Statement of amounts credited to investor education and protection fund (See rule 3)

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Statement of amounts credited to investor education and protection fund (See rule 3) FORM NO. 1 Registration No. Authorised Capital : Rs. (To be submitted by the Company to the concerned Registrar of Companies alongwith the copy of the challan) 1. Name of the company and Address of its registered office: 2. Date of payment of amount to the Fund. 3. Particulars of the Challan : Mode of payment (DD/Cash) : 4. Details of the amount which are credited to the Fund : (a) amounts in the unpaid dividend accounts of companies; (b) the application moneys received by companies for allotment of any securities and due for refund; (c) matured deposits with companies; (d) matured debentures with companies; (e) interest accrued on the amounts referred to in clauses (a) to (d) be shown separately for each item, both in challan and in this Form. (f) grants and donations. Financial year(s) to which the amount(s) relates. 5. Details of filling Form 1A under section 205A(6) and (7) of the Companies Act, 1956. Signature of Person presenting the return Place and Date Date Certificate from auditors Verified and found correct, Chartered Accountant/ Cost Accountant/ Company Secretary/ Statutory Auditor Place : Date :

Statement of Amounts falling due for crediting to Investor Education and Protection Fund set up under Section 205C(2). During the year... FORM NO. 2 (See Rule 8) Company Registration No. Authorised Capital 1. Name of the Company 2. Registered Office 3. Financial year 4. Total amount due as on 31st. March of the relevant financial year 5. Details of amount credited to Investor Education & Protection Fund during the year 6. Details of amounts State the details of amounts remaining unclaimed for six years since becoming due for payment for the following (a) Unpaid dividend (b) Unclaimed share application money (c) Unclaimed matured deposits (d) Unclaimed matured debentures (e) Interest in respect of (a) to (d) 7. Relevant financial year in which amount is due for payment or redemption.. Signature of Person presenting the return: Date and Place Certificate from auditors Verified and found correct. Place Chartered Accountant/ Cost Accountant/ Company Date Secretary/ Statutory Auditor

FORM NO. 3 Application for registration Note : (See rule 14) (1) Submission of the registration form does not necessarily guarantee automatic registration or funding. (2) Committee reserves the right to reject any application in its own discretion without assigning any reason thereof. (3) Committee may call for additional details as and when required for the purpose of granting registration. (4) Any false information furnished or false representation made shall make the application/ registration liable for rejection/ cancellation. 1. Name of Association : 2. Address : Tel No./ Fax No./ E-mail 3. Year of Establishment : Registration No. and Date : 4. Principal office bearer. Address : 5. Organisational structure (a) Office Bearers : Name President Vice-President Secretary Treasurer Educational Qualifications Occupation/ Profession Experience (specify in number of years of experience as investor either in primary or secondary market) Remuneration received from the Association (b) How elected or appointed or nominated and what is the frequency of election to the Board (c) Total number of employees (For the last three years) 6. Membership (For last three years) (a) Total Number (b) Number of Members who are

Application for Funds for Services/ Programmes (See rule 14) FORM NO. 4 1. Name of Applicant : 2. Address : Registered Office : Corporate Office Address : 3. Constitution : (Whether Association/ Chamber of Commerce/ Institute/ Individual) 4. Date of Incorporation/ Registration 5. Details (Number/ Date) of recognition granted by Committee under rule 14 Existing activities (i) Management : Board of Directors : (ii) Details relating to proposed seminar/ programme/ activity Date when to be conducted: Venue: Brief Literature on subject matter: 6. Amount required for the proposed seminar/ programme/ activity and full justification for the same including following detail (i) The Nature of Activity (ii) List of proposed Guests/ VIPs who would chair the dais (iii) Description of expenses proposed to be incurred for the activity (iv) Venue expenses (v) Travelling, Boarding and Lodging expenses of Guests for the activity (vi) Other expenses (vii) Expected number of people who would attend the activity (viii) Any other information for the justification of the amount Signature (with name) President : Vice-President Secretary Treasurer

Statement of amounts credited to investor education and protection fund (See rule 3) FORM NO. 1 Registration No. Authorised Capital : Rs. (To be submitted by the Company to the concerned Registrar of Companies alongwith the copy of the challan) 1. Name of the company and Address of its registered office: 2. Date of payment of amount to the Fund. 3. Particulars of the Challan : Mode of payment (DD/Cash) : 4. Details of the amount which are credited to the Fund : (a) amounts in the unpaid dividend accounts of companies; (b) the application moneys received by companies for allotment of any securities and due for refund; (c) matured deposits with companies; (d) matured debentures with companies; (e) interest accrued on the amounts referred to in clauses (a) to (d) be shown separately for each item, both in challan and in this Form. (f) grants and donations. Financial year(s) to which the amount(s) relates. 5. Details of filling Form 1A under section 205A(6) and (7) of the Companies Act, 1956. Signature of Person presenting the return Place and Date Date Certificate from auditors Verified and found correct, Chartered Accountant/ Cost Accountant/ Company Secretary/ Statutory Auditor Place : Date :

(i) Investors (ii) Connected with Investment activities (iii) Professionals 7. Financial Information (a) Source of Funds (Information for last three years) (i) Membership fees (ii) Annual Subscription fees (iii) Any other fees (iv) Any other source of income (b) Uses of funds (i) Administrative expenses (ii) Salary and wages - Stationery and postage - Miscellaneous (iii) Expenses for holding seminars, meetings and other activities of the Fund (iv) Any other expenses Excess of income over expenditure 8. Activities of the association (a) Objectives of the Association (b) How has the Association met the objectives in the past/ objectives of the present application (c) How does the Association communicates to the investors (d) Whether the Association holds meeting regularly (if yes, details of the number of meetings held during the last three years and the participation to be given).