Specimen application form for making the offer
(on letter head of the individual/ corporate entity)

Date :

Chief General Manager,
Member/Institutional Sales,
BSE Ltd. 15th Floor,
P.J. Towers, Dalal Street,
Fort, Mumbai 400 001

Sir,

Sub: Amount of offer: (In figures): Rs.10,00,000/- (In words): Ten Lakhs

Please acquaint BSE Ltd., that I/we am/are desirous of being admitted as a member with trading rights only on the "Cash and Derivatives Segment (Trading Member or Clearing Member *) of the Exchange" on the terms and subject in all respects to the Rules, Bye-laws & Regulations of the Exchange which now are or hereafter may be for the time being in force

I/We have read & understood the aforesaid Rules.

I/We the applicant company am/are agreeable to the selection and admission procedure, as stipulated in the advertisement issued by the Exchange and the discretion of the Governing Board of the Exchange shall be final and binding upon us.

Yours faithfully,

Name:

Signature:

(Individual / Designated Director)

*- Strike out which ever is not applicable

ENCL: Rs.1 Lac DD or P.O. or cheque payable at par