FORM (MR) - MCX in Marathi

TCMC-20(On the letter head of Member)FORM (MR)(Format of the Return to be sent by the Members of the Recognized/Registeredassociations)NAME OF THE COMMODITY EXCHANGE: MULTI COMMODITY EXCHANGE OFINDIA LIMITEDS. No. Description DetailsName of the member with Code No.1. given by the Exchange2.3.Unique Member Code (to be assignedby the Forward Markets Commission.)Address of the Member withtelephone, Fax, telex, mobilenumber(s) and E mail4.5.6.7.8.9.10.Trade Name of the MemberPAN NumberType of MembershipA) Trading member B) ClearingMember C) Trading cum ClearingMemberIf the member is only trading member,give details of Clearing memberincluding addressDate of admission to MembershipDate of commencement ofTrading/activity.Interested Commodities for trading

11.12.13.Whether dealing in physicalcommodities? If so please specify thedealing A) Farmer B)CommissionAgent C)Stockiest D)TradersE)Exporter F)Bulk ConsumerForm of the Member: soleproprietorship/ partnership/ corporatebody/ financial institutionName and educational qualificationsof proprietor/ partners/ directors14.15.16.17.18.19.20.Whether member of any otherrecognized / registered association(Commodity Exchange). If so, givethe name(s) of the exchanges and codeof membership, date of admission ofother recognized/ registeredassociationsWhether the director or its partners atany time convicted of any offence. Ifso, furnish the details if anydisciplinary and criminal history.Whether the director or partnersdeclared insolvent/bankrupt ordeclared defaulter by any exchange/commodity/ stock market. If yes,furnish details.Net worth of the member. Pleasefurnish details and necessarydocuments in support there ofAre member’s subsidiaries orregistered as trading/clearing memberof securities market?If yes, provide the details ofsubsidiary, its registrations number etcList of clients (with address andtelephone numbers.) and whetherindividual/institutional /hedger.In case there is any change in the status of any item as indicated above, the same may becommunicated to the Forward Markets Commission, Mumbai through respective exchanges.

I declare that the information given in this form is true to the best of my knowledge and belief.Place:Dated:Signature:Name of Member:Confirmation of the ExchangeThis is to certify that ________________________________ is a member of this recognized/registered association (Exchange) and the above information is correct.Place:Dated:Signature:Name and designation: