FORM D APPLICATION FOR THE ISSUE

N A NA NA

3. i. I state that I shall be engaged in the profession of Company Secretary only on whole-time basis and not in any other profession, business, occupation or employment. I am not enrolled as an Advocate on the rolls of any Bar Council and do not hold certificate of practice from any professional body including ICAI and the IC AI. I state that as and when I cease to be in practice, I shall duly inform the Council and shall surrender forthwith the certificate of practice as re!uired by the Company Secretaries Act, "#$%, and the regulations made thereunder, as amended from time to time. I hereby underta&e that, I shall adhere to the mandatory ceiling of not more than eighty companies in aggregate in a calendar year in terms of the Guidelines for Issuing Compliance Certificate and Signing of Annual Return issued by the Institute on '(th )ovember, '%%(. I state that I have issued * did not issue ... + + advertisements during the year '%+ - + in accordance with the Guidelines for Advertisement by Company Secretary in Practice issued by the Institute,. I state that I issued + + + Corporate -overnance compliance certificates under Clause .# of the listing agreement during the year '%+ + - + , I state that I have * have not underta&en + + + Audits under Section //A of the Securities and 01change Board of India 23epositories and 4articipants5 6egulations, "##7 during the year '%+ - + ,

ii.

iii.

iv.

v. vi.

vii. I state that I have * have not maintained a register of attestation*certification services rendered by me*my firm in accordance with the Guidelines for Requirement of Maintenance of a Register of Attestation/Certification Services Rendered by Practising Company Secretary/Firm of Practising Company Secretaries issued by the Institute. , .. /. I send herewith Ban& draft drawn on + + + + + + Ban& + + + + + Branch bearing )o. + + + + for 6s /%%*- towards annual certificate of practice fee for the year ending 3"st 8arch '%"% I further declare that the particulars furnished above are true and correct.

9ours faithfully, 2Signature5 4lace:

0ncl. 3ate: ;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; , Applicable in case renewal or restoration of Certificate of 4ractice