Formats for Currency Derivatives Segment (To Be Submitted by Banks Only)

Formats for Currency Derivatives Segment (to be submitted by banks only)

Membership Application

(On the letterhead of the applicant member)

To be signed by at least two Authorised signatories

Date: ______

To,

The Managing Director,

National Stock Exchange/National Securities Clearing Corporation

Exchange Plaza

Bandra-Kurla Complex

Bandra (E)

Mumbai – 400 050

Subject: Application for Membership

Dear Sir,

I/ We am/are desirous to become the Member of the National Stock Exchange of India Ltd and/or National Securities Clearing Corporation Ltd I/We hereby apply for the said membership, and undertake to conform to and to abide by the Memorandum & Articles of Association and the Rules, Bye-Laws, Regulations, Business-Rules, Circular, Notifications and office orders, issued by the Exchange/Clearing Corporation from time to time. I/We shall be liable for all contracts and transactions in the exchange entered by us or by our authorized representatives and I/We shall comply with all requirements of the Exchange relating to settlement thereof. I/we also abide by all decisions of the Exchange/Clearing Corporation with respect to the operation of the Exchange/Clearing Corporation and would perform accordingly in meeting my/our financial, regulatory and operational responsibility as decided of the Exchange/Clearing Corporation from time to time.

Thanking You.

Yours sincerely

______

Signature with Stamp Signature with Stamp

Place:

APPLICATION FORM FOR MEMBERSHIP OF NATIONAL STOCK EXCHANGE LTD/NATIONAL SECURITIES CLEARING CORPORATION LTD

Please tick any one of the option mentioned below

CURRENCY DERIVATIVES SEGMENT

Trading member

Trading and Clearing member

Professional Clearing member

1. Name of Applicant :

(In BLOCK Letters)

1. Constitution: (please specify)

1. Date of Incorporation: DD/MON/YYYY

1. Permanent Account No :

1. Brief Description of principal activity of the applicant :

1. Brief description of group, if any, to which the applicant belongs :

1. Head Office :

Flat/Door/Block no.
Name or Premise/ Building
Road/Street/Lane/Post Office
Area/Locality/Taluka
City
District
State/Union Territory
Pincode
STD Code
Telephone No.
Mobile No.
Fax
E-mail ID
Website

1. Correspondence/Mailing address –

(Pls give the complete details as point no. 7, in case the same is different from registered address)

Flat/Door/Block no.
Name or Premise/ Building
Road/Street/Lane/Post Office
Area/Locality/Taluka
City
District
State/Union Territory
Pincode
STD Code
Telephone No.
Mobile No.
Fax
E-mail ID
Website

1. Details of the Chief Executive Officer/Managing Director

Name
Designation
Tel. No.
Fax No.
Mobile No.
E-mail ID
PAN

1. a) Net worth of the applicant as per RBI guidelines is Rs.______Crores as on ______(date - DD/MON/YYYY)

(The Networth certificate duly certified by chartered account is enclosed)

b) CRAR (in %) is ______as per last audited statement.

c) Net NPA (in %) is ______as per last audited statement.

d) Net profits (for past 3 years) are as follows:

Year / Profits

1. Name of the Exchange (s) on which the applicant/ group company /associate company is a member

Sr. No. / Name of the Exchange / Registration no. granted by Regulator(s)

(Details provided in Annexure C – 2)

1. Details of compliance officer

Name
Mobile No.
Email
PAN

1. Details of Income Tax Paid. (Copy of the latest Income Tax Assessment Order enclosed)

1. Details of processing fees paid in favour of NSEIL.

Payment in the form of / Demand Draft / Pay order / Cheque
Instrument no.
Issuing Bank
Amount
Instrument date

1. Please give the following details of the applicant (Yes/No- In case answers to any of the above questions is yes, then please provide complete details)

Sr. No. / Particulars / Yes/No
a) / Have you ever been declared a defaulter by any recognized Exchange?
b) / Whether any disciplinary action has been taken by any stock exchange /SEBI / RBI against the applicant or any of the promoters/directors?
c) / Whether the applicant/directors have ever been associated with member of any other stock exchange?

I/We hereby state that the particulars given in the application form are true, correct and complete to the best of my/our knowledge and information. I/We also state that no relevant material fact has been suppressed.

I/We also hereby undertake that I/we have never been declared/rendered incompetent to enter into contract under any law in force in India. Further, I/we have never committed any act which may render us liable to be wound – up and I/we have reported about provisional liquidator or receiver or official liquidator appointed to us, if any, by a competent court.

I/We undertake that all court cases against applicant / directors / promoters /staff have been disclosed by us and that none of them is / are involved in any financial irregularities. I / promoters / directors have never been adjudged bankrupt or have been proved to be insolvent at any time. I/we have disclosed if involved, all litigations, suits or proceedings and any financial liability of contingent or unascertained nature. Further, the applicant / promoters/directors have never been convicted of an offence involving fraud or dishonesty or financial irregularities and have never been pronounced guilty of a criminal offence involving moral turpitude.

I/We have disclosed and reported all the details in regard to inquiry / investigation, if any, that has been conducted by any authorities including government agencies against applicant / promoters / directors etc., during past 10 years and the findings of the concerned agencies available with us have been disclosed fully along with this application.

I/We undertake that any misstatement or misrepresentation or suppression of facts in connection with this application for trading/clearing membership or breach of any undertaking or condition of admission to trading/clearing membership entails rejection of application or of trading cum clearing membership.

I/We shall pay the required fee and deposits to the Exchange and submit the necessary documents as required by the Exchange for my/our seeking the trading/clearing membership of the Exchange/ Clearing Corporation. I/We also agree to provide Exchange/ Clearing Corporation with all such documents as may be called for and be required by Clearing Corporation from time to time. I/We hereby undertake that we will immediately notify the NSE/Clearing Corporation of any change in information provided in the application.

I/We hereby undertake to inform NSE/Clearing Corporation about any change in the above mentioned facts within 15 days of the change taking place/coming to our knowledge, whichever is earlier.

For and on behalf of the Board

Signatories* (With name in Block Letter)

1.

2.

Encl:

1. Disclosures, if any
2. Current status / No Objection Certificate from the concerned agency which is carrying out inquiry/investigation, if any.

Name of the applicant

Date:

Place:

Stamp :

Photographs of signatories

*To be signed by authorized signatories as appointed in Board Resolution.

Annexure: C-1

Certificate dated ______submitted by ______to NSEIL/NSCCL

CERTIFICATE

This is to certify that the Net worth of M/s.______as on ______as per RBI guidelines is Rupees______only.

We further certify that:

• The computation of networth based on my / our scrutiny of the books of accounts, records and documents is true and correct to the best of my / our knowledge and as per information provided to my / our satisfaction.

• The computation of networth is in accordance with RBI guidelines.

Place: For (Name of Accounting Firm)

Date:

Name of Partner/Proprietor

Chartered Accountant

Membership Number

Annexure: C-2

Certificate dated ______

submitted by ______(applicant) to NSEIL/NSCCL

Details of other exchange memberships held by the applicant entity,

holding company, subsidiary company as on ______

S.No / Name / Relation@ / Exchange / Since (specify the date) / Membership No. / Mode of acquisition / Remarks#
1
2
3
4
5

Date:

Place:

Authorised Signatory/Director (s)

NOTES :

@: Give details e.g.:

SELF for membership in the name of company.

PARTNER, CHAIRMAN, WHOLE TIME DIRECTOR, DIRECTOR, HOLDING, SUBSIDIARY.

#: For each of these memberships, give details of disciplinary action, if any, taken by the Stock Exchange or any other regulatory authority in respect of these memberships with dates, providing details such as Expulsion/Suspension/Declared Defaulter/any other disciplinary action or enquiry against the member

Annexure : C-3

Certificate dated ______

submitted by______(applicant) to NSEIL

DETAILS OF DIRECTORS AS ON ______

Sr
No / Name $ / Fathers
Name $ / Designation
@ / Date
of
Birth / Education / PAN
Number / Residential
Address
& Telephone
Nos. / Designated directors
(Yes/No)
# / Share holding * / Directorships/ / controlling shareholding
in other cos.
No. / Amt / %
of total
1
2

NOTES :

@Please clearly state whether the Director is a Managing Director or Wholetime Director or Executive Director or Non-Executive Director or Executive Chairman or Non-Executive Chairman

# Identify at least two designated directors (A designated director is one who is a graduate by qualification (or CA, ICWA or CS) and possesses at least 2 years of banking experience. Every trading member corporate should have at least 2 such directors who meet the aforesaid norms.)

$ All initials to be expanded

Date:

Place:

Authorised Signatory/Director (s)

CERTIFICATE (for corporate only)

This is to certify that the details of directors in ______as given above, based on my/ our scrutiny of the books of accounts, records and documents is true and correct to the best of my/our knowledge and as per information provided to my/our satisfaction.

Place:For (Name of Accounting Firm)

Date:Name of Partner/Proprietor Chartered Accountant Membership Number

Annexure : C-5

Certificate dated______

submitted by ______to NSEIL

DETAILS OF INFRASTRUCTURE / OFFICE

MAIN DEALING OFFICE
ADDRESS
CITY
STATE:
PIN
TELEPHONE
FAX
TELEX
Carpet area of office @ sq. feet
Ownership / Leased /
Others(specify) @ sq. feet
Contact Person / Authorised Signatory and designation :
OTHER OFFICE(S)
ADDRESS
CITY
STATE:
PIN
TELEPHONE
FAX
TELEX
Carpet area of office @ sq. feet
Ownership / Leased /
Others(specify) @ sq. feet
Contact Person / Authorised Signatory and designation :

@ : Give documentary reference

______

Signature of Authorised Signatories with rubber stamp

Annexure : C-6 (For Corporate)

Certificate dated______

submitted by ______to NSEIL

SHARE HOLDING PATTERN of ______as on ______

EQUITY / PREFERENCE (Please indicate and use separate sheets for equity/preference shares)

Sr No. / Name $ / Number of shares held / Face value per share / Amt Paid up
(Rs. In lakh) / % of total
1
2
3
4
5
6
7
8
Others
TOTAL / 100%

$ All initials to be expanded

NOTES:

1. Persons holding 2% or more of the paid up capital should be shown separately and not clubbed in Others.

Date:

Place: Authorised Signatory/Director (s)

1. CERTIFICATE

This is to certify that the shareholding in ______as given above, based on my/ our scrutiny of the books of accounts, records and documents is true and correct to the best of my/our knowledge and as per information provided to my/our satisfaction.

Place:For (Name of Accounting Firm)

Date:Name of Partner/Proprietor

Chartered Accountant

Membership Number

To be submitted by corporate

Annexure : C-9

Certificate dated______

submitted by______to NSEIL

Sr.
No / Name of the Stock Exchange(s) on which company is listed / Listed since (date)
1
2
3
4

Date:

Place:

Authorised Signatory/Director (s)

.

Format for Non-Defaulter Undertaking

UNDERTAKING

(To be given on the letterhead of the company)

We, ______-, hereby declare that we have neither been declared defaulters by any Exchange in India/ by SEBI, nor are we related or associated with any other entity/person that have been declared defaulters by any Stock Exchange in India/SEBI.

We, M/s. ______further declare that none of the shareholders and directors of our company have been declared as defaulters by any Stock Exchange in India/SEBI or are related or associated with any other entity/person who have been declared defaulters by any Stock Exchange in India/SEBI.

We further declare that no enquiry/investigation has been initiated / pending against ______by any Stock Exchange/SEBI.

For and on behalf of the Board

(To be Stamped & Signed by authorised signatories)

Date:

UNDERTAKING WITH RESPECT TO DESIGNATED DIRECTORS

PART 1 TO WHOMSOEVER IT MAY CONCERN

(To be certified by a practicing chartered accountant/ practicing company secretary)

This is with reference to the application of M/s ______(Applicant Company) for seeking provisional membership of the Exchange/NSCCL and subsequent application for registration of application with SEBI in Currency Derivatives Segment.

Based on the information, explanation and documents given to us, we state that the designated directors Mr./Ms. ______and Mr./Ms. ______(names of designated directors) meet the eligibility requirements as prescribed in Securities Contracts (Regulation) Rules, 1957 (Rule 8(4A) and other relevant provisions) and SEBI (Stock Brokers & Sub-brokers) Regulations, 1992.

This confirmation has been issued on the request of the applicant company for submitting to the NSEIL/NSCCL/SEBI.

For M/s

Chartered Accountant

Stamp and Signature

Membership No.

Place:

Date:

UNDERTAKING WITH RESPECT TO DESIGNATED DIRECTORS

PART IITO WHOMSOEVER IT MAY CONCERN

(To be stamped and signed by authorised signatories/company secretary of applicant corporate)

We, M/s______hereby confirm that our designated directors Mr./Ms. ______and Mr/Ms. ______meet the eligibility requirements as prescribed in Securities Contracts (Regulation) Rules, 1957 (Rule 8(4A) and other relevant provisions) and SEBI (Stock Brokers & Sub-brokers) Regulations, 1992.

We undertake to ensure that the above individuals or whosoever is identified by the corporate as designated directors, in future, till the time corporate is registered as a member or the Exchange will continue to meet the eligibility requirements as per Securities Contracts (Regulation) Rules, 1957 and SEBI (Stock Brokers & Sub-brokers) Regulations, 1992.

For M/s

(name of applicant company)

Place:

Date:Stamp and Signature

CERTIFIED TRUE COPY OF BOARD RESOLUTION

RESOLVED THAT: I/We (name of applicant company) is and hereby authorized for applying for membership on the National Stock Exchange of India Limited and /or National Securities Clearing Corporation Limited in the following segments (tick whichever is applicable):

• Currency Derivatives Segment – Trading Member
• Currency Derivatives Segment – Trading and Clearing Member
• Currency Derivatives Segment – Professional Clearing Member.

FURTHER resolved that (name with designation) and / or (name with designation)are authorized to execute individually/jointly (strike whichever is not applicable) the documents necessary for acquiring membership on behalf of the company. Their specimen signatures are as follows:

Sr. No / Names of authorized signatories / Specimen Signatures

Certified to be true.

For (name of bank)

(Names and signatures of authorized signatories of the applicant or designated directors or company secretary of the applicant).

Place:

Date:

UNDERTAKING

We undertake to confirm that ______is authorized by the Reserve Bank of India under section 10 of the Foreign Exchange Management Act 1999 as ‘AD Category – I’ Bank.

We further certify that we fulfill the following minimum prudential requirements:

a)Minimum net worth of Rs. 500 crores

b)Minimum CRAR of 10 per cent.

c)Net NPA not exceeding 3 per cent

d)Made net profits for past three years.

We also undertake that we have been permitted by the respective Regulatory Departments of the Reserve Bank to participate in the Currency Futures Market.

Certified to be true.

For (name of applicant)

(Names of authorized signatories along with signatures and rubber stamp of applicant company).

Place:

Date:

CERTIFICATE (for corporate only)

This is to certify that the details as given above, based on my/ our scrutiny of the books of accounts, records and documents is true and correct to the best of my/our knowledge and as per information provided to my/our satisfaction.

Place: For (Name of Accounting Firm)

Date:

Name of Partner/Proprietor

Chartered Accountant

Membership Number

(on the letterhead of the applicant)

DECLARATION REGARDING ASSOCIATION / NON-ASSOCIATION WITH OTHER RECOGNIZED STOCK EXCHANGES / COMMODITY EXCHANGES

I / We / M/s (Name of applicant), hereby declare the following:

(a)Are you a member of any other recognized Stock Exchange(s) or Commodity Exchange(s)?

YES NO

(b)Incase yes, kindly provide the following details:

Sr. No / Name of Exchange / Trading segment / Authority granting registration / Registration number / Registration date

For M/s

(name of company)

Stamp and Signature

Place:

Date:

FORM AB

APPLICATION FORM FOR REGISTRATION AS TRADING AND/OR

CLEARING MEMBER IN CURRENCY DERIVATIVES SEGMENT

1. Name of the Currency Derivatives Exchange/Segment/Clearing Corporation/Clearing House of which the applicant is the member. Please furnish the tenure of membership.

2. Name of the Member with Code No.

3. Whether the applicant is to act as Trading member and/or Clearing member and/or Self Clearing Member

4. If the applicant is to act as Trading member, the applicant to furnish the name and details of the Clearing member, through whom, he intend to clear and settle his trade

5. Address of the Member

6. Trade Name of Member

7. Form of Organisation: Sole proprietorship/Partnership/Corporate body/Financial institution (Please give names of proprietor/partners/directors).

8. Please furnish a copy of Memorandum and Articles of Association or the Partnership Deed, as the case may be.

9. Educational Qualifications of proprietor/partners/directors, etc.

10. Whether the applicant or its sales personnel or approved user has passed any certification programme? If so, please specify the detail.

11. The experience of the applicant or their two directors or partners in Currency derivatives trading or securities market, if so, please give details.

12. Date of admission to membership to the Currency derivatives exchange or Currency derivatives segment/Clearing Corporation/Clearing House.

13. Whether member of more than one exchange or currency derivatives segment or clearing corporation or clearing house of any segment? If so, please give name(s) of the Clearing Corporation/clearing house, or any stock exchange(s) with code number(s)?

14. Networth of the applicant. Please furnish details along with necessary documents in support thereof.

15. Whether the applicant or its director or partners, any time convicted of any economic offence? If so, please furnish the details?

16. Whether the applicant or its directors or partners, declared insolvent/bankrupt or declared defaulter by any exchange? If so, please furnish details?

17. Whether the applicant or its directors or partners anytime subjected to any proceedings or penalty by the Board under SEBI Act or any of the regulations framed under the SEBI Act? If so, please furnish the details.

18. Indicate fax, telex and phone number(s).

19. Whether the application is accompanied by a requisite fee as per Schedule IV A of the Regulations as applicable to the applicant.