Application To SEBI
Application To SEBI
Application To SEBI
To,
The Membership Compliance Dept.
National Stock Exchange/National Securities Clearing Corporation
Exchange Plaza
Bandra-Kurla Complex
Bandra (E)
Mumbai – 400 051.
Dear Sir/Madam,
Further to Exchange Circular Ref No ____ dated _____we are desirous to obtain SEBI single registration
number. Currently we are registered in CM/FO/CD/Debt segment(s) and having registration no. <Mention
Old Registration no.>
We hereby apply for the single registration as per the documents required by you, 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. 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 Corporation with respect to the operation of the Exchange/Clearing Corporation and
would perform accordingly in meeting my financial, regulatory and operational responsibility as decided
of the Exchange/Clearing Corporation from time to time.
Thanking You.
Yours sincerely,
Place:
FORM A
Table 1:
5 Address of Member
Table 3: Details of sales personnel or approved user who has passed any certification programme
Other details:
1. Please furnish a copy of the memorandum and articles of association or the partnership deed, as the
case may be.
2. If the applicant intends to clear and settle his trades through a clearing member, the applicant is
required to furnish the name and details of the clearing member along with a copy of MoU/ agreement/
contract with them for the same.
Undertaking:
4. Whether the applicant or its director or partners, any time convicted of any economic offence? If so,
furnish the details.
5. Whether the applicant or its directors or partners, declared insolvent or declared defaulter by any
exchange? If so, furnish details.
6. Whether the applicant or its directors or partners at any time subjected to any proceedings or penalty by
the Board under SEBI Act or any of the regulations framed under the SEBI Act? If so, furnish the details.
7. Whether any disciplinary action has been initiated/ taken or penalty has been imposed by SEBI/ stock
exchange(s)/ clearing corporation(s) or any other regulatory authority? If yes, furnish details. Also
provide the details of corrective steps taken thereon.
Declaration:
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.
______________________________________________________________________________
Signature:
Name:
Designation:
FORM AD
5 Address of Member
Experience in derivatives
Educational trading or securities market, as
Sl. No. Names Age PAN Qualifications applicable
Other details:
1. Please furnish a copy of the memorandum and articles of association or the partnership deed, as the
case may be.
Undertakings:
3. Whether the applicant or its director or partners, any time convicted of any economic offence? If so,
furnish the details.
4. Whether the applicant or its directors or partners, declared insolvent or declared defaulter by any
exchange? If so, furnish details.
5. Whether the applicant or its directors or partners at any time subjected to any proceedings or penalty by
the Board under SEBI Act or any of the regulations framed under the SEBI Act? If so, furnish the details.
6. Whether any disciplinary action has been initiated/ taken or penalty has been imposed by SEBI/ stock
exchange(s)/ clearing corporation(s) or any other regulatory authority? If yes, furnish details. Also
provide the details of corrective steps taken thereon.
Declaration:
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.
Signature:
Name:
Designation:
Annexure: C-1 (If not Submitted to the Exchange)
NETWORTH CERTIFICATE
This is to certify that the Net worth of M/s. ______________________as on _____________as per the
statement of computation of even date annexed to this report is Rupees______________ only).
M/s._________________ 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 networth.
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 NSE Circular No. 93 (Ref.No.: NSE/MEM/475)
dated March 4, 1998/the method of computation prescribed by SEBI as per Schedule VI of Securities
and Exchange Board of India (Stock Brokers and Sub-brokers) (Second Amendment) Regulations,
2013 (strike off whichever is not applicable).
Place:
For (Name of Accounting Firm)
Date:
Name of Partner/Proprietor
Chartered Accountant
Membership Number
Annexure C- 1A
The method of computation of Networth as prescribed by Dr. L.C. Gupta Committee on Derivatives for
clearing members is as follows
*Explanation:
Includes debts/advances overdue for more than three months or given to associates
Name of Partner/Proprietor
Chartered Accountant
Membership Number
UNDERTAKING
(To be given on the letterhead of the applicant)
Note:
1. Undertaking to be filled with responses (Yes/No) and details to be provided wherever applicable, stamped &
signed by two designated directors or authorised signatory(ies) as per Board Resolution mentioning names and
designations.
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 .
Declaration by Stock Broker
(To be certified by a practicing chartered accountant/ practicing company secretary)
1. I/We declare that the information given in this application form is true and in 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.
2. I/We hereby declare that the director/designated directors of the company were/are not debarred
and/or no action were/are initiated against them by the Securities and Exchange Board of India
from associating from the capital market and the company undertakes that it will not appoint any
such person/s, in future as director(s)/designated director(s) of the company.
3. I/We hereby declare that neither our company not any of the directors of our company are in any
way associated/connected with any of the defaulting or defaulting trading members of any Stock
Exchange.
4. I/We further declare that no investigation/enquiry by any Stock Exchange is pending against our
company or any of the directors of our company.
5. I/We hereby undertake that as long as the company 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
6. I/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.
.
Place :
Date :
Annexure: C-3 (If Applicable)
Sr Name$ Fathers Designation Date of Education PAN Director Residential Designated Share holding * Directorships/ /
No Name @ Birth Identification Address & directors controlling
Number Telephone (Yes/No) shareholding
(DIN) Nos. # in other cos.
No. Amt. % of
total
1
2
3
4
5
NOTES :
@ Please clearly state whether the Director is a Managing Director or Whole-time Director or Executive
Director or Non-Executive Director or Executive Chairman or Non-Executive Chairman
# Identify atleast two designated directors/partners (A designated director is one who is a HSC by
qualification (or CA, ICWA or CS or equivalent) and possesses atleast 2 years of experience
pertaining to securities market. They, essentially, look after the stock market operations of a trading
member entity. Every trading member corporate should have atleast 2 such directors who meet the
aforesaid norms.)
Date:
Place:
Authorised Signatory / Director(s) / Partner(s)
CERTIFICATE
This is to certify that the details of directors of M/s. ______________ 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-6 (If Applicable)
EQUITY / PREFERENCE (Please indicate and use separate sheets for equity/preference shares)
Sr No. Name $ Number of Face value Amt Paid up % of total
shares held per share (Rs. In lakh)
1
2
3
4
5
6
7
8
Others
TOTAL 100%
$ All initials to be expanded
NOTES:
1. In case of bodies corporate holding not less than 51% of the paid up capital in the trading member
entity, the details of their shareholding shall also be furnished in the same format as given above
2. In case of HUF holding not less than 51% of paid up capital of trading member entity, the details
of Karta and co-parceners to be provided
3. 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)
CERTIFICATE
This is to certify that the shareholding in M/s. ______________ 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-7 (If Applicable)
Sr Name of Person (s) Relation Residential addressNo. of Total % of Total % of PAN CIN (incase
No dominant supporting $ (with PIN code) andshares Amt @ Total of corporate
shareholder dominant contact no. held paid
shareholder up @
Self Relatives
1 A
A1
A2
2 B
B1
B2
3 C
TOTAL
DETAILS OF DOMINANT GROUP as on _____
@ : For arriving at the shareholding of persons constituting the dominant group, the shareholding of
close relatives, namely parents, spouse, children and their descendants, brothers and sisters only may also
be counted.
Date:
Place:
Authorised Signatory/Director(s)
CERTIFICATE
This is to certify that the shareholding in M/s. ______________ 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
Associate Details of all the associate (If Applicable)
(On the letter head of the applicant)
1.
2.
3.
4.
Note: Kindly attach certified copy of PAN card for each of the PANs disclosed above.
Place :
Date :
Details of Other SEBI Registration
Is the Application made to the Board after seeking NOC for Change in Control? – Yes/No
Link Entities
Attachments
S.No. Particulars
1 Status Report from other Exchanges (If Applicable)
2 Experience Certificate of Designated Directors/Proprietors/Partners (as the case maybe)
3 Scanned copy of physical application form for Registration – Each document to be scanned separately
4 Copy of certificate issued by recognized University / Educational Institution
5 Copy of NISM certificates as per the details provided
6 Board Resolution / Declaration in respect of Authorized Signatories
7 Board Resolution w.r.t designated directors (Designated Partner for LLP)
8 Copy of MOA and AOA
9 PAN Card copy of the member
10 PAN Card copy of all directors/Compliance officer/partners/LLP/Top 5 shareholders/Associates
11 Original SEBI certificates of all segments of all Exchanges the member is registered with.
*Alongwith hard copy submission, all the documents are also to be scanned in pdf format
(max upto 2 mb for each document) and sent to compliance_mem@nse.co.in
Checklist:
Sr. Particulars
No. Y/N
1 Application form for SEBI registration
All the segments to be mentioned
SEBI reg. No. for all segment to be mentioned
Table 2:
All the columns to be filled, wherever Not applicable, 'NA' to be filled in
Table 3:
Details of dealers as per the required columns who have cleared NCFM / equivalent
Derivatives Examination/ NISM (atleast 2) to be given
Certified copies of their certificates to be enclosed
Undertaking:
To fill in Yes/ No, as applicable
If Yes, required details to be provided
Declaration of the trading member and the Recommendation of the Exchange should be
on the same page.
Declaration of member to be dated, stamped and signed
Table 2:
All the columns to be filled, wherever Not applicable, 'NA' to be filled in
Undertaking:
To fill in Yes/ No, as applicable
If Yes, required details to be provided
Declaration of the trading member and the Recommendation of the Exchange should be
on the same page.
Declaration of member to be dated, stamped and signed
5 Board Resolution
Board resolution to be in original
To be on the letterhead of the applicant.
To mention the names and designation of authorised signatory(ies) and whether
jointly/severally, etc.
Specimen signatures of authorised signatories to be present on board resolution
Board resolution to be signed by Designated Director(s)
6 Undertaking
To be on letter head
To be in prescribed format
To be filled with responses (Yes/No) and details provided wherever applicable
To be signed by two designated directors or authorised signatory(ies) as per the Board
Resolution
To be stamped and dated
Whether Details of Registration with SEBI or any other Govt. Regulatory Body? (Y/N)
If Yes, Name of Regulator
Registration No.
Registration Start Date
Registration End Date - not mandatory
Activity Details
Details of Action taken in the past (if any)
13 Link Entities
To be in prescribed format (all columns to be present)
To be dated, stamped and signed by the authorised signatories as per Board Resolution.
15 Attachments
Status Report from other Exchanges (If Applicable)
Experience Certificate of Designated Directors/Proprietors/Partners (as the case maybe)
Educational Proof of designated director
Scanned copy of physical application form for Registration
NISM certificates as per the details provided
MOA and AOA
PAN Card copy of the member
PAN of top 5 shareholders
PAN of directors
PAN of Associate co.
Original SEBI certificates of all segments of all Exchanges where the member is
registered.