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Application for grant of certificate of registration as Vault Manager

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..... ill 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 .....

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..... 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 con .....

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..... mplete 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 (VAU .....

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