Annexure- I (On the letter-head of the Member) Application for ID Creation for Authorised Person Member ID: Affix Photograph & Sign across the Photograph To, Operation Department Indian Commodity Exchange Limited 403-A, Reliable Tech Park, B-Wing, 4th Floor, Thane-Belapur Road, Airoli, Navi Mumbai 400 708 Board: +91 22 4038 1500 Fax: +91 22 4038 1513 Dear Sir, Sub: Application for New ID for Authorised Person I, Mr./Ms. (Name of the Authorised Person) having (Authorised Person Code), an Authorized Person of (Trade Name of Member), a member of Indian Commodity Exchange Ltd. having Member ID, am making an application for ID creation for trading through Internet/VSAT/Leased Line terminals as per the s details given below: 1. Address of the office where terminal is to be located. Address: City State Fax No. E-Mail ID: Pin Tel. No. Mob. No.
2. Name of the Approved 3. Date of Birth of Approved 4. Father s / Husband s Name of Approved 5. Residential Address of the Approved First Name Middle Name Last Name Address : City State E-Mail ID: Pin Tel No./ Mobile No. 6. Qualification of 7. PAN ID of (Attach Copy of PAN Card, self attested ) 8. Nationality of Approved 9. Relationship of the Approved with the Member 10. Mode of connectivity for trading from the office where terminal is located. 11. Enable/Disable Trading in PRO Account 12. VSAT/ MPLS Leased Line/ Internet IP Address 13. VSAT / MPLS Leased Line Circuit ID Employee / Authorised Person/ Client/ If Others, please specify (Strikeout whichever is applicable) VSAT MPLS / Lease Line Internet (Tick mark in the box whichever is applicable) PRO Account Enable PRO Account Disable (Tick mark in the box whichever is applicable)
14. No. of Existing IDs at the above VSAT/Leased line Name & Signature of Approved I as an Authorised Person undertake that I shall maintain proper books of accounts and registers in respect of all trades put through by me/my user and shall co-operate with the Member as well as officials of the Exchange as and when such records are required by the Member or Exchange officials or Regulatory Authorities under applicable law for inspection. I further undertake that I shall not indulge in any deceptive, fraudulent or manipulative trade practices and shall not destabilize market equilibrium. The Member shall be responsible to the Exchange to ensure settlement of all deals entered through the Authorised Person/his users and to comply with all the requirements thereto in accordance with Rules, Bye Laws and Regulations of the Exchange. However, between a Member and the Authorised Person, the parties shall be responsible to each other for their acts, omissions and negligence if any. Name & Signature of Authorised Person
(On the letter-head of the Member) UNDERTAKING FOR USER ID Member ID: To, Operation Department Indian Commodity Exchange Limited 8 th Floor, Romell Technology Park, Nirlon Compound, Western Express Highway, Western Express Highway, Goregaon (E), Mumbai- 400063 Please find enclosed herewith number of application (s) as per Annexure I for creation and approval of IDs, duly signed by the s, making application through us. The brief details of such s appointed by me/us are mentioned hereunder (please use Annexure II, if applying for more than two IDs). On approval, I/We hereby agree and bind myself/ourselves to be responsible for all acts, quotations made and transactions done or effected by the approved users on the Trading System of the Indian Commodity Exchange Limited. I/We further undertake that I/we shall be responsible for all transactions done by the approved users using internet facility, if any, provided by the Exchange or for any risk arising out of internet use and shall not hold the Exchange responsible for any loss or risk arising from the use of internet trading. In case any of the said users ceasing to be associated with me/us, I/we shall communicate to you the same along with related details and seek change/cancellation in the ID so allotted against these application, as prescribed. I/We certify that I/we have not applied for any other ID in the name of the said users list attached herewith. I/We further certify that any of the approved users as mentioned is not suspended /debarred by FMC/MCX/NCDEX/SEBI/BSE/NSE and other Commodity Exchange / Stock Exchange. S. No. Name of the PAN ID Mode of Connectivity Terminal Location ID (To be allotted by the Exchange)
(On the letter-head of the Member) Annexure- II I/We (Trade Name of Member) having Member ID, hereby agree for the following approved users to trade on my / our behalf through Internet/VSAT/Leased Line terminals on the Indian Commodity Exchange Ltd. trading system. S. No. Name of the PAN ID Mode of Connectivity Terminal Location ID (To be allotted by the Exchange)