1of 3 First Capital Equities ( Private) Limited No.347/1/1, Dr. Colvin R De Silva Mawatha, Colombo 02, Sri Lanka Tel: +94 11 2145000 Fax: +94 11 5736264 As a full member of the Colombo Stock Exchange, First Capital Equities (Private) Limited is licensed to facilitate Equity and Bond trades on the Securities and Exchange Commission in Sri Lanka. With a team of experienced Investment Advisors we offer an efficient and timely service proposition that includes Online Trading facility, Portfolio Management, Competitive Margin Facilities and Research Reports in daily and weekly basis to our clients to improve their investing experience. Also we provide our Excellency service to the clients those who wish to furnish their consent to trade on their accounts on behalf of them. Company Introductory Form Note: This form should be completed and retained by the Member Firm in accordance with FIU regulations. Title Mr. Mrs. Miss. Rev. Dr. Other- Name of the Applicant CDS A/c No. Date Section A - Basic Account Information 1. Nature of the entity : Please tick ( ) Limited Liability Company Public Limited Company Global & Regional Fund Local Fund Statutory Body A Body established under An Act A Body established under An Act of Parliament Other:(Please specify)... 2. Status: : Please tick ( ) Local Foreign 3. a) Whether Listed on CSE :Please Tick ( ) Yes No b) Whether Listed on other :Please Tick ( ) Yes No Stock Exchange If Listed please specify:. 4. Nature of business 5. Date & place of incorporation 6. Company registration No. Section B - Contact Details of the Applicant Contact Details: a) Name of the Key Contact Person : b) Telephone no. (office) : c) Telephone no. (res) : d) Mobile number : e) Fax number : f) E-mail address : g) Company address :
Section C - Other Details 2of 3 1.Nature of business (Product / service provide): 2. Expected Value of Investment per annum :Please tick ( ) Less than Rs.100,000 Rs.100,000 to Rs.500,000 Rs.500,000 to Rs.1,000,000 Rs.1,000,000 to Rs.2000,000 Rs.2,000,000 to Rs.3,000,000 Rs.3,000,00 to Rs.4,000,000 Rs.4,000,000 to Rs.5,000,000 Rs.5,000,000 to Rs.10,000,000 Over Rs.10,000.000 3. Bank Account /s maintained Bank : Branch : Type of A/c : A/c No. I II 4. Source of funds: Please tick ( ) Business ownership Investments Sales and business turnover Contract proceeds Sale of Property/Assets Gift Commission income Export proceeds Investment Proceeds/savings Profits/Revenue Donations/Charities (Local/Foreign) Others (Specify)... 5. Other Connected Business/Professional activities & business interests... 6.Other Details/Remarks/Notes: (if any) Section D - Details of the Person(s) Authorized to give Instructions 1. Name of the person Capacity Signature 2. 3. Instructions for orders (Accepted at client s risk) Telephone Yes /No If yes, password for identity:... Fax Yes/No E-mail Yes/No Instructions for contract notes / Monthly Statements (tick as appropriate) E-mail Post Fax Deliver E mail address for E- Statements :...
3of 3 Investment objective.. References Name 1. 2. 3. Tel. No. We abide by the terms and conditions of the client declaration form, which is annexed herewith and agreed to be bound by same. Company Seal...... This application is made by us in terms of our company board resolution, a certified copy of which is annexed. Date Secretary In the event of any material change to the information, First Capital Equities (Private) Limited will notify all its clients to their given addresses. ----------------------------------------------------------------------------------------------------------------------------------------------- FOR OFFICIAL USE ONLY Advisor Signature. Date.. ------------------------------------------------------------------------------------------------------------------------------------ Risk profiling Category Rating Total Overall rating Client type Business / trade Investment per annum Compliance Officer.. Signature. Date..
4of 3 COMPANY DECLARATION We... and of... in consideration of the Central Depository Systems (Pvt) Ltd (CDS) agreeing to open a Securities Account in our company, hereby declare as follows: We hereby request First Capital Equities (Pvt) Ltd (hereinafter called and referred to as First Capital Equities (Pvt) Ltd which term or expression as herein used shall where the context so requires and admits of construction mean and include the said First Capital Equities (Pvt) Ltd and its successors and assigns) to open and maintain a Securities Account in our names and to act as our Stock Broker in relation to the shares listed on the Colombo Stock Exchange (CSE). We hereby request and authorize First Capital Equities (Pvt) Ltd to accept and to execute instructions and to give effect to requests to First Capital Equities (Pvt) Ltd to enter into contracts with or for us of any other nature whatsoever provided such instructions are given:- (a) by telephone provided that First Capital Equities (Pvt)Ltd verifies our identity by requesting for the NIC number/s or (b) by email sent from our designated account; or (c) in writing which may be delivered by hand, post, courier, fax or other such means provided First Capital Equities (Pvt) Ltd verifies our identity by cross checking the signature/s placed in such instructions with specimen signatures given by us. We hereby declare that the funds to be invested for the purchase of securities through the Securities Account to be opened with the CDS will not be funds derived from any money laundering activity, funds generated through the financing of terrorist or any other illegal activity and/or funds within the ambit of Prevention of Money Laundering Act No.5 of 2006, Financial Transaction Reporting Act No 6 of 2006 and Suppression of Financing of Terrorism Act no 25 of 2005. We hereby authorize First Capital Equities (Pvt) Ltd at its sole and absolute discretion and at our risk to sell any or all of the shares or securities registered in our account to be opened and maintained with First Capital Equities (Pvt) Ltd for the purpose of compensating the said First Capital Equities (Pvt) Ltd for any liabilities, loss, damage or claims of whatsoever nature that it may incur as a result of our defaulting in making any payment lawfully due in terms of contract for the purchase of shares whether or not the contract notes have been received by us or any transaction pertaining to our Account. In consideration of First Capital Equities (Pvt) Ltd agreeing to arrange for purchase of shares listed in the Colombo Stock Exchange (CSE) as per purchase orders placed by us. we hereby covenant and undertake to settle the payments on due date as per CSE Rules. In case we fail to pay all such sums of monies on due date as aforesaid it is lawful but not obligatory for First Capital Equities (Pvt) Ltd to make such payments by sell and transfer any or all of the shares or securities registered in our account. We hereby agree to pay an interest which shall not exceed 0.1% per day, from the day after the settlement date up to the date of final settlement. In such events we unconditionally and irrevocably undertake to re-pay all such sums of monies together with the interest due or owing to First Capital Equities (Pvt) Ltd. We hereby declare that we are aware that the cost of a Transaction up to 50 million includes 0.640% of Brokerage Fees, 0.084% of CSE Fees,0.024% CDS Fees 0.072% of SEC Fees and 0.300% of Share Transaction Levy and the cost of a Transaction over 50 million includes a Negotiable Brokerage under a 0.2% of minimum Brokerage Fees, 0.0525% of CSE Fees, 0.0150% CDS Fees 0.0450% of SEC Fees and 0.300% of Share Transaction Levy and the charges will be only for one side for Intraday trades. We assume all risks involved in connection with any such instructions and/or requests and in particular with regard to executing instructions given by telephone regarding verification of identity, errors in transmission or misunderstandings, and First Capital Equities (Pvt) Ltd is discharged from all responsibility/losses in respect thereof. We hereby agree to indemnify First Capital Equities (Pvt) Ltd and keep First Capital Equities (Pvt) Ltd indemnified against any loss arising in consequence of acting in reliance on any such instructions and/or requests, and any actions, proceedings, cost, claims and demands in respect thereof We agree to perform and ratify any contracts entered into by First Capital Equities (Pvt) Ltd and/or any action taken by First Capital Equities (Pvt) Ltd as a result of any such instructions and/or requests given or made or purporting to be given or made by or on behalf of us and honestly believed by First Capital Equities (Pvt) Ltd to have been given or made by or on behalf of us. Such assumption of risk, discharge, indemnity and agreement to perform and ratify shall extend to communications made or purporting made or purporting to be made by any representative or attorneys now or hereafter from time to time appointed or believed by First Capital Equities (Pvt) Ltd to have been appointed by us and honestly believed to have been made on our behalf.
5of 3 The giving of time to us or the neglect or forbearance or omission of First Capital Equities (Pvt) Ltd to require enforce performance of any term or condition or payment of any one or more of its claims against us or the granting of any other indulgence to us shall not affect the terms and conditions on our part contained herein. We shall keep First Capital Equities (Pvt) Ltd indemnified at all times against all claims demands actions proceedings losses damages costs and expenses which may be bought against or incurred by it and which arise directly out of or in connection with any transaction in which it acts as our stockbroker because of its waiver of any condition or terms to be complied with by us or due to any other reason whatsoever. We agree and undertake to examine and verify the entries in the contract notes, CDS Statements and Statement of Account tendered to us and make prompt payments due to First Capital Equities (Pvt) Ltd on the purchases made on our behalf or for us by or through First Capital Equities (Pvt) Ltd on the orders placed by us with First Capital Equities (Pvt) Ltd. If there is any discrepancy in the entries shown on such Statements of Account we agree and accept as our responsibility to point out the same within the stipulated period. In such event we agree and accept as our responsibility to point out any discrepancy of orders on the transaction date itself or within the stipulated period. In any event any discrepancy not so pointed out by us in writing to First Capital Equities (Pvt) Ltd within the stipulated time period as given in the relevant document, it shall be conclusively settled between us and First Capital Equities (Pvt) Ltd that all entries in the Statements of Account are correct and accordingly we will be bound by the same. It is our responsibility to check the status of our CDS account periodically and inform non-receipt of the contract notes, CDS statements and statements of account in writing, if any to First Capital Equities (Pvt) Ltd under registered post. This CDS account is opened at our own risk and on the understanding that share trading can result in profits or losses to us and you are in any event not liable or accountable for any loss or damage arising from or occasioned by maintaining the said CDS account for our behalf. Risk Disclosure: We do hereby declare that I understand that the prices of securities fluctuate, sometimes drastically. The price of a security may move up or down, and may become valueless. It is likely that losses may be incurred rather than profits made as a result of buying and selling securities. We shall immediately inform the First Capital Equities (Pvt) Ltd in writing, in the event of any material change to our information given to the firm and any document, addressed to my/our last known address and sent by courier or by post shall deemed to be received by us on the day it would have been delivered in the normal course of business. Any amendment, or modification in respect of this Agreement will be effective if notified by First Capital Equities (Pvt) Ltd in writing (including a writing evidenced by a facsimile transmission) to us and shall deemed to have been accepted by us. This declaration shall be binding upon us and our heirs executors administrators. In the event of this declaration being executed by more than one person our liability shall then be joint and several. We do hereby declare the contents of this declaration have been read over explained and understood by us prior to the signing........ Company Seal...... Company Reg. No Date FOR OFFICIAL USE ONLY I invited the client to read the aforesaid Risk Disclosure Statement, ask questions and take the independent advice if the client wishes and/or Risk Disclosure Statement was clearly explained to the securities account holder/s. Investment Advisor : Signature:... Date: CEO/COMPLIANCE OFFICER/MANAGER-SALES:... Date:...