APPLICATION FORM ROI 5.25% p.a.

TENURE/LOCK-IN PERIOD: 5YEARS

Private & Confidential – Not for Circulation
54EC Bonds Application Number
INDIAN RAILWAY FINANCE CORPORATION LTD.
A Miniratna Company CIN No. L65910DL1986GOI026363
Regd. Office: Room Nos. 1316–1349 3rd Floor, Hotel The Ashok, Diplomatic
Enclave, 50-B, Chanakyapuri, New Delhi – 110021
20048056
E-Mail: [email protected], Website: www.irfc.co.in
APPLICATION FORM FOR NON-CONVERTIBLE REDEEMABLE SECURED Apply in Demat Mode & Get
TAXABLE BONDS, SERIES –VII HAVING BENEFITS UNDER SECTION 54EC OF INCOME TAXT ACT, 1961
Rs. 500/- (Read 25 IFI)
(PLEASE CAREFULLY READ INFORMATION MEMORANDUM FOR PRIVATGE PLACEMENT BEFORE
FILLING UP THIS FORM)
Broker’s Name & Code Sub Broker’s Name & Code Bank Branch Serial No.& Stamp FOR USE BY COLLECTING BANK BRANCH

Date of receipt of Date of credit of Cheque/

I031- application Demand Draft in IRFC Account
SHARKHAN Registrar’s reference no.
Dear Sirs,
I/We have read and understood the Private Placement Memorandum. I/We bind myself/ourselves to their provisions and apply for allotment. Please place my/our name(s) on the
register of Bondholder(s). Payment details (In case payment is done by RTGS-Please send an email of all scanned documents
to [email protected]
No. of Bonds (Minimum 2) (Maximum 500) Cheque/Demand Draft/RTGS Bank A/c Number from Cheque / Demand Dated
In Number (A) Drawn on (Name of the Bank and Branch) which investment is made Draft / UTR No.
In Words
Issue Price of Bond Rs.10,000/- per Bond – Amount Payable (Rs.) (Ax10,000)
Rs.
In Words

I/We are applying as (tick whatever applicable)

Banks/Commercial RRB/Co-operative Financial Institutions Company Mutual Fund Firms NRI Individuals HUF Other(specify ......... )

BOND CERTIFICATE MODE (TICK) ANY ONE

Physical mode Demat Mode DPID No.

ClientID

Mr./Ms/Messrs
FIRST/SOLE APPLICANT’S NAME IN FULL

Date of Birth (if Minor)

SECOND APPLICANT’S NAME IN FULL (ONLY IN CASE OF INDIVIDUAL)

THIRD APPLICANT’S NAME IN FULL (ONLY IN CASE OF INDIVIDUAL)

FATHER’S NAME FOR FIRST / SOLE APPLICANT (IN CASE OF INDIVIDUAL)

CORRESPONDENCE ADDRESS IN FULL (DO NOT WRITE NAME AGAIN)

CITY PIN CODE

Mobile No. EMAIL
BANK PARTICULARS FOR PAYMENT OF INTEREST/REDEMPTION WARRANT (PLEASE ENCLOSE CANCELLED CHEQUE OF BELOW ACCOUNT NO.)
BankName AccountNo.
AccountType SB A/c Current A/c Cash Credit A/c NRO A/c
BranchName/Address
FOR NECS/RTGS/NEFT PAYMENT
IFSC CODE MICR CODE
Abstract of Form-SH-13 (Nomination Form) (For individual only) or Form ISR-3 i.e Name of Authorised signatory(ies) Designation
Declaration to optout of Nomination (ISR-3 form available in IRFC’s website ) (In case of Other than Individual)
Name of Nominee……………………………………………………………...………………………………………………. 1…………………………………………………. 1…………………………………………………
Address ………………………………………………………………………………………………………………………………. 2…………………………………………………. 2…………………………………………………
PAN/AADHAAR No. of Nominee…..…..………….Relation with Applicant………………………………..
In case of Nominee is Minor: Disclaimer: The Bond Issue is being made strictly on a private placement basis. It is not and
Name of Guardian………………………………………………………………………………………………………………… should not be deemed to constitute an offer to the public in general. It cannot be accepted
Date of Birth (if minor) ........................................ Signature of Nominee/Guardian(optional) by any person other than to whom it Is directed
(One Nominee per application)
DECLARATION: I/We certify that the aggregate investment made/being made by me/us in 54EC Capital Gains Tax Exemption Bonds during the current financial year does not exceed
Rs. 50 lakhs and the sources of funds is capital gain" on Land or Building or both being long term capital assets. I/We declare that the investment has been made from the First
Applicant's own Bank Account.
PAN/GIR NO. OCCUPATION SIGNATURE
FIRST APPLICANT
SECOND APPLICANT
THIRD APPLICANT
---------------------------------------------------------------------------------------------------------------------------------------------------------------
ACKNOWLEDGEMENT SLIP INDIAN RAILWAY FINANCE CORPORATION LTD.
(To be filed in by the Sole/First Applicant) Application No.
Regd. Office: : Room Nos. 1316–1349 3rd Floor Hotel The Ashok
54EC Bonds-SERIES-VII
Diplomatic Enclave,50-B Chanakyapuri New Delhi 110021, Ph: 24100385
Received from Mr./Mrs./Ms.………………………………………………………………..…………………… No. of Bonds Amount (Rs.) Date Accepting Officer’s Signature & Bank’s
DPID & (Max 500) Seal
CLIENT ID In Numbers
NO
In Words
Address………………………………………………………………………………………………………………..……
………………………………………………………………………………………………………………………………..… Cheque/DD No. ………………………………………………dated ………………………………. drawn on …………………………………………………….
………………………………………………………………………………………………………………………………..… …………………………………………………………for Rs.……………………………………………………………………………………………………………………
Inwords…………………………………………………………………………………………………………………………………………………………………………..
 INSTRUCTIONS FOR INVESTORS (Must read before investment)

1) Application Forms must be completed in BLOCK LETTERS IN ENGLISH. A blank space must be left between two or more parts of the
name. Filling of KYC form is mandatory annexed in this form Page 3.
2) Minimum investment-2 Bonds of Rs. 10,000/- each and maximum investment-500 Bonds amounting to Rs. 50 lakhs in a financial year.
3) Investors are required to submit the Application Form duly filled along with either a Demand Draft or account payee Cheque payable in
favour of "IRFC CAPITAL GAIN BONDS" along with necessary enclosures at the designated branches of collecting banks –HDFC Bank,
Axis Bank, ICICI Bank, IDBI Bank, Canara Bank, IndusInd Bank, Kotak Mahindra Bank, Yes Bank, and, State Bank of India.
4) Applicant should mention his name, address and application number on the reverse of the Cheque/ Demand Draft. Cash, Money Orders or
Postal Orders will NOT be accepted.
5) For details of designated bank branches, please refer Private Placement Memorandum or visit our website for more details
(https://kosmic.kfintech.com/IRFC/default.aspx).
6) For checking application status, please refer to the link (https://kosmic.kfintech.com/IRFC/irfc_query_window.aspx).
7) Investors are advised in their own interest to fill up complete details of their bank particulars along with a cancelled cheque. In absence of
such information, the interest & redemption warrants shall be mailed at given address at applicant's sole risk.
8) Applicants are deemed to have read the PPM/IM and are supposed to be well versed with the contents of PPM/IM.

9) Application once submitted cannot be withdrawn and subscription amount will not be refunded (as per PPM/IM).
10) The application should be submitted during banking hours at any of the Bank Branches as mentioned our website. Bank charges for such
applications will be borne by applicants. IRFC assumes no responsibility for any applications/ cheques / demand drafts lost in mail or late /
short credit of Application Money.

11) In case neither the PAN nor the GIR No. has been allotted, or the Applicant is not assessed to income tax, the appropriate information should
be mentioned in the space provided. In case the investor has applied for and not yet been allotted the PAN/GIR No. then he is required to
furnish a copy of the acknowledged Form 49A. In case the investor is applying through a demand draft and PAN/GIR No. has not been
allotted he is required to furnish a declaration in Form 60.

12) In case of application under the Power of attorney or by Limited Companies or other corporate bodies, a certified copy of the Power of
Attorney or a copy of the approval of the relevant authority, as the case may be should be submitted along with the Application Form.

13) In case a partnership firm makes investments, the application is required to be made in the name of the partnership firm and the application
form can be signed by any partner(s) authorised to do in this behalf and affixing a rubber stamp of the firm.

14) The applications would be accepted as per the provisions of the PPM/IM of the issue, other applicable rules and regulations. IRFC is entitled,
at its sole and absolute discretion, to accept or reject any application, in part or in full, without assigning any reason. An Application Form that
is not complete in all respect is liable to be rejected.

15) It is advisable that investor keeps a photocopy of the application form and mentions his/her mobile number, email ID in the application form.

16) In case of Bonds allotted under Demat Mode, the demographic details will be picked up from the DPID/ CLIENT ID i.e., Payment warrants
would be prepared in favour of sole/ first applicant and issued as per the details identified by the Bond holder's Demat Account. Therefore,
Bank particulars in the Application Form should match with the bank details provided in the Demat Account.

17) As a matter of precaution against possible fraudulent encashment of interest/redemption warrants due to loss/misplacement,
applicants are requested to mention the full particulars of their bank account, as specified in the Application Form. In case, where
the investor applies for bonds under Physical Mode, all the Payment Warrants will be issued as per the details captured in the
Register of Bond holder and any discrepancy arising due to wrong information furnished in the application form shall at the
applicant’s sole risk.

18) ISSUE HIGHLIGHTS: Interest rate is 5.25% payable annually on 15 October. Lock in period of 5 years (No transfer is permitted). First
Interest payment for bonds whose money has been credited in to IRFC account till August 31, 20xx and are successfully allotted will be
made on October 15, 20xx. For Bonds in respect of which money has been credited into IRFC account after August 31, 20xx will be paid on
October 15 of next year and onwards. The Bonds will automatically redeem after expiry of five years. Bonds are AAA rated by ICRA,
CRISIL and CARE.

19) Interest/Redemption shall be paid by way of warrant/NECS/RTGS/NEFT payable at par at locations where collection centers are appointed.

20) No TDS will be deducted on interest earned on these Bonds. IRFC has received exemption from deduction of TDS on interest of
these bonds in terms of Government Notification No. 28/2018/F. No. 275/27/2017-IT(B) dated June 18, 2018 under Section 193 of
Income Tax Act,1961.

21) IRFC reserves the right to revise the coupon rate and/or close the issue by giving a notice. All applications submitted but not accepted by
IRFC would be returned by IRFC to the applicant without any interest.

22) For status of allotment/ servicing or any other details, please contact our RTA/IRFC.

23) IRFC advises all its investors to keeps a photocopy of the Application Form for their future reference.

24) In case of any inconsistency in the provisions of application form and Private Placement Memorandum, the provisions of Private Placement
Memorandum shall prevail.

25) For eligible investors opting for applying in Demat mode, An amount of Rs. 500/- per PAN per investor for only one year will be paid upon
allotment.
 INDIAN RAILWAY FINANCE CORPORATION LTD.
KNOW YOUR CUSTOMER FORM (FOR INVESTOR)
1. Name of Applicant (1st Applicant)/HUF/Corporate/Firm/Trust/Funds etc.

2. PAN/DIN (Issued by MCA), Wherever Applicable

3. First / Sole Applicant’s Full Permanent Address (with Mobile nos.) in case of Individual and HUF

4. Correspondence Address (with telephone and fax nos.) (Corresponding address proof is not required)

5. Nature of Business
6. Source of Funds – The source of funds for the investment is capital gain arising from the transfer of land or building or both.

Signature of Applicant
Mandatory documents for all the investors
 Self-attested copy of PAN Card (In case of Joint application, self-attested PAN copy of all the applicants) or Form 60 where bond
application size is Rs. 50,000/- or more.
 Photo Copy of cancelled Cheque for NECS facility.
(a) For Resident Indian Nationals
Documents in support of Name and Address (copies attested by Gazetted Officer/Notary/Self Attested in case of Individual only)
PAN Card and any one of the following
(i) AADHAAR Card (consent form required available in IRFC/KOSMIC Website) or MASKED AADHAR (ii) Passport (iii) Driving Licence (iv)
Identify Card issued by any institution (v) Copy of the electricity bill or telephone bill showing residential address (vi) Any document or
communication issued by any authority of the Central Government, State Government or local bodies showing residential address (vii)
voters identity card (viii) Ration Card.'
(b) HUF
HUF Deed, PAN and Address Proof of Karta (copies attested by KARTA)
(c) For NRIs/Other foreign eligible investors

(i) Passport-Mandatory (ii) PAN Card (iii) Photocopy of Cancelled Cheque (NRO Account) (iv) Self certified address proof
(d) For Corporate-Investor

Documents in support (copies attested by Company Secretary/Director)

(i) Certificate of incorporation and Memorandum & Articles of Association (ii) Resolution of the Board of Directors and identification of
those who have authority to operate (iii) Power of Attorney granted to its managers, officers or employees to transact business, on its
behalf (iv) Copy of PAN/PAN Allotment letter.
(e) For Partnership Firms-Investor

Documents in support (copies attested by Notary)

(i) Registration certificate, if registered (ii) Partnership deed (iii) Power of Attorney granted to a partner or an employee of the firm to
transact business on its behalf (iv) Any officially valid document identifying the partners and the persons holding the Power of Attorney
and their addresses (v) Telephone bill in the name of firm/partners (vi) Copy of PAN/PAN Allotment letter.
(f) Trust & Foundations –Investor
Documents in support (copies attested by Notary)
(i) Certificate of registration, if registered (ii) Power of Attorney granted to transact business on its behalf (iii) Any officially valid
document to identify the Trustees, Settlors, Beneficiaries and those holding Power of Attorney, Founders/Managers/Directors and their
addresses (iv) Resolution of the managing body of the Foundation / Association / (v) Telephone bill (vi) Copy of PAN/ PAN Allotment
letter (Otherwise exemption certificate issued by IT Authorities)
 APPLICANT’S UNDERTAKING
I/We here by agree and confirm that:

1. I/We have read, understood and agreed to the contents and terms & conditions of Indian Railways Finance Corporation Limited’s
Private Placement Information Memorandum for Bond Series-VII provisions of Section 54EC of Income Tax Act, 1961 and other
related laws.

2. I/We confirm that the information provided in this form is true & correct and I/We enclose herewith Self attested copies of KYC
Documents.

Applicant’s Signature

FORM NO. 60
(See second proviso to rule 114B)
Form of declaration to be filled by a person who does not have a permanent account
number and who enters into any transaction specified in rule114B

1. Full name and address of the declarant………………………………………………………………………………………………………………………………………….……..

2. Particulars & Date of transaction………………………….……………………………………………………………………………………………………………………………….
3. Amount & mode of the transaction……………………………………………………………………………………………………………………………………………………...
4. Are you assessed to Income tax? ……………..…………………………………………….…………………………………………………………………………………………….
5. If yes,
(i) Details of Ward/Circle/Range where the last return of income was filed?
(ii) Reasons for not having permanent account number?

6. Details of the document being produced in support of address in serial no.1 above**.
7. Aadhar Number (if available)………………………………………………………………………………………………………………
8. Date of Birth (DD/MM/YYYY)…..………………………………………………………………………………………………………….
9. Total Income for the Financial Year: Agricultural Income………………………….Non-Agricultural Income….……………………….

Verification

I ...................................................... do here by declare that what is stated above is true to the best of my knowledge andbelief.

Verified today, the.........................................day of...........................(month)………………………(year).

Date............................................................
Place: ..........................................................
……………………………………….
Signature of the declarant
Documents as an address proof: - **
(Any one of the following)
(a) ADHAAR Card or Ration Card;
(b) Passport;
(c) Driving Licence;
(d) Copy of the electricity bill or telephone bills showing residential address;
(e) Any other document or communication issued by any authority of the Central Government, State Government or local
bodies showing residential address;
(f) Any other valid documentary evidence in support of his address given in the declaration.

Registrar and Transfer Agent (RTA): Any further communications in connection with this application (quoting the application number)
should be addressed to “KFin Technologies Private Limited, Karvy Selenium Tower B, Plot 31-32, Gachibowli, Financial District,
Nanakramguda, Hyderabad, Telangana 500 032 Contact Person : Mr. M Murali Krishna & Mr. R.Williams, Tel. (040) 67162222, FAX
NO.(040)23431551 Email:[email protected]

IRFC: Room Nos. 1316–1349 3rd Floor, Hotel The Ashok, Diplomatic Enclave, 50-B Chanakyapuri, New Delhi – 110021, ; E-Mail: [email protected]
For more details of 54EC Bonds please refer to the link (https://kosmic.kfintech.com/IRFC)
For checking application status please refer to the link (https://kosmic.kfintech.com/IRFC/irfc_query_window.aspx)