This annexure provides detailed information about any new director(s) proposed to be appointed in connection with the merger, demerger, slump sale or transfer of business. It generally covers their name, DIN, designation, qualifications, experience and other relevant particulars as prescribed in the attached format

Annexure D

 From            : (Trading Member Name)

To,

Membership Compliance Department

(Name of the Stock Exchange/s where member is registered)

Dear Sir/ Madam,

We hereby propose to appoint Mr./Mrs./Ms.__________________________ as a director of our company. The details and information with respect to said director is as follows:

1) Name                   :          

2) Residence Address          :

3) Contact No.:

4) Age                                  :

5) Educational Qualification:

6) Experience                       :

7) Shareholding in M/s. _________________ (trading member):

8) Interests in any other company as a Director:

9) Please provide following information about the proposed director:

1. 1. 1. Are any court case/s pending against the proposed director?

1. 1. 2. Has any disciplinary action been taken by any stock exchange against him  or the trading member in which he held the offices of a director and which had been a member of a stock exchange If so, please give details in a separate sheet.

1. 1. 3. Has ever been adjudged bankrupt or have any receiving order been made against them or have been proved to be insolvent at any time?

1. 1. 4. Has ever been involved in litigations, suits or proceedings connected with Capital Market and economic offences or have been involved in any financial liability of contingent or unascertained nature ?

1. 1. 5. Has ever been at any time convicted of any offence (including economic offences) involving fraud or dishonesty or financial irregularities or any warning censor or any penalty has been imposed by Regulatory agencies such as SEBI, RBI, Department of Company affair nor any other such Regulatory body ?

1. 1. 6. Has ever been / is a member of any other Stock Exchange? Give details.

1. 1. 7. Have ever been at any time denied / rejected for membership of any stock exchange or commercial organisation?

1. 1. 8. Whether held the offices of the Director in any company which had been a member of a stock exchange and which has been ever been suspended / expelled / declared a defaulter on any other stock exchange or commercial organisation and whether any economic offence or any warning censor or any penalty has been imposed by any Regulatory agencies such as SEBI, RBI, Department of Company affair nor any other such Regulatory body against such company?

1. 1. 9. Have ever been engaged as principal or employee in any business other than that of securities?

1. 1. 10. Are not ‘Politically Exposed Persons’ (PEP). If yes, please provide following details:

Note:

1. As per SEBI master circular ISD/AML/CIR-1/2010 dated February 12, 2010, ‘Politically Exposed Persons’ (PEP) are individuals who are or have been entrusted with prominent public functions in a foreign country, e.g., Heads of States or of Governments, senior politicians, senior government/judicial/military officers, senior executives of state-owned corporations, important political party officials, etc.

We, _______________________________the trading member of your Exchange hereby propose to appoint Mr.________________ as a director of our company and we have also ensured that he is not disqualified for being members of a stock exchange under the provisions of SCRR.

Thanking you,

Yours Sincerely

For ____________________ (Name of the Trading Member)

Director / Compliance Officer

Name of the Person signing