Additional Information Sheet (AIS) for registration / renewal as Bankers to an Issue

(to be submitted alongwith the application for registration / renewal)

Please read the instructions carefully before filling up the Additional Information Sheet (AIS).

1. Fill in all the particulars as are applicable clearly. Vague replies should not be given.

2. The AIS should be complete in all respects and all answers must be typed / printed.

3. Provide certified true copies of appropriate supporting documents in the form of annexures wherever required and the same should be appropriately numbered and flagged.

I GENERAL INFORMATION:

1	Name of the Applicant
2	Registration no., if renewal
3	Validity of registration, if renewal
4	Status of the applicant (Nationalized Bank, Private Bank, Foreign Bank, Scheduled Co-operative Bank etc.)
5	Details of Promoters
6	Names of Directors
7	Whether activity is permitted by MoA / Statute / Bye-Laws
8	Details of the applicant and its associates’ registrations with SEBI: Name Relation with applicant Regn. No. Validity Nature of activity

II COMPLIANCE:

1	Details of any disciplinary proceedings including enquiry / adjudication / consent / prosecution or any other action (suspension / debarment etc.) / adverse comments (warning / caution) initiated by / pending with SEBI against the applicant, its group entities and / or any of its Promoters, Directors and Key Management Persons.	Completed Actions: a). Against applicant b). Against associates and group entities c). Against promoters, directors and key management persons Pending Actions: a). Against applicant b). Against associates and group entities c). Against promoters, directors and key management persons
2	Details of the corrective measures taken pursuant to actions taken by SEBI including enquiry / adjudication / consent / prosecution or any other action (suspension / debarment etc.) / adverse comments (warning / caution) etc. (only in respect of completed actions). If the applicant has furnished the corrective measures to SEBI earlier on any occasion, only a copy of the earlier letter may be enclosed.
3	Details of the registration of the applicant, its group entities and / or any of its Promoters, Directors and Key Management Persons with any other regulatory agency in India or abroad	a). In India b). Abroad
4	Details of any disciplinary proceedings initiated by / pending with any other regulatory authority, in India or abroad, against the applicant, its group entities and / or any of its Promoters, Directors and Key Management Persons.	a). In India b). Abroad
5	Whether any person directly or indirectly connected with the applicant (as associate, subsidiary, inter-connected or group company of the applicant) has been refused registration by SEBI under the SEBI Act, 1992.
6	Details of any complaints / litigations pending against the applicant, its group entities, its promoter(s) or director(s) and key management person(s) as on date in respect of their activities in the securities market.
7	Whether the applicant has complied with the SEBI (Bankers to an Issue) Regulations, 1994
8	Whether the applicant has complied with the terms and conditions mentioned in the registration letter (for renewal cases only)
9	Whether applicant has submitted all quarterly reports (for renewal cases only)

III OTHER INFORMATION:

1	Compliance Officer: a). Name b). Qualifications c). Experience d). Contact No. (direct no. & mobile no.) e). Email id
2	Details of Principal Officer under Anti Money Laundering Guidelines
3	Designated email id: a). for investor complaints b). for regulatory communications (refer to SEBI circulars dated January 22, 2007 and July 07, 2008)
4	Details of the public / rights issues for which the applicant acted as Banker to an Issue in the last three years (for renewal cases only)
5	Details of fees/dues pending to SEBI from: a). applicant / group companies registered with SEBI b). sub-brokers affiliated to the applicant / group entities registered with SEBI as stock broker
6	Details of non-refundable application fees to be paid alongwith the application for registration / renewal (refer to Schedule II of the SEBI (Bankers to an Issue) Regulations, 1994) : a). D.D. No. b). Date c). Drawn on (name of Bank)

IV UNDERTAKINGS (to be signed by the Compliance Officer):

An undertaking whether the applicant, its group companies, its promoter(s) or director(s) and key management person(s) was/were/has not at any time been involved in any litigation connected with the securities market which has an adverse bearing on the business of the applicant or convicted by court for any offence involving moral turpitude or fraud or has been convicted of any economic offence.
An undertaking whether any convictions or restraint orders have been passed against the applicant, its group companies, its promoter(s), director(s) and key management person(s).
An undertaking whether any orders under the Insolvency Act have been passed against the applicant, its group companies, its promoter(s), director(s) and key management person(s).
An undertaking as to whether the applicant has adequate Infrastructure like adequate office space, equipment, manpower and adequate investor grievance redressal system in place to effectively discharge its activity as a Banker to an Issue.

V ENCLOSURES:

Certified true copy of the relevant part of the MoA / Statute / Bye-Laws permitting the applicant to undertake BTI activities.
Certified true copies of appointment letter, latest month’s pay slip and PAN Card of Compliance Officer.
Certified true copy of acknowledgement letter from FIU as regards appointment of Principal Officer under Anti Money Laundering Guidelines.
Certified true copies of PAN Cards of the applicant and its Promoters, Directors and Key Management Persons.

Bankers to Issue - How to Apply - Additional Information