Annexure- I Member ID: (On the letter-head of the member) Application for New Id Creation Affix Photograph & Sign across the Photograph To, Operation Department Indian Commodity Exchange Limited 8th Floor, Romell Technology Park, Nirlon Compound, W. E. Highway, Goregaon - East, Mumbai 400063 Board: +91 22 3084 9700 Fax: +91 22 3084 9710 Dear Sir, Sub: Application for New ID I, Mr./Ms. (Name of the ) hereby apply for New Id, through (Trade Name of Member), a member of Indian Commodity Exchange Ltd. having Member Id to act as Approved for trading through Internet/VSAT/Leased Line terminals. 1. Status & Address of the office where terminal is to be located. Registered Office Head Office Dealing Office Address (Tick mark in the box wherever applicable) Address: City State Fax No E-Mail ID: Pin Tel. No. Mob. No.
2. Name of the Approved First Name Middle Name Last Name 3. Date of Birth of Approved 4. Father s / Husband s Name of Approved 5. Residential Address of the Approved Address : City State E-Mail ID: Pin Tel No./ Mobile No. 6. Qualification of 7. PAN Id of (Attach Copy of PAN Card, self attested ) 8. Nationality of Approved 9. Relationship of the Approved with the Member 10. Mode of connectivity for trading from the office where terminal is located. Employee / Authorised Person/ Client/ If Others, please specify (Strikeout whichever is applicable) VSAT MPLS / Lease Line Internet (Tick mark in the box whichever is applicable)
11. Enable/Disable Trading in PRO Account 12. VSAT/ MPLS Leased Line/ Internet IP Address 13. VSAT / MPLS Leased Line Circuit Id 14. No. of Existing Ids at the above VSAT/Leased line PRO Account Enable PRO Account Disable (Tick mark in the box whichever is applicable) Name & Signature of Approved
(On the letter-head of the member) UNDERTAKING FOR USER ID Member ID: To, Operation Department Indian Commodity Exchange Limited 8th Floor, Romell Technology Park, Nirlon Compound, W. E. Highway, Goregaon - East, Mumbai 400063 Board: +91 22 3084 9700 Fax: +91 22 3084 9710 Please find enclosed herewith number of application (s) as per Annexure I for creation and approval of Ids, duly signed by the s, making application through us. The brief details of such s appointed by me/us are mentioned hereunder (please use Annexure II, if applying for more than two Ids). On approval, I/We hereby agree and bind myself/ourselves to be responsible for all acts, quotations made and transactions done or effected by the approved users on the Trading System of the Indian Commodity Exchange Limited. I/We further undertake that I/we shall be responsible for all transactions done by the approved users using internet facility, if any, provided by Indian Commodity Exchange Limited or for any risk arising out of internet use and shall not hold Indian Commodity Exchange Limited responsible for any loss or risk arising from the use of internet trading. In case any of the said users ceasing to be associated with me/us, I/we shall communicate to you the same along with related details and seek change/cancellation in the ID so allotted against these application, as prescribed. I/We certify that I/we have not applied for any other ID in the name of the said users list attached herewith. I/We further certify that any of the approved users as mentioned is not suspended /debarred by FMC/MCX/NCDEX/SEBI/BSE/NSE and other Commodity Exchange / Stock Exchange. S. No. Name of the PAN ID Mode of Connectivity Terminal Location Id (To be allotted by Indian Commodity Exchange Limited)
(On the letter-head of the Member) Annexure- II I/We (Trade Name of Member) having Member Id, hereby agree for the following approved users to trade on my / our behalf through Internet/VSAT/Leased Line terminals on the Indian Commodity Exchange Ltd trading system. S. No. Name of the PAN ID Mode of Connectivity Terminal Location Id (To be allotted by Indian Commodity Exchange Limited)