1st Schedule - Application for grant of certificate of registration as Vault Manager - Securities and Exchange Board of India (Vault Managers) Regulations, 2021

FIRST SCHEDULE [See regulations 3 and 7] FORMS FORM A SECURITIES AND EXCHANGE BOARD OF INDIA (VAULT MANAGERS) REGULATIONS, 2021 Application for grant of certificate of registration as Vault Manager INSTRUCTIONS: 1. This form is meant for use by the applicant for grant of certificate of registration as Vault Manager. 2. The applicant should complete this form and submit it, along with all supporting documents to the Board at its head office at Mumbai. 3. This application form should be filled in accordance with these regulations. 4. The application will be considered by the Board provided it is complete in all respects. 5. All answers must be typewritten. 6. Information which needs to be supplied in more detail may be given on separate sheets which should be attached to the application form. 7. The application should be signed and all signatures should be original. 8. The application should be accompanied by an application fee as specified in the Second Schedule to the Securities and Exchange Board of India (Vault Managers) Regulations, 2021 . GENERAL INFORMATION: 1. Name of the applicant 2. Address of registered office, along with the proof of address 3. Name and Address of the Contact Person (representative of the applicant) 4. Designation of the contact person 5. E-mail address and contact number(s) of the contact person 6. Certified copy of the board resolution specifying the approval for providing vaulting services and authorized person for the same. ORGANISATION STRUCTURE 1. Type of entity 2. Date and place of incorporation or establishment and date of commencement of business (enclose certificate of incorporation, memorandum and articles of association or statutory provisions, if any, under which incorporated or established and any other document specifying that the entity is authorized for providing vaulting services). 3. Organization Chart 4. Particulars of Key Managerial Personnel [Name; Address; Qualification; Designation; Date of Appointment; PAN no. (Certified PAN Copy); Telephone No.; Mobile; Email; work experience] 5. Whether registered with any other authority and the copy of registration with that authority BUSINESS INFORMATION 1. Details of the activities carried on by the applicant, in India. 2. Details of associates of the applicant operating in India and activities carried on by them. 3. Whether the applicant is involved in any other business related to the securities market. 4. Details of grievance redressal and dispute resolution mechanism 5. Details of outsourced activities 6. Certified copy of Standard Operating Procedure FINANCIAL INFORMATION 1. Net Worth certificate not older than three months from the date of application 2. Copy of audited financial statements for the last two financial years INFORMATION CONCERNING THE VAULT(s) 1. Number of vault(s) in respect of which recognition is sought: 2. Details of the vaults(s): i. Complete address of the vault(s) along with pin code, email address, contact person and contact number; ii. Year of construction of the vault(s); iii. Storage capacity of each vault; iv. Number of storage units; v. Dimensions of the storage units; vi. Whether the vault(s) is owned/hired/leased, along with documentary proof; vii. If hired / leased, please state duration of the hiring / lease; viii. Name and contact number of the jurisdictional Police Station and distance from the vault(s); ix. Name and contact number of the nearest fire station; x. Number of entry and exit points for the vault(s); xi. Details of the security agency along with contact number; xii. Details of fire safety arrangements (number and type of fire extinguishers, number of fire buckets, water arrangements, number of fire safety alarms and any other measures) (attach a list); xiii. Equipment for weighing gold (attach a list); xiv. Whether all the local laws have been complied with for carrying out the business of providing vaulting services; and xv. Number of staff members in the vault(s) SECURITY FEATURES 1. Vault access control systems; 2. Systems for tracking of gold deposited with the Vault Manager; and 3. Risk control and operations manuals (enclose copies). OTHER INFORMATION 1. Whether the applicant or any of its director, officer and employee is involved in any litigation connected with the securities market which has an adverse bearing on the business of the applicant; or has at any time been charged for any violation by other persons or convicted for any moral turpitude or at any time has been found guilty of any economic offence; and 2. Whether there has been any instance of violation or non-adherence to the securities laws, code of ethics/conduct, code of business rules, for which the applicant, or its parent or holding company or affiliate may have been subject to civil or criminal liability or suspended from carrying out its operations or whether the registration has been revoked temporarily. DECLARATION STATEMENT I/We hereby agree and declare that the information supplied in the application, including the attachment sheets, is complete and true. I/We further agree that, I/we shall notify the Securities and Exchange Board of India immediately of any change in the information provided in the application. I/We further agree that I/we shall comply with, and be bound by the Securities and Exchange Board of India Act, 1992 , and the Securities and Exchange Board of India (Vault Managers) Regulations, 2021 and such other circulars, guidelines or instructions as may be issued by the Securities and Exchange Board of India from time to time. For and on behalf of_______________ (Name of the applicant) Authorized signatory __________ Authorized signatory_________ (Name) (Name) Signature_________ Signature_________ Date: Place: FORM B SECURITIES AND EXCHANGE BOARD OF INDIA (VAULT MANAGERS) REGULATIONS, 2021 Certificate of Registration as Vault Manager I. In exercise of the powers conferred by sub-section (1) of section 12 of the Securities and Exchange Board of India Act, 1992 read with the regulations made thereunder for Vault Managers, the Board hereby grants a certificate of registration to _________________ as a Vault Manager subject to the conditions provided in the Act and as the case may be in the regulations made thereunder from time to time. II. The Registration Number of the Vault Manager is IN/VM/________ III. This certificate of registration shall be valid till it is suspended, cancelled or surrendered. Date: Place: MUMBAI By Order (Signature) For and on behalf of Securities and Exchange Board of India