Annexure 1

Letter of Application by Mutual Fund Distributors (MFD) who intends to act as an

intermediary for selling and marketing of mutual funds units through BSE StAR MF

(On letterhead of the applicant)

To,
Manager,
Membership Operations
14th Floor, BSE Limited
P J Tower. Dalal Street,
Fort, Mumbai – 400 001

Sub. : Registration as ‘Mutual Fund Distributor in the BSE StAR MF platform of

BSE Ltd.

I/We, < Name of the applicant> hereby apply for the registration as the “Mutual Fund
Distributor” in the BSE StAR Mutual Fund platform of BSE Ltd for distribution and
redemption of Mutual Fund Units.

I/We are registered with ______________________ <MFs/AMCs> for offering their

products through your platform. ((Pl attach separate sheet as Annexure, if required)

I/We confirm that we have read all the SEBI guidelines, circulars etc. and are conversant
with the conditions stipulated by SEBI vide their circular no CIR /MRD/DSA/32/2013
dated 4th October, 2013 and any amendments thereto. We also undertake to comply with
and be bound by the circulars issued/ that may be issued by the BSE Ltd., Indian Clearing
Corporation Ltd. (ICCL), SEBI, RBI and any other statutory and regulatory bodies, from
time to time.

I/We hereby confirm that our ARN Code is __________ and the same is currently valid.

I/We agree and undertake that we shall execute, sign, and subscribe, to such documents,
papers, agreements, covenants, bonds and/or undertakings as may be required by BSE
Ltd. / ICCL from time to time in relation to the mutual fund activities.

I/We certify that all the statements are true and correct to the best of our knowledge. I/We
are aware that in case any of the statements are found to be incorrect or false, we are liable
for disciplinary action.

I/We request you to grant us the permission to function as “Mutual Fund Distributor” in the
BSE StAR Mutual Fund platform of the BSE Ltd for the above mentioned MF(s)/AMC(s)
schemes.

Date : ( Signature of Authorised Signatory)

Place : (Name and Designation of Authorised Signatory)