List of Documents required from existing CSE trading ...



List of Documents required from existing CSE trading members for getting SEBI Registration for Equity Derivative Segment of CSE for the limited purpose of sharing the Derivatives Segment of

NSE and or other Exchanges under Section 13 of SCRA.

(Individual)

|1 |Application to CSE for admission as Trading member on derivative segment of NSE/BSE u/s 13 SCRA | |

|2 |Application Form | |

|3. |Application form as Trading Member in F & O Segment | |

|4. |Additional information | |

|5. |Net worth Certificate and Computation of Net-worth (as per Annexure – A-1 and A-2/AA2) | |

| |Please note that the networth requirement for F&O segment is Rs.18 lakh | |

|6. |Details of Individual/Proprietor (as per Annexure – A-3) | |

|7. |Declaration Regarding Association / Non-Association With Other Recognized Stock Exchanges / Commodity Exchanges | |

| |(as per Annexure – A-4) | |

|8. |Disclosure of PAN Details (as per Annexure – A-5) | |

|9 |Proof of Age and Residence proof and qualification of Proprietor and Experience Certificate | |

|10 |Undertaking for Fit and Proper Person (As per Annexure –A-6) | |

|11 |Undertaking With Respect To Proprietor (As per Annexure –A-7) | |

|12 |Undertaking Regarding Violations/Non-Adherence To Securities Market Related Regulations (As per Annexure –A-8) | |

|13 |Undertaking (As per Annexure –A-9) | |

|14 |Infrastructure Undertaking (As per Annexure –A-10) | |

|15 |Copy of NCFM Certificate in Derivatives Segment duly attested by the candidate and countersigned by the | |

| |applicant (proprietor) | |

|16 |If member of another Stock Exchange, please submit details of stock exchange membership (as per Annexure – A-11)| |

|17 |Details of Regulatory Actions by SEBI Annexure A-12 | |

|18 |There is no adverse comment against us or our firm in the following:- | |

| | | |

| |Defaulters list of RBI as available at - Suit filed cases - Suits filed of Rs.100 lakhs and above | |

| |and Suits filed of Rs.25 lakhs and above (as per latest data available), | |

| | | |

| |b. Prosecution list of CIS (as per latest data available) and non-CIS (as per latest data available) cases on | |

| |the SEBI website (as per latest data available) in | |

| |i) Database of prosecution launched against CIS entities | |

| |ii) Database of prosecution launched against other than CIS entities | |

| | | |

| |c. List of companies & Directors/shareholders/ proprietors against which orders have been passed U/s 11B of SEBI| |

| |Act. (As per latest data available in Vanishing Companies under Issues and Listing on .in). | |

|19 |Experience Certificate (to be given by the Exchange in case of existing member) | |

|20 |Bankers Report (to be taken by the Exchange on behalf of the member from the concerned bank) | |

|21 |A Photo Copy of SEBI Registration Certificate | |

|22 |Confirmation of Clearing Member (to be given by the Exchange) | |

|23 |Undertaking to be submitted by the applicant seeking registration / prior approval Annexure A-13 | |

|24 |Broker Database (Format to be taken from CSE Website) | |

Date: _______________

Managing Director & CEO

The Calcutta Stock Exchange Limited,

7, Lyons Range,

Kolkata-700 001.

Sir,

Sub: Application to CSE for admission as Trading member on derivative segment of NSE/BSE u/s 13 SCRA.

I _______________ S/o.__________________. Residing At_____________________ _____________ (Tel ) hereby apply for Trading Membership of Equity Derivative Segment on the Calcutta Stock Exchange Limited(CSE) for the limited purpose of enabling us to trade on NSE Equity Derivatives Platform and/or any other Equity Derivatives Platform as per the Bye-laws , Rules, Regulations, Notifications of CSE /SEBI ,SCRA and the arrangement by CSE with NSE and/or any other Exchanges u/s 13 of SCRA.

We hereby apply for the said Trading Membership as per the details given below, and undertake to conform to and to abide by the Memorandum & Articles of Association and the Rules, Bye-Laws, Regulations, Business-Rules, Circulars, Notifications and office orders etc., issued by the Exchange/Clearing House/Clearing Corporation from time to time. We shall be liable for all contracts and transactions in the exchange entered by us or by our authorized representatives and we shall comply with all requirements of the Exchange relating to settlement thereof. We also confirm to abide by all decisions of the Exchange/Clearing House/Clearing Corporation with respect to the operation of the Exchange/Clearing House/Clearing Corporation and would perform accordingly in meeting my financial, regulatory and operational responsibility as decided of the Exchange/Clearing House/Clearing Corporation from time to time.

We further undertake to confirm that we shall also comply with the Rules, Byelaws, Regulations & Circulars of NSE and any other Exchange where we will be sharing the Trading Platforms regarding trading, clearing & settlement, risk management etc. in respect of our transactions on NSE and/or any other Exchange u/s 13 of SCRA.

Please find enclosed our application along with other relevant documents.

Date:

Place: Kolkata

-----------------------------------------

Signature of the applicant

|[pic] |

APPLICATION FORM (For individual)

(To be completed in Capital Letters)

| 1. Name of the Applicant …………………………………………………………………… | |

| | |

| |Affix Passport Size |

| | |

| |Photograph of the |

| |Individual |

| |Applicant |

2. Particulars of the Applicant :

|Father’s Name | |

|Age | |

|Date of Birth | |

|Educational Qualification | |

3. Correspondence Office Address details:

|Address | |

|City | |

|District |  |

|State/Union Territory | |

|Pin code | |

|STD Code | |

|Telephone No. | |

|Fax | |

|E-mail ID | |

|Website | |

4. Details of Infrastructure / Office: (In case the applicant has any other offices, the details of the same can be given in similar format)

|Address | |

|City | |

|State | |

|PIN | |

|Telephone | |

|Fax | |

|Carpet Area of office in sq. feet | |

|Ownership / Leased, etc. | |

|Contact Person / Authorized Signatory and | |

|designation | |

5. Details of Compliance Officer

|Name | |

|Mobile No. | |

|Email | |

|PAN | |

|Date of Appointment | |

|Educational Qualification | |

6. Name and address of the banker/s and the facilities availed from such bank/s.

(Please enclose reference letters from each bank)

|Name & Address of the Banker |Facilities availed from this Bank |

| | |

7. Please give the following details of the applicant (If Yes, please provide complete details)

|Sr. # |Particulars |Yes/No |

|a) |Whether the applicant is a citizen of India | |

|b) |Business or profession in which the applicant was last occupied | |

|c) |Whether the applicant is connected with any other business or profession? | |

|d) |Whether ever compounded with creditors, if yes, on what terms? | |

|e) |Whether even adjudged bankrupt or proved to be insolvent? | |

|f) |Have you had a provisional liquidator or receiver or official liquidator appointed to it by a competent court? | |

|g) |Are you aware that on admission of membership of the Exchange the applicant will have to severe connection with any| |

| |business other than that of securities? | |

|h) |The applicant is not associated with any of the members /sub-brokers / authorized persons of the Exchange. | |

|i) |Is the applicant also a member of other Stock Exchange? If yes, please provide the information as per Annexure – A | |

| |-11 | |

|j) |Whether at any time expelled or declared a defaulter by any other Stock Exchange? | |

|k) |Whether engaged in fund based activities for 3 years? | |

|l) |Whether at any time your application was rejected by the Calcutta Stock Exchange Ltd., if yes, please mention the | |

| |date of rejection and the reason thereof? | |

8. In case of partnership firm, all the details of partners required:

9. Principle activity of the applicant:

10. Brief Description of group, if any, to which the applicant belongs:

We hereby undertake / state that:

- The above-mentioned particulars are true, correct and complete to the best of our knowledge and information and no relevant material fact has been suppressed.

- There is no misstatement or misrepresentation or suppression of facts in connection with this application for trading membership or breach of any undertaking or condition of admission to trading membership entails rejection of application or of trading membership.

- 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.

- We shall pay the required fee and deposits to the Exchange and submit the necessary documents as required by the Exchange for our seeking the trading membership of the Exchange and as required from time to time.

- We will notify the Exchange within 15 days of any change in information provided in the application.

-----------------------------------------

Signature of the Applicant

Date:

Place:

APPLICATION FORM AS TRADING MEMBER IN F & O SEGMENT

…………………………………………………………

|1 |Name of the Derivatives Exchange/ Segment/Clearing |: | |

| |Corporation/Clearing House of which the applicant is | | |

| |the member. Please furnish the tenure of membership | | |

|2 |Name of 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 Member |: | |

|6 |Trade name of Member |: | |

|7 |Form of organization-Sole proprietorship, Partnership,|: | |

| |Corporate body, Financial Institution. Please give | | |

| |name 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 derivatives trading or securities | | |

| |market, if so, please give details. | | |

|12 |Date of admission to membership to the derivatives |: | |

| |exchange or derivatives segment/Clearing | | |

| |Corporation/Clearing House | | |

|13 |Whether member of more than one Stock |: | |

| |Exchange/Derivative segment/clearing house/clearing | | |

| |corporation? If so, please give name of the Stock | | |

| |Exchange(s) with code no. | | |

|14 |Net worth 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 of the Regulations as | | |

| |applicable to the applicant. | | |

I declare that the information given in this form is true and in the event of any information furnished is false, misleading or suppression of facts; my certificate of registration is liable to be cancelled by SEBI without assigning any reasons whatsoever

|Dated: |Signature |

| | |

| | |

Recommendation for Equity Derivative Segment of CSE for the limited purpose of sharing the Derivatives Segment of NSE and or other Exchanges under Section 13 of SCRA

--------

This is to certify that _________________________________________________ is a member of this Derivatives Exchange/Derivatives Segment or Clearing Corporation or Clearing House and is recommended for registration.

Signature :

Name :

Designation :

ADDITIONAL INFORMATION

-------------

|1. |Name of the Stock Exchange |: |The Calcutta Stock Exchange Ltd. |

|2. a) |Name of the Applicant Member Broker |: | |

| b) |Exchange Clearing Code No.(allotted |: | |

| |By the Stock Exchange) | | |

|3. |Trade Name of Member |: | |

|4. |Address of Member |: | |

| | | | |

| |Tel. No.(O) |: | |

| |Tel. No.(R) |: | |

| |Fax No. |: | |

|5. |Form the Organization. Please tick the relevancy |

| (a) |Sole Proprietorship | | | |(b) |Partnership | |

| | | | | |

| (c) |Corporate Body | | | |1) |Financial Institution |

| | |

| 2) |Others | |

|3) |Foreign Joint Venture | |

(If an Indian Company is holding more than 25% of total equity in the joint venture, please give details of top five shareholders of Indian Company)

| NAME OF INDIAN COMPANY |% HOLDING |

|Top 5 Shareholders | |

|1. | |

|2. | |

|3. | |

|4. | |

|5. | |

| FIPV Approval if applicable |

6. A) Sole Proprietorship

|Name of Proprietor |Educational Qualification |Age (on the date of filing of |Experience (specify the nature and |

| | |application) |years) |

| | | | |

B) Partnership

|Name of partners |Age (on the date of |Educational Qualification |Experience (specify the |In case of partner(s) are |

| |application) | |nature and years)) |registered with SEBI, give|

| | | | |SEBI Regd.No. |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

C) Corporate Body (Financial Institution/Others)

1) MOA object clause contains stock broking as one of the object in

|a) |Main Object | |

|b) |Other Object | |

|c) |Incidental Object | |

(If stock broking clause appears in other object, please attach a copy of special resolution to amend the MOA to incorporate Stock Broking in main object clause)

|2) |Mention relevant clause no. | |

(Please enclose copy of the relevant clause of the MOA duly certified by the stock exchange. If certified copy is not enclosed application would be returned)

3) Information regarding directors

|Name of directors with |Percentage of Share |Educational Qualification |Experience (specify the |Whether directors in other|

|Designation whether whole |holding | |nature and years) |corporate bodies engaged |

|time/designated/additional| | | |in capital markets (please|

| | | | |give names and SEBI |

| | | | |Regd.No. |

| | | | | |

| | | | | |

| | | | | |

4) Details of top five shareholders

|Name of shareholders |Percentage of Share |Educational Qualification |Experience (specify the |Whether directors in other|

| |holding | |nature and years) |corporate bodies engaged |

| | | | |in capital markets (please|

| | | | |give names and SEBI |

| | | | |Regd.No. |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

|7.a) |Date of admission to Membership | |

|2) |Conversion | |

|3) |Succession | |

|4) |Auction Purchase | |

| |(In case member has become defaulter) | |

|5) |Market Purchase | |

|6) |Transfer to another Company Under same management |

| |(please specify reasons) |

|7) |Others | | Please specify | |

|c) |Please give the following information in all the cases | | |

| |other than the case of new membership | | |

|1) |Name of the previous holder | | |

| |of the card | | |

|2) |SEBI Registration No. | | |

|3) |Date of Registration with | | |

| |SEBI | | |

|d) |Whether the applicant is member of more than one stock exchange ? |

|YES | | NO | |

|e) |If yes, please give name(s) of the stock exchange(s) with Code No. and SEBI Registration No. |

|Name of exchange(s) | | |

|SEBI Registration No. | | |

8. a) Whether any of the Associate Companies/Partnership/Proprietorship Firm is/are

having direct/indirect interest (* as defined below) in capital market.

|YES | | NO | |

• The member is deemed to have direct/indirect interest in the following conditions:

|1) |Where he is individual, he or any of his relative being a broker/any intermediary, he or any of his relative being a |

| |partner in broking firm/any intermediary, he or any of his relative being a director in a broking company/any |

| |intermediary or he or any of his relatives clubbed together holding substantial equity in any broking company/any |

| |intermediary company engaged in capital market |

| | |

|2) |Where it is partnership firm/company, the relative(s) of the partner(s) director(s) in the firm(s)/corporate body being|

| |a broker/any intermediary or being partner(s)/director(s) in any broking/intermediary or the same set of shareholders |

| |holding substantial equity in other broking/any intermediary engaged in capital market |

| | |

|3) |Relative shall mean husband, wife, brother, unmarried sister or any near ascendant or descendant of an individual |

b) If yes, please give details (you may attach separate sheet, if required)

|Name |Form of organization |Type of intermediary # |Whether registered with |Nature of interest |

| | | |SEBI (give Regd. No.) | |

| | | | | |

| | | | | |

| | | | | |

# Merchant Banker, Portfolio Manager, Registrar to issue & Share Transfer Agent,

Banker to an issue, Mutual Fund, Venture Capital, Underwriter, Debenture Trustee, FII

9. Disciplinary Action initiated/taken against the Associate entities, as indicated in 8(b) above (Please state details of nature of violation, action initiated/taken and by which authority)

a) Disciplinary action taken by SEBI (if yes, please attach details mentioning nature of violation and action taken)

|YES | | NO | |

b) Disciplinary action taken by any other authority (please attach details of nature of violation and auction initiated)

|YES | | NO | |

c) Disciplinary action initiated by SEBI (if yes, please attach details of nature of violation and action initiated)

|YES | | NO | |

d) Disciplinary action initiated by any other authority (please attach details of nature of violation and action initiated)

|YES | | NO | |

|10. a) |Net-worth as per requirement of the exchange (Rs. In Lakhs) | | |

| |(Individual 18 lakhs , Corporate 32 Lakhs) | | |

| | | | |

| | | | |

| b) |Applicant’s net-worth in accordance with formula prescribed | | |

| |By concerned stock exchange (Rs. In Lakhs) | | |

(Certificate from a qualified C.A. certifying the above should be enclosed)

| c) |Please indicate the net-worth as per the following formula (Rs.in lakhs) | | |

| | | | |

|1) |Paid up Capital | | |

| | | | |

|2) |Free Reserves (Exclusive of Revaluation Reserves) | | |

| | | | |

|3) |Less Misc. Expenditure not written off | | |

| | | | |

|TOTAL NET-WORTH (1+2-3) | |

| | |

| | |

I/we declare that the information given in this form is true to the best of my knowledge and belief.

Date: Signature

Name and Address of the applicant

LIST OF ENCLOSURES :

1. Copy of relevant clause of MOA duly certified by the stock exchange.

2. Certificate from the qualified Chartered Accountant certifying the net-worth and

paid up capital

3. 90 Undertaking by applicant that he/she had not introduced through any member

broker/sub-broker of the exchange any fake/forged shares in the Exchange/market

If yes, details thereof including action taken, if any, by the applicant.

Certification by Stock Exchange

The above details have been scrutinized as per record made available to the stock exchange.

SIGNATURE :

Name :

DESIGNATION :

SEAL OF STOCK EXCHANGE:

ANNEXURE : A-1

(For Individuals)

NETWORTH CERTIFICATE

(In original & on the letterhead of the Chartered Accountant)

This is to certify that the Net worth of M/s./Mr./Ms.______________________as on _____________as per the statement of computation of even date annexed to this report is Rupees______________ only ( Rupees______).

We further certify that:

▪ M/s./Mr./Ms._________________ is not engaged in any fund-based activities or business other than that of securities. Existing fund based assets, if any have been divested from the books of account and have not been included for the purpose of calculation of net worth.

▪ the computation of net worth 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 net worth is in accordance with the method of computation prescribed by Dr. L C Gupta Committee Report i.e.Annexure-AA1

Place: For (Name of Chartered Accountant)

Date:

Name of Partner/Proprietor

Chartered Accountant

Membership Number

(Note: Methodology for calculating net worth is given in Annexure AA-1)

Annexure AA-1

Format for Calculation of net worth for an Individual , Partnership & Corporate Firm

The method of computation of Networth as prescribed by Dr. L.C. Gupta Committee on Derivatives for trading members is as follows

Capital + Free Reserves

Not including :- Non-allowable assets viz.,

a) Fixed Assets

b) Pledged Securities

c) Member’s Card

d) Non-allowable Securities ( Unlisted Securities )

e) Bad deliveries

f) Doubtful Debts and advances*

g) Prepaid Expenses and Losses

h) Intangible Assets

i) 30 % of marketable securities

*Explanation:

Includes debts/advances overdue for more than three months or given to associates.

Place: For (Name of Accounting Firm)

Date:

Name of Proprietor

Chartered Accountant

Membership Number

Annexure – A-3

DETAILS OF PROPRIETOR / INDIVIDUAL AS ON

|Sr.No |Name $ |Fathers |Designation |Date |Education |PAN |

| | |Name $ | |of | |Number |

| | | | |Birth | | |

| | | | | | | |

| | | | | | | |

| | | | | | | |

For M/s

(name of Proprietor)

Stamp and Signature

Place :

Date :

Annexure- A -5

(On the letterhead of the applicant)

To,

Membership Department

The Calcutta Stock Exchange Limited

7 Lyons Range

Kolkata-700 001

Madam/Sir,

Kindly find details i.e Name & PAN Card for all the entities mentioned below along with the certified copy of their PAN card (copies attached).

A    Promoters;

B    Associate(s) / Group companies;

C    Principal Officer / Key management person(s);

D   All entities / persons falling within the verticals of applicant, both from bottom to top (e.g. holding company) and top to bottom (e.g. subsidiary company), irrespective of whether they are registered with SEBI or any other regulatory authority as per details provided below:

|A |Details of Promoters . | | |

|Sr. No |Name of Entity |PAN card No. |Certified copy of PAN Card |

| | | |enclosed |

|1 |  |  | |

|2 |  |  | |

|B | | | |

| |Details of Associate/ Group Companies. | | |

|Sr. No |Name of Entity |PAN card No. |Certified copy of PAN Card |

| | | |enclosed |

|1 |  |  | |

|2 |  |  | |

|C | |

| |Details of Principal Officer/ Key management person. |

|Sr. No |Name of Entity |PAN card No. |Certified copy of PAN Card |

| | | |enclosed |

|1 |  |  | |

|2 |  |  | |

|D |Details of Holding Company & Subsidiary Company (irrespective of whether they are registered with SEBI or any other regulatory |

| |authority) |

|Sr. No |Name of Entity |PAN card No. |Certified copy of PAN Card |

| | | |enclosed |

|1 |  |  | |

|2 |  |  | |

…2

-2-

We confirm that the above stated facts and details are true and correct and we have not misrepresented and / or concealed /suppressed any material facts in this regard.

We also confirm that in the event of any false / incorrect particulars furnished by us or any misrepresentation of facts / suppression /concealment of facts by us, our application for membership may be rejected / our membership registration may be cancelled and penal action may be taken against us.

Yours Faithfully,

|(Signature) | |

| | |

|Name of Proprietor | |

| | |

| | |

| | |

| | |

| | |

|Rubber Stamp of Entity | |

| | |

Date:

Place:

Annexure –A-6

Undertaking for Fit and Proper Person

(Applicable to Proprietor)

(On the letterhead of the applicant)

I / We, M/s ____________ (name of the applicant) hereby declare that I/we am/are ‘fit and proper person’ as per SEBI (Intermediaries) Regulations, 2008, SEBI (Stock Brokers & Sub-brokers) Regulations, 1992 and Securities & Exchange Board of India (Stock Brokers & Sub-brokers) (Second Amendment)Regulations, 2013 as amended till date including with reference to following criteria:

(i) integrity, reputation and character;

(ii) absence of conviction and restraint orders;

(iii) competence including financial solvency and networth.

We further confirm the following in this regard:

(a) The applicant or its whole time director or managing partner has not been convicted by a Court for any offence involving moral turpitude, economic offence, securities laws or fraud;

(b)  No order for winding up has been passed against the applicant;

(c)  The applicant, or its whole time director, or managing partner has not been declared insolvent and has been discharged;

(d) No order, other than an order of suspension of certificate of registration as an intermediary, restraining, prohibiting or debarring the applicant, or its whole time director or managing partner from dealing in securities in the capital market or from accessing the capital market has been passed by the Board or any other regulatory authority wherein a period of three years from the date of the expiry of the period specified in the order has not elapsed;

(e) No order canceling the certificate of registration of the applicant has been passed by the Board on the ground of its indulging in insider trading, fraudulent and unfair trade practices or market manipulation;

(f) No order withdrawing or refusing to grant any license / approval to the applicant or its whole time director or managing partner which has a bearing on the capital market, has been passed by the Board or any other regulatory authority;

(g)  The applicant is financially sound;

(h) There is no other reason, recorded in writing by the Board, which in the opinion of the Board, renders such applicant or its whole time director or managing partner unfit to operate in the capital market.

(Signature)

Name of Proprietor

Rubber Stamp

Date:

Place:

Note: In case the applicant wishes to furnish any other details, the same can be provided as annexure (duly stamped and signed by the authorized signatories) to the undertaking.

Annexure - A-7

UNDERTAKING WITH RESPECT TO PROPRIETOR

TO WHOMSOEVER IT MAY CONCERN

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

This is with reference to the application of Mr./Ms. _____________________ (applicant name) for seeking trading membership of the Calcutta Stock Exchange Limited Equity Derivative Segment for the limited purpose of sharing the Derivatives Segment of NSE and subsequent application for registration of application in F&O Segment.

Based on the information, explanation and documents given to us, we state that the Proprietor, Mr./Ms. ________________ meets the eligibility requirements as prescribed in Securities Contracts (Regulation) Rules, 1957 (Rule 8(4A) and other relevant provisions), SEBI (Stock Brokers & Sub-brokers) Regulations, 1992 and Securities & Exchange Board of India (Stock Brokers & Sub-brokers) (Second Amendment) Regulations, 2013.

This confirmation has been issued on the request of the applicant for submitting to the CSE.

For M/s

Chartered Accountant

Stamp and Signature

Membership No.

Place :

Date :

Annexure A-8

UNDERTAKING REGARDING VIOLATIONS/NON-ADHERENCE TO SECURITIES MARKET RELATED REGULATIONS

(On the letter head of the applicant)

a) Are there any instances of violation or non-adherence to any securities market related regulations by the applicant or its associate(s) / group companies in India or abroad?

YES NO

b) Whether any action has been taken by a regulatory agency in this regard?

YES NO

For M/s. (name of applicant)

Stamp and Signature of Proprietor

Place :

Date :

If yes, kindly provide the following additional information as an Annexure:

a. Top 10 monetary penalties in case of foreign entities and all monetary penalties in case of Indian entities, imposed against the applicant or any associate of the applicant (for irregularities/ violations in the financial services sector or for defaults in respect of shareholders / debenture holders and depositors, by any financial regulatory body or government authority or settlement arrived with any financial regulatory body during the last five years and details thereof). Penalties awarded for economic offences may be disclosed only in case of the applicant.

b. Details of all cases of suspensions and cancellation of certificate of registration (for irregularities / violations in financial services sector or for defaults in respect of shareholders, debenture holders and depositors) of the applicant or any associate of the applicant shall be disclosed for the last 10 years.

All disclosures on penalties and action taken as per (a) and (b) above against foreign entities may be limited to the jurisdiction of the country where the principal activities (in terms of income / revenue) of the applicant / associate companies are carried out or where the headquarters is situated.

Annexure A-9

UNDERTAKING

(To be given on the letterhead of the trading member)

To, Date:

The Calcutta Stock Exchange Ltd.

This to confirm that:

We, M/s. ______________ (Proprietor Mr./Ms. ________), hereby undertake / declare / confirm that:

1. no enquiry/investigation/ has been initiated/pending against the applicant or its proprietor by any Stock Exchange/SEBI.

2. no enquiry/adjudication/prosecution or any other action including consent proceedings, administrative warning, caution or advisory letter, etc., have been initiated against me or any of my associate company. Or

the details of enquiry/adjudication/prosecution initiated by SEBI against me or my associate company alongwith the details of corrective steps taken by us to prevent the recurrence of such irregularities or to improve our systems are enclosed.

3. no any action in respect of deviations in our stock broking operations has been initiated against me by the stock exchange pursuant to inspection/audit, etc. Or

the details of action initiated by the Exchange against me for deviations observed in its stock broking operations pursuant to inspection/audit, etc. alongwith the details of corrective steps taken by us to prevent the recurrence of such irregularities are enclosed.

4. we have not, at any point, introduced any fake / forged/ stolen shares in the market.

5. The proprietor Mr./Ms. _____________meet the eligibility requirements as prescribed in Securities Contracts (Regulation) Rules, 1957 (Rule 8(4A) and other relevant provisions), SEBI (Stock Brokers & Sub-brokers) Regulations, 1992 and Securities & Exchange Board of India (Stock Brokers & Sub-brokers) (Second Amendment)Regulations, 2013.

6. we shall ensure that the proprietor till the time the applicant is registered as a member or the Exchange will continue to meet the eligibility requirements as per Securities Contracts (Regulation) Rules, 1957, SEBI (Stock Brokers & Sub-brokers) Regulations, 1992 and Securities & Exchange Board of India (Stock Brokers & Sub-brokers) (Second Amendment)Regulations, 2013.

7. Necessary infrastructure like adequate office space, equipments and man power to effectively discharge his activities is available with us.

8. As long as the applicant is engaged in stock broking as a member of any recognized Stock Exchange in India, it will engage itself in only such business as a member of a recognized Stock Exchange is permitted to engage in under the securities and contracts (Regulation) Rules, 1957, and the Rules, Bye-laws & regulations of the Stock Exchange.

Further, we are aware and acknowledge that if we engage in any other business the Exchange will be entitled to take disciplinary action (including fine, suspension &/or expulsion) against us.

(Stamp and signature of authorised signatory)

Date:

Place:

Note:

1. Undertaking to be stamped & signed by proprietor mentioning name and designation.

2. In case the applicant has to furnish any details pertaining to the above mentioned confirmations, the same can be provided as annexure (duly stamped and signed by the authorised signatories) to the undertaking.

Annexure-A 10

1. (on the letterhead of the Applicant)

2.

Infrastructure Undertaking

I hereby declare the following:-

I have the necessary infrastructure like adequate office place, equipment and manpower to effectively undertake our activities as member of CSE

Below mentioned are the basic infrastructure requirements that I own / have taken on rent/ leave and licence /lease for being a TM of CSE.

|S No. |PARTICULARS |DETAILS |

|1 |Name of Company | |

|2 |Address | |

|3 |Telephone Numbers | |

|4 |Fax Numbers | |

|5 |Office Premises Description |(office space in sq ft) |

|6 |Particulars of office Premises |Is the office Premises owned / taken on rent/ leave and licence/lease – please |

| | |specify clearly |

|7 |Office address (es) | |

|8 |Other Assets |Details of Fixtures & Furniture or any other related movable assets (Also specify |

| | |clearly whether owned / taken on rent / leave and licence/ lease ) |

|9 |No. of Computers |(owned / taken on rent/ leave and licence/ lease – please specify clearly |

|10 |Back Office |Proposed from / (name of the vendor) |

|11 |No. of Employees | |

I confirm that the above stated facts and details are true and correct and I have not misrepresented and / or concealed /suppressed any material facts in this regard.

I also confirm that in the event of any false / incorrect particulars furnished by me or any misrepresentation of facts / suppression /concealment of facts by me, my application for membership may be rejected / our membership registration may be cancelled and penal action may be taken against me.

Date:

Place:

For _________ (Trade name of applicant)

(Signature)

Name:

Proprietor / Individual

Rubber Stamp

ANNEXURE : A – 11

Certificate dated _________ submitted by ____________________ to CSE

DETAILS OF STOCK EXCHANGE MEMBERSHIPS

[pic]1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Date:

Place:

Signature(s)

NOTES :

@ : Give details e.g. :

SELF for membership in the name of applicant company, Firm.

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

In case of Individuals, give details such as

FIRM in which the applicant is a partner; Details of other partners in the said firm,

COMPANY in which the applicant has controlling interest.

# : 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 in the following format :

• Expulsion

• Suspension

• Default

• Any other disciplinary action or enquiry against the member

I confirm that the above stated facts and details are true and correct and I have not misrepresented and / or concealed /suppressed any material facts in this regard.

I also confirm that in the event of any false / incorrect particulars furnished by me or any misrepresentation of facts / suppression /concealment of facts by me, my application for membership may be rejected / my membership registration may be cancelled and penal action may be taken against me.

Date :

Place :

For _________ (Trade name of applicant)

ANNEXURE –A-12

(on the letterhead of the applicant)

To,

Membership Department

Calcutta Stock Exchange Limited

7 Lyons Range

Kolkata-700 001

Sub: Details of Regulatory Actions by SEBI

Dear Sir/Madam,

I _______________________________ have applied for membership in The Calcutta Stock Exchange Ltd. as Trading Member/Trading cum Clearing Member/Professional Clearing Member. I hereby provide details of Regulatory Actions by SEBI as under:

|Sr. No |Particulars |Remarks |

|1 |Whether SEBI has initiated any Enquiry / Adjudication / |YES / NO |

| |Prosecution or any other action including consent | |

| |proceedings, administrative warning, caution or advisory | |

| |letter etc. against the applicant company or any of its | |

| |associate company or any of its directors. | |

|2 |Details of corrective steps taken to prevent the recurrence | if Yes : provide relevant information |

| |of such irregularities or to improve systems. |if No: mention Not Applicable |

Yours Faithfully,

(Signature) (Signature)

Name of Proprietor Name of Proprietor

/Authorized signatory /Authorized signatory

Rubber Stamp of Entity

Date:

Place:

Note: You may attach a separate sheet providing details along with supporting documents, wherever applicable.

Annexure A - 13

Annexure A – (to Fit & Proper person Undertaking)

(Applicable to Corporate / Partnership/Proprietor)

(On the letterhead of the applicant)

(to be filled in if applicable)

I. *Details of top 10 monetary penalties in case of foreign entities (to be provided for applicant and its associate(s) / group companies)

(For irregularities / violations in the financial services sector or for defaults in respect of shareholders /debenture holders and depositors, by any financial regulatory body or government authority or settlement arrived with any financial regulatory body during the last five years.)

II. *Details of all monetary penalties in case of Indian entities (to be provided for applicant and its associate(s) / group companies)

(For irregularities / violations in the financial services sector or for defaults in respect of shareholders /debenture holders and depositors, by any financial regulatory body or government authority or settlement arrived with any financial regulatory body during the last five years.)

III. *Details of all penalties awarded (to be provided for the applicant only)

(For economic offences)

IV. *Details of all cases of suspensions and cancellation of certificate of registration (to be provided for the applicant and any associates of the applicant only for the last 10 years)

(For irregularities / violations in financial services sector or for defaults in respect of shareholders, debenture holders and depositors)

(Signature) (Signature)

Name of Designated Director/Partner/Proprietor Name of Designated Director/ Partner/ Proprietor

/ Authorized signatory / Authorized signatory

Rubber Stamp Rubber Stamp

Date:

Place:

Note: All disclosures on penalties and action taken as per (I) & (IV) above against foreign entities may be limited to the jurisdiction of the country where the principal activities (in terms of income / revenue) of the applicant / associate companies are carried out or where the headquarters is situated.

* Strike off whichever is not applicable

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