ICDR-Schedule IX

Front Page:

Report of the Monitoring Agency

Name of the Issuer:

For quarter ended:

Name of the Monitoring Agency:

(a) Deviation from the objects:

– Utilization different from Objects stated in OD but in line with change of objects approved by shareholders’ resolution; or
– Utilization neither in line with Objects stated in OD nor approved by shareholders’ resolution
– In case of no deviation, the fact would be stated.

(b) Range of Deviation*:

Indicate range of percentage deviation from the amount of issue proceeds earmarked for objects. For example, up to 10%, 10 – 25%, 25-50%, 50-75%, 75-100%, not ascertainable etc.

* Range of Deviation may be computed by taking weighted average of financial deviation of each object in the ratio of issue proceeds allocated for it. Non-financial deviation may be indicated separately by way of notes.

Declaration:
I/We hereby declare that this report is based on the format as prescribed by SEBI (ICDR) Regulations, 2009, as amended. I/We further declare that this report provides true and fair view of the utilization of issue proceeds.

I/We declare that we do not have any direct / indirect interest in or relationship with the
issuer/promoters/directors/management and also confirm that we do not perceive any conflict of interest in such relationship / interest while monitoring and reporting the utilization of issue proceeds by the issuer.

Signature:
Name of the Authorized Person/Signing Authority:
Designation of Authorized person/Signing Authority:
Seal of the Monitoring Agency:
Date:

Subsequent Pages:

1) Issuer Details:

Name of the issuer :
The names of the promoters of the issuer :
Industry/sector to which it belongs :

2) Issue Details:

Issue Period :
Type of issue (public/rights) :
Type of specified securities :
Grading :
Issue size (Rs in Crores) :

3) Details of the arrangement made to ensure the monitoring of issue proceeds:

(Give item by item description for all the objects stated in offer document separately in following format)

ParticularsReplyComments of Monitoring
Agency
Comments of Board of
Directors
Whether all the utilzation is as per disclosure in Offer
Document?
Yes/No
Whether Shareholder approval is obtained in case of material deviations# from expenditures disclosed in Offer
Document?
Yes/No
Whether means of finance for disclosed objects of the Issue has changed?Yes/No
Any major deviation observed over the earlier monitoring agency reports?Yes/No
Whether all Government / Statutory approvals related to the object(s) obtained?Yes/No
Whether all arrangements pertaining to technical
assistance/collaboration in operation?
Yes/No
Any favorable events improving object(s) viabilityYes/No
Any unfavorable events affecting object(s) viabilityYes/No
Any other relevant information that may materially affect the decision making of the investorsYes/No

# Where material deviation may be defined to mean:
a) Deviation in the objects or purposes for which the funds have been raised
b) Deviation in the amount of fund actually utilized by more than 10% of the amount projected in the offer documents.

4) Details of object(s)s to be monitored:

(i) Cost of object(s)-

(Give Item by Item Description for all the Objects Stated in Offer Document separately in following format)

Sl. NoItem HeadOriginal Cost (as per Offer Document)Revised CostComments of Monitoring AgencyComments of Board of Directors
Reason of cost
revision
Proposed financing
option
Particulars of firm arrangements made

(ii) Progress in the object(s)-

(Give Item by Item Description for all the Objects Stated in Offer Document separately in the following format)

Sl. NoItem Head$Amount as proposed in Offer DocumentAmount utilizedTotal unutilized
Amount
Comments of Monitoring AgencyComments of Board of Directors
As at Beginning
of the quarter
During the quarterAt the end of the
quarter
Reason of idle fundsProposed Course of
Action

$ Provide following details under Item Head:
(a)Name of the object(s):
(b)Brief description of the object(s):
(c)Location of the object(s) (if applicable):

(iii) Deployment of unutilized IPO proceeds-

Sl. no.Type of instrument
where amount invested*
Amount investedMaturity dateEarningsReturn on Investment (ROI %)Market Value as at
the end of quarter**

* Also indicate name of the party/company in which amounts have been invested
** Where market value is not practical to find, provide NAV/NRV/Book Value of the same

(iv) Delay in implementation of the object(s)-

Object(s) NameCompletion DateDelay (No. of days/
months)
Comments of Board of Directors
As per Offer DocumentActual *Reason of delayProposed Course of
Action

* In case of continuing object(s) please specify latest/revised estimate of completion date.