Form No. 03 - Application for registration - Investor Education and Protection Fund (Awareness and Protection of Investors) Rules, 2001

Form No. 03 (See rule 14) Application for registration Notes . (1) Submission of the registration form does not necessarily guarantee automatic registration or funding. (2) Committee reserves the right to reject any application in its own discretion without assigning any reason thereof. (3) Committee may call for additional details as and when required for the purpose of granting registration. (4) Any false information furnished or false representation made shall make the application/registration liable for rejection/ cancellation. 1. Name of Association: 2. Address: Tel No./Fax No./E-mail 3. Year of Establishment: Registration No.: and Date: 4. Principal office bearer. Address: 5. Organisational structure (a) Office Bearers: Name Educational Qualifications Occupation/Profession Experience (specify in number of years of experience as investor either in primary or secondary market) Remuneration received from the Association President Vice President Secretary Treasurer (b) How elected or appointed or nominated and what is the frequency of election to the Board; (c) Total number of employees. (For the last three years) 6. Membership (For last three years) (a) Total Number; (b) Number of Members who are: (i) Investors (ii) Connected with Investment activities (iii) Professionals. 7. Financial Information: (a) Source of Funds (Information for last three years) (i) Membership fees (ii) Annual Subscription fees (iii) Any other fees (iv) Any other source of income (b) Uses of funds: (i) Administrative expenses (ii) Salary and wages: Stationary and postage Miscellaneous (iii) Expenses for holding seminars, meetings and other activities of the Fund (iv) Any other expenses Excess of income over expenditure 8. Activities of the association (a) Objectives of the Association. (b) How has the Association met the objectives in the past/objectives of the present application. (c) How does the Association communicates to the investors; (d) Whether the Association holds meeting regularly (if yes, details of the number of meetings held during the last three years and the participation to be given). (e) Number of shareholders/conferences/seminars held during the last three years. (f) Whether representatives of the Association are sent to attend shareholders' meeting of companies. (g) Whether the association handles investors grievances? (if yes, then number of grievances received and settled during the last 12 months to be given). (h) Grievances redress system of the Association. (i) House Journal/publication of the Association. (j) Whether any representation has been made by the Association in the past to the Stock Exchanges/Government/Companies in the interests of the investors in general and the members in particular. (k) Any other activity. (l) Whether any suits/proceedings are pending against the association or any of its office bearers/members in any court of law, if so details may be given. (m) Whether the association agrees to abide by the rules/ regulations/guidelines framed by Committee/Central Government from time to time for its effective functioning and better discipline. (n) Whether any office bearer of the Association is a board member of any corporate entity. 9. Enclosures (i) Copies of Memorandum and Articles of Association, rules regulations/bye laws; (ii) Latest membership and their addresses; (iii) Copies of the audited statement of accounts/annual report for the last three years; (iv) Copies of last 3 issues of the House magazine/journal, if any; (v) A copy of the statement authenticating registration of the Association; (vi) A statement elaborating details of activities of the Association. Signature (with name) President Vice President Secretary Treasurer