Application for notification of a zero coupon bond under section 2(112)

Row No.

Particulars

1.

Name

(refer Note 1)

2.

Category

(Select anyone)

● Infrastructure capital company

● Infrastructure capital fund

● Infrastructure debt fund

● Public sector company

3.

Address

(refer Note 2)

4.

Permanent Account Number

5.

Date of incorporation/registration

dd/mm/yyyy

(refer Note 3)

6.

In case of an Infrastructure debt fund in sl. no. 2-

(a) Date of approval under Schedule VII (Table: Sl. No. 46)

dd/mm/yyyy

(b)Notification number under Schedule VII (Table: Sl. No. 46)

(refer Note 3)

7.

In case of public sector company in sl. no. 2, please specify nature of business

8.

Objects of the applicant including main objects and ancillary objects

(refer Note 3)

Row

No.

Particulars

1.

Date of issue

2.

Number of bonds

3.

Total amount of the bond

4.

Amount payable on maturity/redemption of the bond

5.

Discount [(3)-(2)]

6.

Period of life of the bond

Years

Months

Days

7.

Financial year during which the bond is to be issued

y

y

y

y

y

y

y

y

8.

Details of investment proposed to be made:

A.

Details of entity in which investment is proposed

(a)

Name of entity

(refer Note 1)

(b)

Nature of entity (select anyone)

(i) Public Sector

Company

(ii) Other company

(iii) Any

other

enterprise or

undertaking or entity

(c)

Permanent Account Number

(d)

Address

(refer Note 2)

(e)

Nature of business

B.

Project Details:

(a)

Details of Address/Location of Project

(Add rows in case of

multiple projects within a

company/undertaking/entity)

(refer Note 2)

(b)

Planned date of commencement of Project

dd/mm/yyyy

(c)

Planned date of commencement of operations

dd/mm/yyyy

(d)

Date of commencement of commercial operations of

project

(Applicable in case of

Infrastructure Debt Fund)

dd/mm/yyyy

C.

Source of Investment

Source

Amount principal officer

Zero Coupon Bond

Own Funds

Other loan and borrowings

Issue of rupee denominated bonds

Issue of foreign currency bond

Others (Specify)

TOTAL

D.

Details of management responsible for execution of project (refer Note 3)

(i)

Designation

1. Director

2. Trustee

3. Others

(ii)

Name

(iii)

Permanent Account Number

(iv)

Qualification

(v)

Experience and performance

(vi)

Address

Repeat details as per D, if required

E.

Amount of funds realised by issue of Zero Coupon Bond proposed to be invested project wise in (Select the first financial year)

Name of Project

Financial Year 1

Financial Year 2

Financial Year 3

Financial Year 4

Financial Year 5

F.

Whether copy of the project report is available?

Yes/no

(refer Note 3)

9.

Other details

(refer Note 3)

Annexure

With respect to

Particulars

A-1-1

Part A (Row No. 5)

Enclose copy of certificate of incorporation/trust deed/relevant Act, as applicable

A-2

Part A (Row No. 6(b))

Enclose copy of notification of Infrastructure Debt Fund under Schedule VII (Table: Row No. 46)

A-3

Part A (Row No. 8)

(i) Provide note on the objects including main objects and ancillary objects

(ii) Enclose copy of Memorandum/Trust deed, etc.

A-4

Part B (Row No. 8(D))

Enclose copy of organisation structure chart of management responsible for execution of project

A-5

Part B (Row No. 8(F))

Enclose copy of Project Report, if any

AA-6

Declaration

Power of Attorney of the authorised signatory