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Application for Grant of Certificate of Registration as Alternative Investment Fund

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..... 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 shall be considered by the Board provided it is complete in all respects. 5. All answers must be legible and all the pages must be numbered with signature/ stamp on each page of the form. 6. Information which needs to be supplied in more detail may be given on separate sheets which should be attached to the application form and appropriately numbered. 7. The application must be signed and all signatures must be original. 8. The application must be accompanied by an application fee as specified in the Second Schedule to these regulations. 1. GENERAL INFORMATION (a) Name, .....

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..... es as an Alternative Investment Fund (i) Copy of the draft placement memorandum. 2. DETAILS OF APPLICANT I. In case applicant is a Trust: 1. Write-up on the activities of the applicant 2. Whether the Trust Deed is registered under the provisions of the Registration Act, 1908. (Enclose relevant extract of the Registered Trust Deed) 3. Whether the Trust Deed permits the carrying on of the activity of an Alternative Investment Fund 4. Whether the applicant is prohibited by its trust deed from making an invitation to the public to subscribe to its units; 5. Provide details of Trustees/ Trustee Company as below: a. Whether Trustee is an individual or a Trustee company. b. Name, registered office address, telephone number(s) and fax number(s) of .....

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..... making an invitation to the public to subscribe to its securities; IV. In case applicant is a Body Corporate 1. Write-up on the activities of the applicant 2. Shareholding pattern and profile of the directors (Enclose Identity proof and address proof of the directors) 3. Whether the applicant is set up or established under the laws of the Central or State Legislature 4. Whether the applicant is permitted carrying on of the activity of an Alternative Investment Fund (Enclose relevant extract of the relevant Statute/Act) 5. Whether the applicant is prohibited by its memorandum and articles of association from making an invitation to the public to subscribe to its securities; 3. DETAILS OF SPONSOR(S) (Sponsor shall be as defined in 2 [clause .....

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..... ly, which are registered with the Board. If yes, details of the same. 4. DETAILS OF MANAGER (a) Name, address of the registered office address for correspondence, telephone number(s), fax number(s), of the Manager(s). (b) Name, direct line number, mobile number and e-mail of the contact person(s). (c) Legal status of the Manager (whether Manager(s) is/are individual/company/limited liability partnership/body corporate) and date and place of incorporation/ establishment, wherever applicable. (d) Write up on the activities of the Manager including past experience in advising or managing pools of capital or in fund or asset or wealth or portfolio management or in the business of buying, selling dealing of securities or other financial assets. .....

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..... to that effect). (b) Whether the applicant/ Sponsor/ Trustee/ Manager or its directors or Partners or employees are / have been involved in any litigation connected with the securities market which may have an adverse bearing on the business of the applicant or any order has/ had been passed against them for violation of securities laws. (If Yes, provide details. If No, enclose a declaration to that effect). (c) Whether applicant/ Sponsor/ Trustee/ Manager or its directors or Partners has/ have been refused a certificate by the Board or its/ their certificate has been suspended at any time prior to this application. (If Yes, provide details. If No, enclose a declaration to that effect). 7. OTHER INFORMATION/DECLARATIONS (a) Amount contribut .....

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..... ide by such operational instructions/directives 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 (Signature) FORM B Securities and Exchange Board of India (Alternative Investment Funds) Regulations, 2012 See regulation 6 Certificate of registration as Alternative Investment Fund I. In exercise of the powers conferred by sub-section (1) of section 12 of the Securities and Exchange Board of India Act, 1992 (15 of 1992), read with the regulations made thereunder, the Board hereby grants a certificate of registration to _______________________________________________________________as an Alternat .....

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