ISSUE OPENS ON : FEBRUARY 19, 2014 ISSUE CLOSES ON : MARCH 12, 2014* MUTHOOTTU MINI FINANCIERS LIMITED Credit Rating: CARE BB+[CARE DOUBLE B PLUS] Application Form No. P L E A S E
F I L L
I N
B L O C K
L E T T E R S T E A R
H E R E
T E A R
H E R E
To, The Board of Directors
MUTHOOTTU MINI FINANCIERS LIMITED PUBLIC ISSUE OF SECURED REDEEMABLE NON-CONVERTIBLE DEBENTURES (NCD) OF FACE VALUE ` 1,000/- EACH VIDE PROSPECTUS DATED FEBRUARY 12, 2014 I/We hereby confrm that I/We have read and understood the terms and conditions of this Application Form and the attached Abridged Prospectus and agree to the Applicants Undertaking as given overleaf. I/We hereby confrm that I/We have read the instructions for flling up the Application Form given overleaf. LEAD MANAGER/SYNDICATE MEMBERS/ TRADING MEMBERS STAMP & CODE SUB-SYNDICATE MEMBERS STAMP & CODE SUB-BROKERS/ AGENTS STAMP CODE ESCROW BANK/SCSB BRANCH STAMP & CODE BANK BRANCH SERIAL NO. REGISTRARS / SCSB SERIAL NO. DATE OF RECEIPT 1. APPLICANTS DETAILS - PLEASE FILL IN BLOCK LETTERS (Please refer to point no. 26 of the Abridged Prospectus) First Applicant (Mr./ Ms./M/s.) Date of Birth D D M M Y Y Y Y Name of Guardian (if applicant is minor) Address __________________________________________________________________________________________________________________________ Pin Code (Compulsory)__________________ Tel. No. (with STD Code) / Mobile _________________________ Email _________________________________ Second Applicant (Mr./ Ms./M/s.) Third Applicant (Mr./ Ms./M/s.) DPID / CLID PAN Acknowledgement Slip for Lead Managers / Syndicate Member / Sub Syndicate Members / Sub-Brokers / Trading Member / SCSB Application Form No. Option I II III IV V VI VII VIII Issue Price (`) 1,000/- No. of NCDs applied for Grand Total Total No. of NCDs Total Amount Payable (`) Stamp & Signature of Lead Managers / Syndicate Member / Sub-Syndicate Members/Sub Broker / Trading Member / SCSB alongwith the date stamp (mandatory) Received from (Name of Sole / First Applicant): _____________________ ______________________________ Application Form No. APPLICATION FORM (FOR RESIDENT APPLICANTS)
*For Early Closure / Extension of the Issue refer to page 3 of Abridged Prospectus While submitting the Application Form, the Applicant should ensure that the date stamp being put on the Application Form by the Member of the Syndicate/Trading Member/SCSB matches with the date stamp on the Acknowledgement Slip. -----------------------------------------------------------------------------------------------------TEAR HERE---------------------------------------------------------------------------------------------------- (A) Cheque/Demand Draft (DD) in favour of Muthoottu Mini Financiers Limited - NCD Escrow Account Cheque / DD No. Dated D D M M Y Y Drawn on (Bank Name & Branch) 6. PAYMENT DETAILS (Please tick () any one of payment option A or B below) (Please write Application No., Sole/First Applicant Name & Phone No. on reverse side of the Cheque / DD) Amount paid in (` in fgures) (` in words) (B) ASBA Bank A/c. No. ASBA A/c. Holder Name (in case Applicant is different from ASBA A/c. Holder) Bank Name & Branch Note that the Company would allot Option VI NCDs to all valid applications, wherein the applicants have not indicated their choice of NCDs. 7A. SOLE/ FIRST APPLICANT 7B. SECOND APPLICANT 7C. THIRD APPLICANT PERMANENT ACCOUNT NUMBER (PAN) SIGNATURE(S) 7D. Signature of ASBA Bank Account Holder(s) (As per Bank Records) (For ASBA Option Only) Lead Managers/Syndicate Members/ Trading Members / SCSB Branchs Stamp (Acknowledging upload of Application in Stock Exchange System) (Mandatory) I/We authorize the SCSB to do all acts as are necessary to make the Application in the Issue 1 2 3 Date _______________, 2014 Furnishing PAN is mandatory. Please refer point no. 27 of the Abridged Prospectus. Acknowledgement Slip for Applicant PUBLIC ISSUE OF SECURED REDEEMABLE NON-CONVERTIBLE DEBENTURES (NCD) OF FACE VALUE ` 1,000/- EACH VIDE PROSPECTUS DATED FEBRUARY 12, 2014 Cheque / DD/ASBA Bank A/c No. ____________________________________________ Dated _____________ Bank & Branch ______________________________________________________________________________ Tenure 400 days 24 months 36 months 66 months Options I II III IV V VI VII VIII Frequency of Interest Payment Monthly Cumulative Monthly Cumulative Monthly Yearly Cumulative Cumulative Minimum Application 5 NCDs (`5,000)(across all options of NCDs) In Multiples of 1 NCD after the minimum application Face Value / Issue Price (` / NCD) `1,000 Coupon (%) per annum in Category I, II and III 12.00% NA 12.25% NA 12.50% 13.00% NA NA Coupon (%) for Existing Debenture Holders, Ex-servicemen and Senior Citizen 12.25% NA 12.50% NA 12.75% 13.25% NA NA Effective Yield (per annum) Category I, II and III 12.68% 12.50% 12.96% 12.50% 13.24% 13.00% 13.50% 13.43% Effective Yield (per annum) for Existing Debenture Holders, Ex-servicemen and Senior Citizen 12.96% 12.75% 13.24% 12.75% 13.52% 13.25% 13.75% 13.43% No. of NCDs applied Grand Total Total No. of NCDs Total Amount Payable (`) 4. IN CASE OF APPLICATION TO HOLD THE NCDs IN PHYSICAL FORM, PLEASE PROVIDE FOLLOWING DETAILS (Please enclose self attested copies of the KYC Documents along with the Application Form. For list of KYC documents, please refer overleaf) NOMINATION (Please see point no. 71 of the Abridged Prospectus) Name of the Nominee : ____________________________________________ If Nominee is Minor, Guardians Name : _______________________________ Bank Details for payment of Refund / Interest / Maturity Amount (Mandatory) Bank Name, Branch: ________________________ MICR Code: ___________________ Account No.: ________________________ IFS Code : _________________________ 3. IN CASE OF APPLICATION IN DEMATERIALISED FORM, PLEASE PROVIDE APPLICANTS DEPOSITORY DETAILS (Please refer to point no. 28 of the Abridged Prospectus) For NSDL enter 8 digit DP ID followed by 8 digit Client ID / For CDSL enter 16 digit Client ID NSDL / CDSL MUTHOOTTU MINI FINANCIERS LIMITED MUTHOOTTU MINI FINANCIERS LIMITED 5. INVESTMENT DETAILS (For details, please refer Issue Structure overleaf) -----------------------------------------------------------------------------------------------------TEAR HERE---------------------------------------------------------------------------------------------------- Amount Paid (` in fgures) Bank & Branch Cheque / DD / ASBA Bank A/c No. Dated Received from Mr./Ms./M/s. Telephone/Mobile Email Stamp & Signature of Banker 2. Investor Category (Please refer overleaf) # In case of Existing Debenture Holder, Senior Citizen and Ex-servicemen please tick the appropriate category below in order to avail additional coupon & mention the relevant sub-category code under serial number 2. Ex-Servicemen Senior Citizen Existing Debenture Holder^ ^If the Applicant is an Existing Debenture Holder please mention 1. Folio No. ...................... 2. Debenture Certifcate No. .......................... For Additional KYC documents to be submitted in case of Existing Debenture Holder, Senior Citizen and Ex-servicemen please see overleaf. Category I Category II Category III Sub Category Code #
All future communication in connection with this Application should be addressed to the Registrar to the Issue. For details, please refer overleaf. Acknowledgment is subject to realisation of Cheques / DD/ Availability of funds in the ASBA account. Application submitted without being uploaded on the terminals of the Stock Exchange will be rejected. SBICAPSEC 23/10529 SBICAPSEC 23/10529 31200752 31200752 31200752 2 MUTHOOTTU MINI FINANCIERS LIMITED IN THE NATURE OF FORM 2A - MEMORANDUM CONTAINING SALIENT FEATURES OF THE PROSPECTUS ISSUE STRUCTURE In case of queries related to allotment/ credit of allotted NCDs/ refund, the Applicants should contact Registrar to the Issue. In case of ASBA Applications submitted to the SCSBs, the Applicant should contact the relevant SCSB. In case of queries related to upload of ASBA Applications submitted to the Member of Syndicate/Trading Members, the Applicants should contact the relevant Member of Syndicate/Trading Members. While submitting the Application Form, the applicant should ensure that the date stamp being on the application form by the Lead Managers/Syndicate Members/Trading Members/SCSB matches with the date Stamp on the Acknowledgement Slip. The grievance arising out of Applications for NCDs made through Trading Members may be addressed directly to the Stock Exchanges. Acknowledgement is subject to realisation of Cheque/DD/Availability of Funds in the ASBA account. Applications submitted without being uploaded on the terminals of the Stock Exchanges will be rejected. COMPANY CONTACT DETAILS REGISTRAR CONTACT DETAILS MUTHOOTTU MINI FINANCIERS LIMITED Registered Offce: 994, Muthoottu Buildings, Kozhencherry, Pathanamthitta 689 641, Kerala, India; Tel.: +91 468 2310148; Fax: +91 468 2314390; Corporate Offce: Mini Muthoottu Tech Towers, Kaloor, Cochin 682017, Kerala, India; Tel.: +91 484 4101050; Fax: +91 484 4101027 Website: www.minimuthoottu.com Compliance Offcer and Contact Person: Ms. Priya Menon Tel.:+91 484 410 1078; Fax: +91 484 4101027; E-mail: cs@minimuthoottu.com LINK INTIME INDIA PRIVATE LIMITED C- 13 Pannalal Silk Mills Compound, LBS Marg, Bhandup (West), Mumbai 400078, Maharashtra, India Tel: +91 22 2596 7878; Fax: +91 22 2596 0329 Email: mmf.ncd@linkintime.co.in Investor Grievance mail: mmf.ncd@linkintime.co.in Website: www.linkintime.co.in Contact Person: Sachin Achar SEBI Registration Number: INR000004058 ------------------------------------------------------------------------------------------------------ TEAR HERE ------------------------------------------------------------------------------------------------------- APPLICANTS UNDERTAKING I/We hereby agree and confrm that: 1. I/We have read, understood and agreed to the contents and terms and conditions of MUTHOOTTU MINI FINANCIERS LIMITED Prospectus dated February 12, 2014 (Prospectus) 2 I/We hereby apply for allotment of the NCDs to me/us and the amount payable on application is remitted herewith. 3. I/We hereby agree to accept the NCDs applied for or such lesser number as may be allotted to me/us in accordance with the contents of the Prospectus subject to applicable statutory and/or regulatory requirements. 4. I/We irrevocably give my/our authority and consent to IL&FS Trust Company Ltd., to act as my/our trustees and for doing such acts as are necessary to carry out their duties in such capacity. 5. I am/We are Indian National(s) resident in India and I am/ we are not applying for the said NCDs as nominee(s) of any person resident outside India and/or Foreign National(s). 6. The application made by me/us do not exceed the investment limit on the maximum number of NCDs which may be held by me/us under applicable statutory and/or regulatory requirements. 7. In making my/our investment decision I/We have relied on my/our own examination of the company and the terms of the issue, including the merits and risks involved and my/our decision to make this application is solely based on disclosures contained in the Prospectus. 8. I/We have obtained the necessary statutory and/or regulatory permissions/approvals for applying for, subscribing to, and seeking allotment of the NCDs applied for. 9. Additional Undertaking, in case of ASBA Applicants: 1) I/We hereby undertake that I/We am/are an ASBA Applicant(s) as per applicable provisions of the SEBI Regulations; 2) In accordance with ASBA process provided in the SEBI Regulations and disclosed in the Prospectus, I/We authorize (a) the Lead Managers / Syndicate Member / Sub-Syndicate Members / Trading Members or the SCSBs, as the case may be, to do all acts as are necessary to make the Application in the Issue, including uploading my/our application, blocking or unblocking of funds in the bank account maintained with the SCSB as specifed in the Application Form, transfer of funds to the Public Issue Account on receipt of instruction from the Lead Managers and Registrar to the Issue, after fnalization of Basis of Allotment; and (b) the Registrar to the Issue to issue instruction to the SCSBs to unblock the funds in the specifed bank account upon fnalization of the Basis of Allotment. 3) In case the amount available in the specifed Bank Account is insuffcient as per the Application, the SCSB shall reject the Application. 10. Additional Undertaking in case the Applicant wishes to hold the NCDs in physical form: 1. In terms of Section (8)(1) of the Depositories Act, 1996, I/we wish to hold the NCDs in physical form. 2. I/We confrm that the Information provided in this form is true and correct and I/We enclose herewith self attested copies of the KYC Documents. 3. I/We confrm that we do not hold any Demat Account. 11. Additional Undertaking in case the Applicant wishes to apply under the Existing Debenture Holders, Ex-servicemen and Senior Citizen categories: I/We confrm that the information provided in this form is true and correct and I/We enclose herewith copies of the Mandatory KYC Documents. ISSUE RELATED INFORMATION FOR FILLING THE APPLICATION FORM KYC Documents to be submitted by Applicants who do not have a Demat account and are applying for NCDs in the Physical Form: a. Self-attested copy of the proof of identifcation (for individuals); Any of the following documents shall be considered as a verifable proof of identifcation: Passport; Voters ID; Driving Licence; Government ID Card; Defence ID Card; Photo PAN Card Photo Ration Card. b. Self-attested copy of the PAN card (in case of a minor, the guardian shall also submit the self attested copy of his/ her PAN card); c. Self-attested copy of the proof of residence; Any of the following documents shall be considered as a verifable proof of residence: ration card issued by the GoI; valid driving license issued by any transport authority of the Republic of India; electricity bill (not older than three months); landline telephone bill (not older than three months); valid passport issued by the GoI; AADHAAR Letter issued by Unique Identifcation Authority of India (UIDAI); voters Identity Card issued by the GoI; passbook or latest bank statement issued by a bank operating in India; leave and license agreement or agreement for sale or rent agreement or fat maintenance bill; Registered Offce address in case of applicants under Category I or Category II; or life insurance policy. d. Copy of a cancelled cheque of the bank account to which the amounts pertaining to payment of refunds, interest and redemption, as applicable, should be credited. MANDATORY KYC DOCUMENTATION REQUIREMENTS FOR EXISTING DEBENTURE HOLDERS, SENIOR CITIZENS AND EX-SERVICEMEN Existing Debenture Holders, Ex-servicemen and Senior Citizen, shall be eligible for the extra coupon on the NCDs that is allotted to them under Options I, III, V and VI.However, the additional coupon shall be available only to those Applicants who have submitted the following documents: Type of Applicants KYC Documents Retired Servicemen Self-attested copy of Ex-Servicemen identity card issued by the ZillaSainik Board Senior Citizen Self-attested copy of PAN Card Existing Debenture Holder Self-attested copy of the existing debenture certifcate issued by our Company Investor Categories: Category I (Institutional Portion) Sub Category Code Category II (Non-Institutional Portion) Sub Category Code Category III* (Retail Individual Portion) Sub Category Code Resident Public Financial Institutions, Statutory Corporations 11 Companies, Bodies Corporate, Registered Societies 21 Resident Indian individuals 31 Commercial Banks, Co-operative Banks, Regional Rural Banks 12 Public/Private Charitable/Religious trusts 22 Hindu Undivided Families through the Karta 32 Provident Funds, Pension Funds, Superannuation Funds, Gratuity Fund 13 Scientifc and/or Industrial Research Organizations 23 Venture Capital funds / Alternative Investment Funds registered with SEBI 14 Partnership frms in the name of the partners 24 Insurance Companies registered with the IRDA 15 Limited Liability Partnerships 25 National Investment Fund 16 Educational Institutions and Association of Persons 26 Mutual Funds registered with SEBI 17 Resident Indian individuals making an application for value exceeding ` 5 lacs 27 Hindu Undivided Family through the karta making an application for value exceeding ` 5 lacs 28 In case of Existing Debenture Holder, Senior Citizen and Ex-servicemen mention the relevant sub-category code under serial number 2. Ex-Servicemen 41 Senior Citizen 42 Existing Debenture Holder 43 *Applications aggregating to a value not more than ` 5 Lacs. Tenure 400 days 24 months 36 months 66 months Options I II III IV V VI VII VIII Frequency of Interest Payment Monthly Cumulative Monthly Cumulative Monthly Yearly Cumulative Cumulative Minimum Application 5 NCDs (`5,000)(across all options of NCDs) In Multiples of 1 NCD after the minimum application Face Value of NCDs (` / NCD) `1,000 Issue Price (` / NCD) `1,000 Mode of Interest Payment/Redemption Through Various options available Coupon (%) per annum in Category I, II and III 12.00% NA 12.25% NA 12.50% 13.00% NA NA Coupon (%) for Existing Debenture Holders, Ex-servicemen and Senior Citizen 12.25% NA 12.50% NA 12.75% 13.25% NA NA Coupon Type Fixed Redemption Amount (`/NCD) for Category I, II and III 1,000 1,137.78 1,000 1,265.63 1,000 1,000 1,462.14 2,000 Redemption Amount (`/NCD) for Existing Debenture Holders, Ex-servicemen and Senior Citizen 1,000 1,140.55 1,000 1,271.26 1,000 1,000 1,471.82 2,000 Effective Yield (per annum) Category I, II and III 12.68% 12.50% 12.96% 12.50% 13.24% 13.00% 13.50% 13.43% Effective Yield (per annum) for Existing Debenture Holders, Ex-servicemen and Senior Citizen 12.96% 12.75% 13.24% 12.75% 13.52% 13.25% 13.75% 13.43% Put and Call Option Not Applicable Deemed Date of Allotment The date of issue of the Allotment Advice, or such date as may be determined by the Board or a duly constituted committee thereof, and notifed to the Exchange. All benefts relating to the NCDs including interest on the NCDs shall be available to the investors from the Deemed Date of Allotment. The actual Allotment of NCDs may take place on a date other than the Deemed Date of Allotment For Grounds for Technical Rejection. Please refer to point no. 41 of the Abridged Prospectus. Basis of Allotment : For details, please refer to point no. 57 of the Abridged Prospectus.