FORM NO. 59A
[See rule 20A]
Application for approval of mutual funds investing in the eligible issue of public companies under section 88(2)(xvii) of the Income-tax Act

1. Name of the Mutual Fund and the address of its registered office
2. Details of the trustees of the fund such as names, addresses, their
professional experience, etc.
3. Objects of the fund
(i) Main objects
(ii) Ancillary objects (Enclose a copy of the Mutual Fund deed)
4. Whether registered with SEBI; if yes, please specify the date and the
number of the order (enclose a copy of the SEBI's order)
5. Whether notified under section 10(23D) of the Income-tax Act; if
yes, please specify the date and the number of the order (enclose a
copy of the order)
6. Details of the custodians (enclose a copy of the custodian agreement
for mutual fund)
7. Details of Asset Management company such as names of directors
with their experience, qualifications and profession, and whether
related to the trustees (enclose a copy of the audited balance sheet
for last 3 years)
8. Plan-wise details of various schemes launched so far and the
application of their proceeds (enclose audited balance sheet for last 3
years)
9. Details of the proposed scheme to be launched for the purpose of
section 88(2)(xvii), such as number of units, face value, total amount
to be mobilised, etc. (enclose a copy of the approval by the SEBI)
10. Name and address of the public company in whose public issue
subscription is proposed to be made, along with the details of the
issue (enclose a copy of the approval of the public issue by the
Board)
11. Names and addresses of the Bankers
12. Names and addresses of the auditors
Signatures of the authorised signatory
Verification
I, _____________________________________________________________ , certify that the information furnished above is
true to the best of my knowledge and belief.
(Signatures of the authorised signatory)
Note : The application form (in duplicate) should be sent to the Board by the Mutual Fund along with the documents as
mentioned in the application form.