[Schedule D] [Inserted by Notification No. SEBI/LAD-NRO/GN/2019/32, dated 17.9.2019 (w.e.f. 15.1.2015).]

[See regulation 7B]

Form for Informant's Voluntary Information Disclosure to be submitted to the Board.

Note: For submission of information through a legal representative, the redacted copy of the Form expunging information that may identify the Informant shall be submitted by the legal representative without expunging any information relating to the legal representative and the details relating to the violation of securities laws.

*Indicates that the required field is non-mandatorily, remaining fields are mandatory

I. Personal Information of The Informant

A.Individual 1:

Last Name:....................

First Name:....................

Title:.................

Address:

City / State:

PIN:

Telephone (with State Code):

Mobile:

E-Mail address:

Employment Details*:

Permanent Account Number, if available:

II. Legal Representative (where applicable)

Last Name:.................

First Name:.......................

Title:.................

Firm Name (if not self-employed):

Contact address :

City / State:

PIN:

Residence address:

City / State:

PIN:

Telephone (with State Code):

Mobile:

E-Mail address:

Bar Council Enrolment Number:

III Submission of Original Information

1. Is it a violation of securities laws? Yes /

No

2. If yes to question (1), please describe the

type of violation:

3. Has the violation: Occurred / Occurring /

Potential to occur in future

4. If the violation has occurred, date of

occurrence: dd/mm/yy(in case exact date is not known, an

approximate period may be entered)

5. Have the individual(s) or their

representatives had any prior communication(s) or representations

with the Board concerning this matter? Yes (Details thereof) / No

6. Does this violation relate to an entity of

which the individual is or was an officer, director, counsel,

employee, consultant or contractor? Yes (Details thereof) / No

7. If yes to question (6), was the original

information submitted first to your Head or internal legal and

compliance office? Yes / No

8. If yes question (7), then please provide,

Date of submission of original information: dd/mm/yy

9. Please describe in detail why you think the

information submitted is a violation?

10. What facts or supporting material is your

allegation based on? Please attach any additional documents to

this form, if necessary.

11. Identify any documents or other information

in your submission that you believe could reasonably be expected

to reveal your identity and explain the basis for your belief

that your identity would be revealed if the documents were

disclosed to a third party.

12. Provide details of connection amongst the

Informant, the company whose securities are involved and the

person against whom information is being provided:

IV. Declaration

I/we hereby declare

that,-

A. I/we have read and

understood the Securities and Exchange Board of India

(Prohibition of Insider Trading) Regulations, 2015;

B. I/we accept that

mere furnishing of information by me/us does not by itself confer

on me/us right to get reward and that I/we may not get any Reward

at all. I/we would be bound by the decisions that the authority

competent to grant reward may take;

C. I/we accept that

the Securities and Exchange Board of India is under no obligation

to enter into any correspondence regarding action or inaction

taken as a result of my/our information.

D. I/we accept that

the reward would be an ex-gratia payment which, subject to the

Securities and Exchange Board of India (Prohibition of Insider

Trading) Regulations, 2015, shall be granted at the absolute

discretion of the competent authority. The decision of the

authority shall be acceptable to me/us and I/we shall not

challenge it in any litigation, appeal, adjudication, etc.

E. In the event of

my/our death before the reward us paid to me/us, it may be paid

to ............ (Details of nominee)

F. I/we declare that

the information contained herein is true, correct and complete to

the best of my/our knowledge and belief and not obtained from the

categories of persons indicated in sub-regulation (2) and

sub-regulation (6) of regulation 7G of the Securities and

Exchange Board of India (Prohibition of Insider Trading)

Regulations, 2015 and agree to indemnify the Board in case it is

not so found. I/we fully understand that I/we may be subject to

action under securities laws as well as Section 182 of the Indian

Penal Code, 1860 (45 of 1860) and ineligible for Reward if, in

my/our submission of information or in any other dealings with

the Board, I/we knowingly and wilfully make any false,

fictitious, or fraudulent statements or representations, or use

any false writing or document knowing that the writing or

document contains any false, fictitious, or fraudulent statement.

Signature:.............................

Date: dd/mm/yy

Place:

V. Certificate By Legal Representative (where

the information is submitted through legal representative)

I hereby certify as

follows,-

(a) I have reviewed the completed and signed Voluntary

Information Disclosure Form for completeness and accuracy and the

information contained therein is true, correct and complete to

the best of my knowledge;

(b) I have irrevocable consent from the Declarant, to provide to

the Securities and Exchange Board of India, the original

Voluntary Information Disclosure Form in the event of a request

for it from the Securities and Exchange Board of India due to

concerns that the Informant has not complied with these

regulations or where the Securities and Exchange Board of India

requires the said information for the purpose of verification for

declaring any gratuitous reward to the Informant or where the

Securities and Exchange Board of India determines that it is

necessary to seek such information to accomplish the purpose of

the Securities and Exchange Board of India Act including for the

protection of investors, sharing with foreign securities

regulators and foreign and Indian law enforcement agencies, etc.;

(c) I am and shall continue to be legally obligated to provide

the original Voluntary Information Disclosure Form without demur

within seven (7) calendar days of receiving such request from the

Securities and Exchange Board of India.

Signature:.................................

Date: dd/mm/yy

Place:

[Schedule E] [Inserted by Notification No. SEBI/LAD-NRO/GN/2019/32, dated 17.9.2019 (w.e.f. 15.1.2015).]

[See regulations 7D and 7E]

Form for Informant's Reward Claim to be submitted to the Board within the time specified in the intimation of prima facie eligibility to receive an Informant Reward.

All fields are mandatory

I. Personal

Information

A. Informant:

Last name:———————

First Name:————————

Title:——————

Address:

City / State:

PIN:

Telephone (with State code):

Mobile:

E-Mail Address:

Employment Details:

Permanent Account Number:

II Original Information Submitted

Online Acknowledgment

Receipt Number:

(Annex Original Form for Voluntary Information

Disclosure, if not yet submitted to Securities and Exchange Board

of India)

Subject matter of submission:

Date of submission: dd/mm/20

Case Name:

SEBI Order No.:

Date: dd/mm/20

III Consideration For Reward

Provide any material information that may be

relevant in light of the criteria for determining the amount of

Reward or denial thereof. Include any supporting documents if

necessary.

IV Declaration By Informant

I/we hereby declare

that, -

A. I/we have read and understood the Securities and Exchange

Board of India (Prohibition of Insider Trading) Regulations,

2015;

B. I/we accept that mere furnishing of information by me/us does

not by itself confer on me/us right to get reward and that I/we

may not get any Reward at all. I/we would be bound by the

decisions that the authority competent to grant reward may take;

C. I/we accept that the Securities and Exchange Board of India is

under no obligation to pay any reward or enter into any

correspondence regarding action or inaction taken as a result of

this communication.

D. I/we accept that the reward would be an ex-gratia payment

which, subject to the Securities and Exchange Board of India

Prohibition of Insider Trading) Regulations, 2015, shall be

granted at the absolute discretion of the competent authority.

The decision of the authority shall be acceptable to me/us and

I/we shall not challenge it in any litigation, appeal,

adjudication, etc.

E. In the event of my/our death before the reward is paid to

me/us, it may be paid to ………….

(Details of nominee)

F. I/we declare that the information contained herein is true,

correct and complete to the best of my/our knowledge and belief

and not obtained from the categories of persons indicated in

sub-regulation (2) and sub-regulation (6) of regulation 7G of the

Securities and Exchange Board of India (Prohibition of Insider

Trading) Regulations, 2015 and agree to indemnify the Board in

case it is not so found. I/we fully understand that I/we may be

subject to action under securities laws as well as Section 182 of

the Indian Penal Code, 1860 (45 of 1860) and ineligible for an

Informant Reward if, in my/our submission of information or in

any other dealings with the Board, I/we knowingly and wilfully

make any false, fictitious, or fraudulent statements or

representations, or use any false writing or document knowing

that the writing or document contains any false, fictitious, or

fraudulent statement.

Signature:......................

Date: dd/mm/yy

Place:

V Certificate By Legal Representative (where

applicable)

I hereby certify as

follows, -

(a) I have reviewed the completed and signed claim form for

completeness and accuracy and the information contained therein

is true, correct and complete to the best of my knowledge; and

(b) The declarant is the person who signed the original Voluntary

Information Disclosure Form.

Signature:...............

Date: dd/mm/yy

Place: