Note

1. The Application should be made by the acquirer, either by himself or with any persons acting in concert with acquirer (PACs)(hereinafter referred as "acquirer"). If it is made by a person other than the acquirer, the letter of authority granted by the acquirer, must be attached with the application.
    
2. If the acquirer is a body corporate, a true copy of the resolution of its Board of Directors or the Governing Body authorizing making of the application and sanctioning the investment in acquisition of shares / voting rights under reference, must be attached with the application.
    
3. The application should be complete in all respects and only complete application would be processed.
    
4. Five copies of the complete application should be submitted.
    
5. The application must be supported by an affidavit of the applicant verifying the facts stated in the application as true and correct.
    
6. All the information given in the application should be as of the date of application unless otherwise specified herein.

1. GENERAL DETAILS

1. Date of the application.
    
2. Name and address of the acquirer(s) and PACs (including telephone number, fax, email etc.)
    
3. If the applicant is a person other than the acquirer, then state name, address, etc., of the applicant and its relationship with the acquirer and also state whether letter of authority given by the acquirer, is enclosed.
    
4. State the details of the filing fees paid in respect of the application.
    
5. State identity of the acquirer (including group, if any, to which it belongs).
    
6. If the acquirer is a body corporate, state the following

1. Whether true copy of the resolution authorizing the signatory and sanctioning the investment in acquisition of shares / voting rights under reference, is enclosed.
2. Brief history of acquirer company (including inter alia date of incorporation, public / private / joint sector, areas of business, date of initial public offer, offer price etc.)
3. Total paid up share capital
4. Networth
5. Whether it is a listed company, if so, the names of the Stock Exchanges where it is listed.

7. State the sources of funds out of which the proposed acquisition will be financed
8. If the acquirer already holds shares in the target company give the following particulars :

1. The type and number of shares held and the percentage thereof to the total capital of the target company.
    
2. Whether disclosure in respect of these shares already held in the target company has been made as required under Chapter II.

(II) DETAILS OF THE TARGET COMPANY

1. Name and address of the target company (include phone, fax, email etc )
    

2. Brief history of the target company stating inter alia, date of incorporation, place of registered office public sector / joint sector, main business activity, date of initial public offer, offer price etc.)
    
3. Details of Board of Directors stating the total number of directors, their names and status namely whether Executive Director, Promoter Director, Nominee Director and Independent director
    
4. Details of share capital of the target company.

1. No. of equity shares issued / subscribed and paid up and face value of each equity share.
2. No. of preference shares issued, subscribed and paid up and face value of each preference share.
3. Whether all equity shares have uniform voting rights, if not, then the details of voting rights attached to equity shares.
4. Total paid up Equity Share Capital (number of shares x face value), showing separately, calls in arrears, if any.
5. Total paid up Preference share Capital (number of shares x face value), showing separately calls in arrears, if any.

1. Networth Rs……….
2. Book value per equity share - Rs.
3. Return on Networth %
4. Earnings per share Rs.

6. Name of Stock Exchanges where shares of Target company are listed / permitted to trade.
    
7. Indicate opening and closing prices of its shares as on a date prior to the date of the application.

8. Calculate and indicate the minimum offer price of the shares of the target company, in accordance with Regulation 20 (taking date of application as the reference date).

(III) DETAILS OF THE PROPOSED ACQUISITION

1. Whether it is acquisition of control of the target company, if so, the manner and relevant details of such acquisition of control inter- alia details like nature of approvals required for such acquisition , status of such approvals whether obtained or not etc.
    
2. Whether it is acquisition of shares / voting rights, if so the manner and mode of acquisition i.e. by purchase or otherwise.
    
3. Number and details of shares of the target company proposed to be acquired and the voting rights attached thereto.
    
4. Percentage of Equity shares / voting rights proposed to be acquired, to the total subscribed and paid up share capital/total voting power of the target company.
    
5. Acquisition price to be paid per share of the shares proposed to be acquired.
    
6. Names and address of parties from whom the above shares are proposed to be acquired.
    
7. Shareholding pattern of the target company before and after the proposed acquisition in the following format.

4. DETAILS OF THE EXEMPTION SOUGHT
    
   1. Nature and details of the exemption sought (including reference to the relevant regulation from which exemption is sought viz 10,11(1),11(2) or 12)
   2. Grounds for seeking such exemption .
       
      5. OTHER DETAILS , IF ANY

Place

Date