(On the Letter-Head of the Company)
Letter of Intent cum Master Creation Form
(Part – B)
Particulars of Bonds/Debentures to be admitted with CDSL
Kindly ensure that all the columns are properly filled. Write “N.A.” wherever not applicable. Fill up the
form in BLOCK LETTERS only. Affix stamp and initials in each page of the form.
Date
D D M M Y E A R
To,
The Managing Director
Central Depository Services (India) Limited
Phiroze Jeejeebhoy Towers
16th Floor, Dalal Street, Fort
Mumbai – 400 001
Dear Sir,
We are interested in offering demat option to our security holders. Kindly admit the securities as per the
details given below and allot an International Securities Identification Number/s (ISIN/s) for the same.
We confirm that the information provided is true and correct to the best of our knowledge and we will be
solely responsible for any false or incorrect information or failing to furnish the relevant information
along with the required documents.
The details of our securities are as given below:
Issuer Details:
1
Issuer Name
:
Name
2
Issuer Former Name(s)
3
Corporate Identity Number (CIN)
A) Based on ownership
4
Type of Issuer
B) Nature
5
Business Sector
Issuer Admission
With Effect From
01
:
02
03
:
01
02
01
: 02
03
01
02
03
:
04
05
06
:
Public Sector Undertaking (PSU)
Non PSU
Bank
NBFC
Other
Basic Materials
Consumer Goods including FMCG
Consumer Services
Energy
Finance
Healthcare
Central Depository Services India Limited
Page 1
6
Address of Registered
Office of the Issuer
7
Name of the
Compliance Officer /
Company Secretary
Add1
Add2
Add3
City
Zip Code
State
Country
:
:
:
:
:
:
:
Compliance Officer
:
Company Secretary
:
07
08
09
10
Industrial
Technology
Telecommunications
Utilities
01
02
01
02
03
04
01
02
03
01
02
01
02
Bonds
Debentures
Public Issue
Private Placement
Bonus Issue
Rights Issue
Yes
No
Not Applicable
Promissory Note
Debenture
Secured
Unsecured
Instrument Details:
8
Type of Instrument
:
9
Mode of Issue
:
10
Whether ISIN is required for Letter of
Allotment (LOA)
:
11
Whether issued in the Form of
:
A) Whether Secured or Unsecured
:
12
If secured, provide complete details regarding
the assets Secured / Hypothecated /
Mortgaged etc.
B) Whether Guaranteed or Partially Guaranteed
If Guaranteed, provide complete details
regarding the Guarantee
A)
Type of Convertibility
13
14
B)
:
01
: 02
03
:
01
: 02
03
01
:
02
If convertible, kindly provide the details
thereof
:
Seniority in Repayment
01
: 02
03
Issuer Admission
Guaranteed
Partially guaranteed
Not guaranteed
Fully Convertible
Partly Convertible
Non-Convertible
Optionally Convertible
Compulsorily Convertible
Senior
Subordinate – Tier 1
Additional – Tier 1
Central Depository Services India Limited
Page 2
15
16
17
18
04
05
06
07
08
01
:
02
Whether tax free
If Tax Free, quote the section of the Income
Tax Act, 1961 under which it is tax free
Whether bonds / debentures fall under
Infrastructure Category as per
Government Notification
Coupon Basis
:
:
01
Yes
02
No
01
Fixed
: 02
03
If Fixed
19
Coupon
Rate
21
22
23
Index Linked
Equity Linked
Commodity Linked
Mibor Linked
Inflation Linked
Others
Zero
Benchmark
Spread over
:
Floor Value
Cap Value
01 Simple
:
02 Compounding
If Variable
If compounding, provide the compounding
frequency details
Whether Step up / Step down coupon basis
is available
If yes, kindly provide the details thereof along
with details of coupon reset value(s) and
date(s) of reset
Day Count Convention (*)
Note: As per SEBI Circulars, the day count
convention of Actual/Actual shall be
followed for calculating interest rates.
However, the said field is provided for
capturing historical Information
Frequency of Interest Payment with specified
dates
24
Put option with specified dates
25
Indicate whether Put option will be
exercised at Discount / Premium / Par
If yes, details thereof
26
Call option with specified dates
27
Indicate whether Call option will be
Issuer Admission
Variable
01
02
03
04
05
06
:
Coupon Type
20
Subordinate – Tier 2
Subordinate – Tier 2 – Upper
Subordinate – Tier 2 – Lower
Subordinate – Tier 3
Perpetual
Yes
No
:
:
01
02
Step up
Step down
:
01
02
: 03
04
30/360*
Actual/360*
Actual/actual
Actual/365*
Frequency
Date(s)
Put Option
:
Date(s)
01 Discount
: 02 Premium
03 Par
:
Call Option
:
Date(s)
: 01 Discount
:
Central Depository Services India Limited
Page 3
exercised at Discount / Premium / Par
28
29
30
31
32
33
34
35
36
37
38
39
40
If yes, details thereof
Whether Debentures/Bonds are perpetual in
nature
Redemption Details (For issue of CFI Code)
Fixed maturity (i.e. the principal amount
01
is repaid in full at maturity)
Fixed maturity with call feature (i.e. the
02 issue may be called for redemption prior
to the fixed maturity date)
Fixed maturity with put (i.e. the holder
03 may request the reimbursement of his
bonds prior to the maturity date)
04 Fixed maturity with put and call
Amortization plan (i.e. reduction of
05
principal by regular payments)
Amortization plan with call feature (i.e.
the redemption of principal may occur as
06
the result of the outstanding portion of
the bond being called)
07 Amortization plan with put
08 Amortization plan with put and call
Perpetual (i.e. the debt instrument has no
fixed maturity date and is only due for
09
redemption in the case of the issuer's
liquidation)
Perpetual with call feature (i.e. the issue
10 may be called for redemption at some
time in the future)
Indicate whether Partly Paid
If Yes, specify the Paid up Value
Instrument Description (Long)
Instrument Description (Short)
Series (if any)
Face Value
Issue price (per instrument)
Date of Allotment
Redemption Date/Last Conversion Date (if
convertible)
Tenure of the instrument at the time of
Issuance
Total Allotment Quantity
Issue Size (Total allotment Quantity X Issue
Price) (Rs. In Crores)
Premium
Par
01
02
Yes
No
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
Years
: Months
Days
:
:
41
Certificate Nos. / Distinctive Nos.
:
42
Scheduled Opening Date (for Public Issue
only)
:
Issuer Admission
02
03
From
To
Central Depository Services India Limited
Page 4
43
44
45
Scheduled Closing Date (for Public Issue only)
Actual Closing Date (for Public Issue only)
Redemption premium details (if any)
:
:
:
01
46
Redemption Type
:
02
Sr.
No.
47
Details of Partial Redemption
:
Quantity/Value Redeemed (In case of Partial
Redemption) $
:
Sr.
No
.
48
49
50
51
Redemption Method
(i.e. by Face Value
Redemption/
Quantity
Redemption)
Partial
Redemption
Dates
Indicate whether the instrument is rated
Issuer Admission
Current rating (if rated by
multiple Credit Rating
Agencies, include all such
ratings)
Earlier rating and date of
rating (if any)
01
02
03
04
05
Quantity
Redeemed
01
02
03
04
05
Total Quantity/Value Redeemed
Net Quantity (Total Allotment Quantity – Total
Quantity Redeemed)
$ - To be provided by issuer at the time of
Redemption
Credit Rating
with name of
Credit Rating
Agency and
Date of Credit
Rating
Full Redemption
Partial Redemption (including
details, if redemption is due to
exercise of call or put option)
A By Face Value Redemption
B By Quantity Redemption
Face
If Redemption is
Partial
Value/Qua based on Quantity
Redempti ntity
(specify whether
on Dates Redempti on lot basis or proon
rata basis)
Value
Redeemed
Reason for
redemption (Call,
Put, Premature
redemption,
Maturity, Buyback,
conversion)
:
:
:
01 Yes
02 No
Name of the
Credit Rating Credit Rating
Agency
Name of
the
Credit
:
Rating
Agency
Credit
Rating
Central Depository Services India Limited
Date of
Credit
Rating
Date of Credit
Rating
Date of
Rating
change
Page 5
52
53
Registrar (Name,
Address & Contact
Details)
Organization Name
Contact Person
Designation
Add1
Add2
Add3
City
Zip Code
State
Country
Phone – 1
Phone – 2
Fax
Email
Organization Name
Contact Person
Designation
Add1
Add2
Add3
Lead Manager to the
issue (Name, Address & City
Contact Details)
Zip Code
State
Country
Phone – 1
Phone – 2
Fax
Email
54
Arranger to the issue
(Name, Address &
Contact Details)
55
Debenture Trustee
(Name, Address,
Contact Details
including email
address & website
Issuer Admission
Organization Name
Contact Person
Designation
Add1
Add2
Add3
City
Zip Code
State
Country
Phone – 1
Phone – 2
Fax
Email
Organization Name
Contact Person
Designation
Add1
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
1
2
1
2
1
2
Central Depository Services India Limited
Page 6
address)
Add2
Add3
City
Zip Code
State
Country
Phone – 1
Phone – 2
Fax
Email
:
:
:
:
:
:
:
:
:
:
01
: 02
03
Status of Listing
56
57
58
59
Listed
Unlisted
To be listed
Stock Exchange Details (Applicable, if Listed /
:
To be Listed)
Name of Stock Exchange
Sr
Listed / Proposed to be Date of Listing (If
in which Listed or
No
Listed
Listed)
Proposed to be Listed
01
02
03
Term Sheet (access to Stock Exchange
:
website)
Annual report ( URL to Stock Exchange
:
website)
Any Other Information
Whether, under,
Permitted to Trade
category
:
Signature of Authorized Signatory
Name
:
Designation
:
Place
:
Issuer Admission
Date
: D
D
M
Central Depository Services India Limited
M
Y
Y
Y
Y
Page 7