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..... ...................... Instructions:- 1. Applicants must submit a completed 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 then not applicable should be specified. 3. Information which needs to be supplied in more detail may be written on separate sheets which should be attached to the application form. 4. Original copy of form duly signed should be submitted for registration. PART I General Information 1. Applicant s details 1.1 Name of the applicant: 1.2 Address of the applicant: Pin code: Telephone No.: Telex No.: Fax No.: E-mail: 1.3 Address of the applicant for correspondence: Pin code: Telephone N .....

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..... ame and activities of associate companies/concerns. Name/Address/Phone Nos./Type of activity/Ownership details/Nature and quantum of financial trading. 2.7 List of major shareholders (holding 5% or more voting rights) and percentage of their shareholdings. 3. Details of infrastructural facilities: 3.1 Office space (mention the extent of area and ownership details available). 3.2 Office equipment (mention the details of electronic office equipment, typewriters, telecommunication equipment, furniture and fixtures, other communication facilities, etc.) (For point Nos. 3.1 and 3.2, please mention the infrastructure for debenture trustee activity separately) 4. Business plan (for three years) (a) History, major achievements and present activity .....

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..... trustee (Name of the body corporate, on whose behalf the applicant has acted as debenture trustee, particulars of debenture issue, size of debenture issue, when trust deed is signed, remuneration/fee received.) 8.2 Details where applicant has resigned as debenture trustee or have discharged therefrom, give full details and reasons therefor. 8.3 In case of resignation or discharge as the case may be whether the applicant has vacated the office before the appointment of successor. If so, give reasons and full details. 8.4 Whether the applicant has ensured that security has been created in the stipulated time in respect of debentures it acted as debenture trustee. 8.5 Whether the applicant has taken steps like appointment of nominee directors .....

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..... ................. Name of applicant Name of applicant Place: Place: Date: Date: 4 [***] FORM B Securities and Exchange Board of India (Debenture Trustees) Regulations, 1993 [ 5 [Regulation 8]] 6 [Certificate of Registration] 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 Rules and Regulations made thereunder for the debenture trustee, the Board hereby grants a certificate of registration to......as a debenture trustee, subject to the conditions in the Rules and in accordance with the Regulations. II. Registration Code for the debenture trustee is........ 7 [III. This certificate of registration shall be valid unless it is suspended or cancelled b .....

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..... complied with the terms and conditions mentioned in the registration letter? 2. Whether the applicant has complied with the SEBI (Debenture Trustees) Rules and Regulations and the guidelines issued by SEBI from time to time. 3. Whether any associate/group company of the applicant is also registered with SEBI under any Regulations, and if so the following details are to be furnished: Name of the company/ concern SEBI Regn No. Any warning given/penal action taken/investigation/enquiry initiated/pending 4-5. Whether any investigation/enquiry has been initiated/is pending against the applicant. 6. Whether the applicant has submitted all the quarterly reports. 7. Any warning given/penal action taken against the applicant. 8. Whether the applica .....

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..... (Change In Conditions Of Registration Of Certain Intermediaries) (Amendment) Regulations, 2016 w.e.f. 08-12-2016. Prior to this the words were substituted by the SEBI (Debenture Trustees) (Amendment) Regulations, 2011, w.e.f. 5-7-2011 for the words Certificate of Registration . 7 Substituted by the Securities and Exchange Board of India (Change In Conditions Of Registration Of Certain Intermediaries) (Amendment) Regulations, 2016 w.e.f. 08-12-2016. Prior to substitution paragraph III read as under: III. This certificate of registration shall be valid from .. to . / for permanent, unless suspended or cancelled by the Board. Prior to this paragraph III was substituted by the SEBI (Debenture Trustees) (Amendment) Regulations, 2011, w.e.f. 5-7- .....

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