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Acknowledgement Slip for Lead Managers/
Consortium/Sub-Consortium Member/
Brokers/Sub-Brokers/Trading Members / SCSB’s
POWER FINANCE CORPORATION LIMITED
(A Government of India undertaking)
Application
Form No.
Application
Form No.
Name of Sole / First Applicant
___________________________________________
___________________________________________
Cheque / DD/ASBA Bank A/c No.
Drawn on (Name of Bank & Branch)
TEAR HERE
Date, Stamp & Signature of Escrow
Bank (Mandatory)
Cheque / DD/ASBA Bank A/c No. Dated___________,2015
Received from Mr./Ms. /M/s.
Telephone / Mobile Email
Amount Paid (` in gures) Bank & Branch
PAN
DPID/
CLID
TEAR HERE
Acknowledgement Slip for Applicant
Date Stamp & Signature of Lead
Manager/Consortium/Sub-Consortium
Members/Trading Members/SCSB
2. Investor Category (Please refer overleaf) Category I Category II Category III Category IV Sub Category Code (Please refer overleaf)
3. PLEASE PROVIDE APPLICANT’S DEPOSITORY DETAILS (Please Refer To Point No. 29A Of The Attached Abridged Prospectus) For NSDL Enter 8 Digit DP ID Followed By 8 Digit Client ID / For CDSL Enter 16 Digit Client ID
NSDL / CDSL
6. PAYMENT DETAILS (Please tick ( ) any one of payment option A or B below)
D D M M Y Y
TEARHERETEARHEREPLEASEFILLINBLOCKLETTERS
POWERFINANCE
CORPORATIONLIMITED
(AGovernmentofIndiaUndertaking)
Dated ,2015
APPLICATION FORM
(FOR RESIDENT APPLICANTS)
ISSUE OPENS ON : OCTOBER 5, 2015
ISSUE CLOSES ON* : OCTOBER 9, 2015
I/we hereby con rm that I/we have read and understood the terms and conditions of this Application Form and the attached Abridged Prospectus and agree to the Applicant s ndertaking
as given overleaf. I/we hereby con rm that I/we have read the instructions for lling up the Application Form given overleaf.
PUBLIC ISSUE OF TAX FREE BONDS IN THE NATURE OF SECURED, REDEEMABLE, NON-CONVERTIBLE DEBENTURES VIDE SHELF PROSPECTUS & TRANCHE I PROSPECTUS DATED SEPTEMBER 22, 2015.
To, The Board of Directors,
POWER FINANCE CORPORATION LIMITED
LEAD MANAGER/ CONSORTIUM / TRADING MEMBER STAMP & CODE SUB BROKER/AGENT
CODE
SUB- CONSORTIUM MEMBER /BROKER’S
STAMP & CODE
ESCROW BANK / SCSB BRANCH
STAMP & CODE
BANK BRANCH
SERIAL NO.
1. APPLICANT’S DETAILS - PLEASE FILL IN BLOCK LETTERS (Please refer to point no. 29A of the attached Abridged Prospectus)
D D M M Y Y Y Y
First Applicant (Mr./ Ms./M/s.)
Date of Birth Name of Guardian (if applicant is minor) Mr./Ms.
Address
Pin Code (Compulsory)
Tel No. (with STD Code) / Mobile Email
Second Applicant (Mr./ Ms./M/s.)
POWER FINANCE CORPORATION LIMITED
(A Government of India undertaking)
Credit Rating : “CRISIL AAA” by CRISIL Limited, “[ICRA] AAA” (stable) by ICRA Limited, “CARE AAA” by CARE Limited
COMMON APPLICATION FORM
FOR ASBA / NON ASBA
REGISTRAR’S / SCSB
SERIAL NO.
DATE OF
RECEIPT
Applications submitted without being uploaded on the terminals of the Stock
Exchanges will be rejected.
While submitting the Application Form, the Applicant should ensure that the date stamp being put on the Application Form by the Lead Manager/Consortium /Sub-Consortium Member/Broker/Sub Broker/Trading Member/SCSB matches with the date stamp on the Acknowledgement Slip
(B) ASBA
Bank A/c No.
ASBAA/c. Holder Name ____________________________________________________
(in case Applicant is different from ASBAA/c. Holder)
Bank Name & Branch ______________________________________________________
6D. Signature of ASBA Bank Account Holder(s)
(as per Bank Records)(for ASBA Option only)
1)
I/We authorize the SCSB to do all acts as are necessary to
make the Application in the Issue
2)
3)
6A. PAN & SIGNATURE OF
SOLE/ FIRST APPLICANT
6B. PAN & SIGNATURE OF
SECOND APPLICANT
Date : ___________________, 2015
Furnishing PAN of the Applicant is mandatory including minor s PAN in case of
Application by minor. Please refer point no. 29A of the attached Abridged Prospectus
LEAD MANAGER’S / CONSORTIUM /
SUBCONSORTIUM MEMBER’S /BROKER’ S/
SUBBROKER’S/ TRADING MEMBER’S /SCSB
BRANCH’S STAMP
(ACKNOWLEDGING UPLOAD OF APPLICATION IN
STOCK EXCHANGE SYSTEM) (MANDATORY)
Please write a Sole/First Applicant’s Name, Phone No. and Application No. on the reverse of Cheque/DD.
6C. PAN & SIGNATURE OF
THIRD APPLICANT
All future communication in connection with this application should
be addressed to the Registrar to the Issue. For details, pleaser
refer overleaf.Acknowledgement is subject to realization of Cheque
/ Demand Draft / /Availability of funds in the ASBA account.
Please note that you cannot apply for the Bonds through the ASBA Process if you wish to be Allotted Bonds in Physical Form
Third Applicant (Mr./ Ms./M/s.)
Amount Paid (` in gures) (` in words)
A. CHEQUE/ DEMAND DRAFT (DD) to be drawn in favour of “PFC Tax Free Bonds 2015 – EscrowAccount - R”
Cheque/DD No. Dated
Drawn on (Bank Name & Branch)
M K
M K
*For early closure or extension of the issue, refer overleaf
PAN PAN PAN
Options/Series of Bonds Series 1A / 1B Series 2A / 2B Series 3A / 3B
Issue Price (`/Bond) ` 1,000 ` 1,000 ` 1,000
No. of Bonds applied for
Amount Payable (`)
Grand Total (`)
Application
Form No.
5. INVESTMENT DETAILS (For details, please refer Issue Structure overleaf)
Options / Series of Bonds Series 1A Series 2A Series 3A
Coupon rate / Annualised yield (%) per annum for Category I, II, III 7.11% 7.27% 7.35%
Options / Series of Bonds Series 1B Series 2B Series 3B
Coupon rate / Annualised yield (%) per annum for Category IV 7.36% 7.52% 7.60%
For Category I, II, III & IV
Tenor 10 years 15 years 20 years
Face Value / Issue Price ` 1000 per Bond ` 1000 per Bond ` 1000 per Bond
Frequency of Coupon / Interest Payment Annual
Minimum Application and in the multiple of thereafter 5 Bonds (` 5,000) (individually or collectively, across all Series of Bonds) and in the multiple of One Bond (` 1,000) thereafter
No. of Bonds applied
Amount Payable (`)
Grand Total (`)
PUBLIC ISSUE OF TAX FREE BONDS IN THE NATURE OF SECURED, REDEEMABLE, NON-CONVERTIBLE DEBENTURES VIDE SHELF PROSPECTUS & TRANCHE I PROSPECTUS DATED SEPTEMBER 22, 2015.
4. IN CASE OF APPLICATION TO HOLD THE NCDs IN PHYSICAL FORM, PLEASE PROVIDE FOLLOWING DETAILS
(Please enclose self attested copies of the KYC Documents along with the Application Form. For list of KYC documents, please refer overleaf)
NOMINATION (Please see Page 30 of this Abridged Prospectus)
Name of the Nominee : _________________________________________________________
If Nominee is Minor, Guardian’s Name : ____________________________________________
Bank Details for payment of Refund / Interest / Maturity Amount (Mandatory)
Bank Name : ____________________________________________Branch : ________________________________
Account No.: __________________________IFSC Code : __________________MICR Code: ___________________
Company shall allocate and Allot Bonds of Tranche 1 Series 1A/1B maturity to all valid Applications (depending upon the Category of Applicants), wherein the Applicants have not indicated their choice of the relevant Series applied for.
01/121 23/13116-31
35026120
35026120
35026120
MMFSL
MMFSL
- FA0327

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Power Finance Corporation Tax Free Bonds 2015 Application Form Call Anandaraman 9445296519

  • 1. Acknowledgement Slip for Lead Managers/ Consortium/Sub-Consortium Member/ Brokers/Sub-Brokers/Trading Members / SCSB’s POWER FINANCE CORPORATION LIMITED (A Government of India undertaking) Application Form No. Application Form No. Name of Sole / First Applicant ___________________________________________ ___________________________________________ Cheque / DD/ASBA Bank A/c No. Drawn on (Name of Bank & Branch) TEAR HERE Date, Stamp & Signature of Escrow Bank (Mandatory) Cheque / DD/ASBA Bank A/c No. Dated___________,2015 Received from Mr./Ms. /M/s. Telephone / Mobile Email Amount Paid (` in gures) Bank & Branch PAN DPID/ CLID TEAR HERE Acknowledgement Slip for Applicant Date Stamp & Signature of Lead Manager/Consortium/Sub-Consortium Members/Trading Members/SCSB 2. Investor Category (Please refer overleaf) Category I Category II Category III Category IV Sub Category Code (Please refer overleaf) 3. PLEASE PROVIDE APPLICANT’S DEPOSITORY DETAILS (Please Refer To Point No. 29A Of The Attached Abridged Prospectus) For NSDL Enter 8 Digit DP ID Followed By 8 Digit Client ID / For CDSL Enter 16 Digit Client ID NSDL / CDSL 6. PAYMENT DETAILS (Please tick ( ) any one of payment option A or B below) D D M M Y Y TEARHERETEARHEREPLEASEFILLINBLOCKLETTERS POWERFINANCE CORPORATIONLIMITED (AGovernmentofIndiaUndertaking) Dated ,2015 APPLICATION FORM (FOR RESIDENT APPLICANTS) ISSUE OPENS ON : OCTOBER 5, 2015 ISSUE CLOSES ON* : OCTOBER 9, 2015 I/we hereby con rm that I/we have read and understood the terms and conditions of this Application Form and the attached Abridged Prospectus and agree to the Applicant s ndertaking as given overleaf. I/we hereby con rm that I/we have read the instructions for lling up the Application Form given overleaf. PUBLIC ISSUE OF TAX FREE BONDS IN THE NATURE OF SECURED, REDEEMABLE, NON-CONVERTIBLE DEBENTURES VIDE SHELF PROSPECTUS & TRANCHE I PROSPECTUS DATED SEPTEMBER 22, 2015. To, The Board of Directors, POWER FINANCE CORPORATION LIMITED LEAD MANAGER/ CONSORTIUM / TRADING MEMBER STAMP & CODE SUB BROKER/AGENT CODE SUB- CONSORTIUM MEMBER /BROKER’S STAMP & CODE ESCROW BANK / SCSB BRANCH STAMP & CODE BANK BRANCH SERIAL NO. 1. APPLICANT’S DETAILS - PLEASE FILL IN BLOCK LETTERS (Please refer to point no. 29A of the attached Abridged Prospectus) D D M M Y Y Y Y First Applicant (Mr./ Ms./M/s.) Date of Birth Name of Guardian (if applicant is minor) Mr./Ms. Address Pin Code (Compulsory) Tel No. (with STD Code) / Mobile Email Second Applicant (Mr./ Ms./M/s.) POWER FINANCE CORPORATION LIMITED (A Government of India undertaking) Credit Rating : “CRISIL AAA” by CRISIL Limited, “[ICRA] AAA” (stable) by ICRA Limited, “CARE AAA” by CARE Limited COMMON APPLICATION FORM FOR ASBA / NON ASBA REGISTRAR’S / SCSB SERIAL NO. DATE OF RECEIPT Applications submitted without being uploaded on the terminals of the Stock Exchanges will be rejected. While submitting the Application Form, the Applicant should ensure that the date stamp being put on the Application Form by the Lead Manager/Consortium /Sub-Consortium Member/Broker/Sub Broker/Trading Member/SCSB matches with the date stamp on the Acknowledgement Slip (B) ASBA Bank A/c No. ASBAA/c. Holder Name ____________________________________________________ (in case Applicant is different from ASBAA/c. Holder) Bank Name & Branch ______________________________________________________ 6D. Signature of ASBA Bank Account Holder(s) (as per Bank Records)(for ASBA Option only) 1) I/We authorize the SCSB to do all acts as are necessary to make the Application in the Issue 2) 3) 6A. PAN & SIGNATURE OF SOLE/ FIRST APPLICANT 6B. PAN & SIGNATURE OF SECOND APPLICANT Date : ___________________, 2015 Furnishing PAN of the Applicant is mandatory including minor s PAN in case of Application by minor. Please refer point no. 29A of the attached Abridged Prospectus LEAD MANAGER’S / CONSORTIUM / SUBCONSORTIUM MEMBER’S /BROKER’ S/ SUBBROKER’S/ TRADING MEMBER’S /SCSB BRANCH’S STAMP (ACKNOWLEDGING UPLOAD OF APPLICATION IN STOCK EXCHANGE SYSTEM) (MANDATORY) Please write a Sole/First Applicant’s Name, Phone No. and Application No. on the reverse of Cheque/DD. 6C. PAN & SIGNATURE OF THIRD APPLICANT All future communication in connection with this application should be addressed to the Registrar to the Issue. For details, pleaser refer overleaf.Acknowledgement is subject to realization of Cheque / Demand Draft / /Availability of funds in the ASBA account. Please note that you cannot apply for the Bonds through the ASBA Process if you wish to be Allotted Bonds in Physical Form Third Applicant (Mr./ Ms./M/s.) Amount Paid (` in gures) (` in words) A. CHEQUE/ DEMAND DRAFT (DD) to be drawn in favour of “PFC Tax Free Bonds 2015 – EscrowAccount - R” Cheque/DD No. Dated Drawn on (Bank Name & Branch) M K M K *For early closure or extension of the issue, refer overleaf PAN PAN PAN Options/Series of Bonds Series 1A / 1B Series 2A / 2B Series 3A / 3B Issue Price (`/Bond) ` 1,000 ` 1,000 ` 1,000 No. of Bonds applied for Amount Payable (`) Grand Total (`) Application Form No. 5. INVESTMENT DETAILS (For details, please refer Issue Structure overleaf) Options / Series of Bonds Series 1A Series 2A Series 3A Coupon rate / Annualised yield (%) per annum for Category I, II, III 7.11% 7.27% 7.35% Options / Series of Bonds Series 1B Series 2B Series 3B Coupon rate / Annualised yield (%) per annum for Category IV 7.36% 7.52% 7.60% For Category I, II, III & IV Tenor 10 years 15 years 20 years Face Value / Issue Price ` 1000 per Bond ` 1000 per Bond ` 1000 per Bond Frequency of Coupon / Interest Payment Annual Minimum Application and in the multiple of thereafter 5 Bonds (` 5,000) (individually or collectively, across all Series of Bonds) and in the multiple of One Bond (` 1,000) thereafter No. of Bonds applied Amount Payable (`) Grand Total (`) PUBLIC ISSUE OF TAX FREE BONDS IN THE NATURE OF SECURED, REDEEMABLE, NON-CONVERTIBLE DEBENTURES VIDE SHELF PROSPECTUS & TRANCHE I PROSPECTUS DATED SEPTEMBER 22, 2015. 4. IN CASE OF APPLICATION TO HOLD THE NCDs IN PHYSICAL FORM, PLEASE PROVIDE FOLLOWING DETAILS (Please enclose self attested copies of the KYC Documents along with the Application Form. For list of KYC documents, please refer overleaf) NOMINATION (Please see Page 30 of this Abridged Prospectus) Name of the Nominee : _________________________________________________________ If Nominee is Minor, Guardian’s Name : ____________________________________________ Bank Details for payment of Refund / Interest / Maturity Amount (Mandatory) Bank Name : ____________________________________________Branch : ________________________________ Account No.: __________________________IFSC Code : __________________MICR Code: ___________________ Company shall allocate and Allot Bonds of Tranche 1 Series 1A/1B maturity to all valid Applications (depending upon the Category of Applicants), wherein the Applicants have not indicated their choice of the relevant Series applied for. 01/121 23/13116-31 35026120 35026120 35026120 MMFSL MMFSL - FA0327