PROPRIETOR, AS APPLICABLE.
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 attempting to mislead the Board shall render the applicant liable to disciplinary proceedings.
I/We certify that the above information and information supplied in the application form is true, complete and correct.
For and on behalf of -------------------------------------------- (Name of Applicant)
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PLACE
Date