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MUTUAL FUNDS ACT, 1996

SCHEDULE 1

(Section 9 (2) (a))

APPLICATION FOR REGISTRATION OF A PUBLIC FUND

1. Applicant: state name and address of the fund

2. Constitution: (a) state the legal form of the fund

(i) company

(ii) partnership

(iii) unit trust

(b) state the name of the country or Jurisdiction where the fund is constituted

(c) state the title of the law under which the fund is constituted

3. Officers: (a) state name, address, place of birth and citizenship of each officer of the fund:

(i) directors;

(ii) general partners; or

(iii) trustees

(b) state educational and professional qualifications of each officer

(c) give details of business, occupation or employment of each officer

4. References: give two personal references, a bank reference and a police clearance certificate for each officer

5. Functionaries: state names, addresses and business activities of each of the fund's

(a) managers;

(b) administrators;

(c) investment advisers; and

(d) custodians.

6. Prior Registration:

state if the fund is now or has been registered, licensed, recognised or authorised under any law or regulations relating to mutual funds, collective investment schemes/funds or securities in any country or jurisdiction.

7. Refusal or Disciplinary Measure:

Has the fund, any of its officers, managers, administrators, investment advisers or custodians been the subject of

(a) refusal of an application for registration, licence, recognition or authorisation, or

(b) suspension, cancellation or revocation of registration, licence, recognition or authorisation

by any authority in any country or jurisdiction?

give details and reasons

8. Civil Proceedings:

Has a judgment been rendered or any suit, action or proceedings pending against any officer of the fund or of any of its functionaries listed in question 5 above, in civil proceedings in any court or tribunal in any country or jurisdiction which has been or is based in whole or in part on fraud, theft, deceit, misrepresentation or similar conduct?

give details

9. Offences:

Has any officer of the fund or of any of its functionaries listed in question 5 above been or is being charged, indicted or convicted in any country or jurisdiction for any offence in any criminal or civil proceedings relating to fraud or theft arising out of dealing in mutual funds, collective investment schemes/funds or securities?

10. Bankruptcy:

Has an officer of the fund or of any of its functionaries listed in question 5 above been

(a) declared bankrupt or been party to bankruptcy or insolvency proceedings,

(b) subject to proceedings relating to winding-up, dissolution or creditors' arrangement, or

(c) subject to proceedings relating to receivership or Creditors' compromise,

in any country or jurisdiction?

AFFIDAVIT

I, .............................. , in my capacity as (Director, general partner or trustee) acting for and on behalf of the applicant public mutual fund,

Do depose and say that I have read and understood the questions in this application form and hereby certify under Oath that the foregoing answers and statements are true, correct and complete to the best of my knowledge, information and belief.

Sworn before me .....................

Commissioner of Oaths

at the city of ......................

this ....... day .............. 19....

Name and

Signature

of Deponent