76

"INTERE5TED PER5ON5 ARE ENTITLED TO A PRO5PECTU5, IF THEY 5O DE5IRE, AND THAT COPIE5 OF
PRO5PECTU5 MAY BE OBTAINED FROM THE I55UER AND THE I55UE MANAGER."

Deshlandhu IoIyner Liniled

AIILICATION IORM
AIILICATION IOR SHARLS Y INVLSTORS OTHLR THAN NON-RLSIDLNT ANCLADLSHI (S)
WarnIng: IIease read lhe inslruclion al lhe lack of lhis forn. IncorreclIy fiIIed appIicalion nay le rejecled.

Thc ManagIng DIrcctnr
Deshlandhu IoIyner Liniled ankers SI. No.
Moslafa Cenlre H#59, R#27, anani, Dhaka - 1213

Dear Sir,
I/ve appIy for and requesl you lo aIIol ne/us lhe .. nunler of Shares and I/ve agree lo accepl lhe sane or any
snaIIer nunler lhal nay le aIIolled lo ne/ us upon lhe lerns of lhe conpanys approved Irospeclus and suljecl lo
lhe Menorandun and ArlicIes of Associalion of lhe conpany. Iurlher, I/ve aulhorize you lo pIace ny/our nane(s) on
lhe Regisler of Menlers of lhe conpany and deposil lhe said shares lo ny O (eneficiary Ovner) Accounl and/or
Crossed (Accounl Iayee onIy) cheque in respecl of any appIicalion noney refundalIe ly posl/courier al ny/our risk lo
lhe firsl appIicanls address slaled leIov:

1. No. Ordinary shares .... of Tk. 10 each.
2. Anounl of Tk. (in figure): ....., Taka (in vords): ......
onIy deposiled vide Cash/ Cheque/ drafl/ pay Order No.............Daled.............
on..... ank..............ranch.

3. Deposilory (/O) Accounl Nunler
(If ynu dn nnt mcntInn ynur va!Id BO (BcncfIcIary Owncrs) accnunt, ynur app!IcatInn wI!! bc trcatcd as In va!Id)

4. I/ve agree lo fuIIy alide ly lhe inslruclion given herein.
5. IarlicuIars of AppIicanl(s):
a) 5n!c/FIrst App!Icant
Nane:
Ialhers / Husland nane:
Molhers nane:
IoslaI Address:
Occupalion: NalionaIily: TeIephone No.(if any):
Fnr rcfund warrant (App!IcatInn wI!! nnt bc trcatcd as va!Id If anynnc uscs a nnn-schcdu!cd bank. Tn avnId thIs cnmp!IcatInn, Invcstnrs arc
rcqucstcd nnt tn usc thc namc nf any nnn-schcdu!cd bank) P!casc wrItc thc cnrrcct and fu!! namc nf bank and branch.
Ior refund purpose: I/ve vanls refund lhrough ank Accounl* Hand deIivery/Courier (pIease pul lick narks in vhich refund viII le
nade). Thc app!Icant sha!! prnvIdc wIth thc samc Bank Accnunt numbcr In thc app!IcatInn fnrm as It Is In thc BO accnunt nf thc app!Icant.
OthcrwIsc thc app!IcatInn wI!! bc cnnsIdcrcd Inva!Id and thc subscrIptInn mnncy may bc fnrfcItcd.
AppIicanls ank A/C No:
Nane of lhe ank:

b) 5ccnnd App!Icant
Nane:
Ialhers / Husland nane:
Molhers nane:
IoslaI Address:
Occupalion: NalionaIily: TeIephone No.(If any):

6. I/ve herely decIare lhal I/ve have read lhe Irospeclus of Dcshbandhu Pn!ymcr LImItcd and have viIIingIy sulscriled for
... no. of shares of Tk 10.00 each.

7. 5pccImcn 5Ignaturc(s):
(i) Nane ( in lIock Iellers): Signalure:
(ii) Nane ( in lIock Iellers): Signalure:

*In case of deposil inlo lhe appIicanls lank accounl, lhe appIicanl viII lear lhe appIicalIe charge, If any, of lhe appIicanls
lanker, and lhe issuer shaII sinuIlaneousIy issue a Ieller of inlinalion lo lhe appIicanl conlaining, anong olhers, lhe dale and
anounl renilled vilh delaiIs of lhe lank lhrough and lo vhich lank such renillance has leen effecled.
......................................................

ANKLRS ACKNOWLLDCLMLNT
Cerlified lhal lhis ank has received Tk. .... /- (in vord) ............ onIy forn
Mr./Mrs./Ms...................leing lhe appIicalion noney for ......nos. of Ordinary
Shares of Deshlandhu IoIyner Liniled.

Bankcr's 5!. Nn. 5ca! and Datc AuthnrIzcd 5Ignaturc
(Namc & DcsIgnatInn)


77
IN5TRUCTION5

1. As per provision of Deposilory Acl, 1999 and reguIalions nade lhere under shares viII onIy le issued in
denaleriaIized condilion. IIease nenlion your O (eneficiary Ovner) Accounl nunler in lhe appIicalion forn.
If you do nol nenlion your vaIid O (eneficiary Ovner) Accounl, your appIicalion viII le lrealed as invaIid.

2. AII infornalion nusl le lyped or vrillen in fuII (in Iock Iellers) in LngIish or in engaIi and nusl nol le
allrevialed.

3. AppIicalion nusl le nade on lhe Conpanys prinled forn/pholocopy or lyped copy/hand vrillen forn
lhereof.

4. AppIicalion nusl nol le for Iess lhan 5OO Ordinary Shares and nusl le for a nuIlipIe of 5OO Ordinary Shares.
Any AppIicalion nol neeling lhis crilerion viII nol le considered for aIIolnenl purpose.

5. Renillance for lhe fuII anounl of lhe Shares nusl acconpany each AppIicalion and nusl le forvarded lo any
of lhe ankers lo lhe Issue. Renillance shouId le in lhe forn of Cash/ Cheque/ ank Drafl/ Iay Order payalIe
lo one of lhe ankers lo lhe Issue A/C Deshlandhu IoIyner Liniled and crossed A/C Iayee onIy and nusl
le dravn on a ank in lhe sane lovn as lhe ank lo vhich lhe AppIicalion forn has leen senl.

6. In lhe case of }oinl AppIicalion Iorn, lhe AIIolnenl Leller viII le dispalched lo lhe person vhose
nane appears firsl on lhis AppIicalion Iorn.

7. }oinl AppIicalion forn for nore lhan lvo persons viII nol le accepled. In case of joinl AppIicalion, each parly
nusl sign lhe AppIicalion Iorn.

8. AppIicalion nusl le in fuII nane of individuaIs or conpanies or socielies or lrusls and nol in lhe nane of
firns, ninors or persons of unsound nind. AppIicalion fron financiaI and narkel inlernediary conpanies and
Irivale Conpany nusl le acconpanied ly Menorandun and ArlicIes of Associalion and Cerlificale of
Incorporalion.

9. An app!Icant can nnt submIt mnrc than twn app!IcatInns, nnc In hIs/hcr nwn namc and annthcr jnInt!y
wIth annthcr pcrsnn. In casc an app!Icant makcs mnrc than twn app!IcatInns, a!! app!IcatInns wI!! bc trcatcd
as Inva!Id and wI!! nnt bc cnnsIdcrcd fnr a!!ntmcnt purpnsc. In addItInn, whn!c nr part nf app!IcatInn mnncy
may bc fnrfcItcd by thc CnmmIssInn.

1O. No receipl viII le issued for lhe paynenl nade vilh AppIicalion, lul lhe lankers viII issue a
provisionaI acknovIedgnenl lo lhe Issue for AppIicalion Iodged vilh lhen.

11. In lhe case of non-aIIolnenl of securilies, if lhe appIicanls lank accounls as nenlioned in lheir IIO
AppIicalion Iorns are nainlained vilh lhe ankers lo lhe Issue, refund anounl of lhose appIicanls viII le
direclIy crediled in lo lhe respeclive lank accounl as nenlioned in lheir IIO AppIicalion Iorns. Olhervise,
refund viII le nade onIy lhrough Accounl Iayee cheque(s) shoving lank accounl nunler and nane of lank
and lranch as nenlioned in lhe AppIicalion payalIe al Dhaka or Chillagong, as lhe case nay le.

12. AIIolnenl viII le nade soIeIy in accordance vilh lhe inslruclions of lhe Securilies and Lxchange
Connission (SLC).

13. Making of any faIse slalenenl in lhe appIicalion or suppIying of incorrecl infornalion lherein or suppressing
any reIevanl infornalion shaII nake lhe appIicalion IialIe lo rejeclion and suljecl lo forfeilure of appIicalion
noney and /or forfeilure of share (unil) lefore or afler issuance of lhe sane ly lhe issuer. The said forfeiled
AppIicalion noney or share (unil) viII le deposiled in accounl specified ly lhe Securilies and Lxchange
Connission (SLC). This nay le in addilion lo any olher penaIlies as nay le provided for ly lhe Iav.

14. AppIicalions, vhich do nol neel lhe alove requirenenls, or appIicalions, vhich are inconpIele, shaII nol le
considered for aIIolnenl purpose.

15. The ankers lo lhe Issue anks shaII le olIiged lo receive lhe A/C Iayee Cheque(s) on lhe cIosing day of
lhe sulscriplion of lhe IIO.

16. Nn sa!c nf sccurItIcs sha!! bc madc, nnr sha!! any mnncy bc takcn frnm any pcrsnn, In cnnncctInn wIth
such sa!c untI! 25(twcnty fIvc) days aftcr thc prnspcctus has bccn pub!Ishcd.








78
BANKER5 TO THE I55UE













Namc nf thc Branchcs Namc nf thc Branchcs Namc nf thc Branchcs Namc nf thc Branchcs Namc nf thc Branchcs
Invcstmcnt CnrpnratInn
Of Bang!adcsh (ICB)
Head Office, r, Dhaka
Chillagong r, Clg
Rajshahi r, Rajshahi
KhuIna r, KhuIna
arishaI r, arishaI
SyIhel r, SyIhel
ogra r, ogra
LocaI Office, Dhaka

5nuthcast Bank Ltd
IrincipIe r, Dhaka
Corporale r, Dhaka
Inanagonj r, Dhaka
Dhannondi r, Dhaka
Ullara ranch, Dhaka
N. LIephanl Rd r,Dhaka
KakraiI ranch, Dhaka
anai ranch, Dhaka
angshaI ranch, Dhaka
Nev Lskalon r, Dhaka
Agargaon r, Dhaka
Iragali Sarani r, Dhaka
ShanoIi ranch, Dhaka
Agarnagar r, Dhaka
Sal Mosjid r, Dhaka
Madhaldi r, N.shingdi
AshuIia ranch, Dhaka
Narayanganj r, N.ganj
}oypara r, Dhaka
Savar ranch, Dhaka
Mouchak ranch, Dhaka
Konalari r, Cazipur
Tongi ranch, Cazipur
ashundhar r, Dhaka
Mohannadpur r, Dhaka
Madanlilir Hal r, Clg
ConiIIa ranch, ConiIIa
andar azar r, SyIhel
MouIvilazar r, M. azar
Helingonj r, SyIhel
Chouhalla r, SyIhel
LaIdhirpar r, SyIhel
ShajaIaI Uposhar r, SyIhel
KuIaura r, MouIvilazar
IalhanluIa r, SyIhel
Agralad r, Clg
Khalunganj r, Clg
}ulIee Road r, Clg
HaIishahr r, Clg
Chovnuhani r, N.khaIi
CDA Avenue r, Clg
Coxs azar r, C. azar
ChhagaInaiya r, Ieni
Ieni ranch, Ieni
IaharliI r, Clg
ashurhal r, NoakhaIi
Monin Road r, Clg
Rangpur r, Rangpur
ogra ranch, ogra
KhuIna ranch, KhuIna
arisaI ranch, arisaI
Rajshani r, Rajshahi
Naogaon r, Naogoan

McrcantI!c Bank Ltd.
Dhannondi r, Dhaka
Kavranlazar r, Dhaka
Agralad r, Clg
}oypara r, Dhaka
anani r, Dhaka
Rajshahi r, Rajshahi
Naogaon r, Naogoan
SyIhel r, SyIhel
oard azar r, Cazipur
Nayalazar r, Dhaka
Khalunganj r, Clg
Mohakhani r, Dhaka
Mirpur ranch, Dhaka
AshuIia ranch, Dhaka
Ullara ranch, Dhaka
}uliIee Rd r, Clg
LIephang Rd r, Dhaka
MolijheeI r, Dhaka
Madan ilir Hal r, Clg
KhuIna ranch, KhuIna
Rangpur r, Rangpur
Salnasjid r, Dhaka
OR Nazin Rd r,, Clg
ogra ranch, ogra
Konalari r, Cazipur
CuIshan r, Dhaka
Ieni r, Dhaka
MouIvilazar r, M.azar
ijoyagar r, Dhaka
Moghlazar r, Dhaka
arisaI r, arisaI
ConiIIa r, ConiIIa
Creeen Rd r, Dhaka
Sheikh Mujil Rd r, Clg
Lng. Insl. r, Dhaka
Mazar Road r, Dhaka
Dinajpur r, Dinajpu
}essore r, }essore
Irogali Sarani r, Dhaka
Chillagong LIZ r, Clg
Narayangonj r, N.gonj
Ialia r. Chillagong

NCC Bank LImItcd
Agralad r, Clg
AnderkiIIa r, Clg
anani r, anani
alulazar r, Dhaka
ijoy Nagor r, Dhaka
angshaI r, Dhaka
araiyarhal r, Clg
araIekha r. SyIhel
ogura r, ogura
Chakaria r., Coxs azar
CLIZ r., Chillagong
Chovhalla r., Sunangonj
Chovnuhuni r, NoakhaIi
ConiIIa r., ConiIIa
Coxs azar r, Coxs azar
Dhannondi r, Dhaka
DiIkusha r, Dhaka
LIephanl Rd r, Dhaka
Ioreign Lx. r, MolijheeI
Ieni r, Ieni
CuIshan r, Dhaka
Cazipur r, Cazipur
CuIshan r, CuIshan
Hajigonj r, Chandpur
HaIishahar r, Clg
IsIanpur r, Dhaka
}essore r, }essore
}oydelpur r, Cazipur
}alralari r, Dhaka
}uliIee Rd r, Clg
Kavran azar r, Dhaka
KhuIna r, KhuIna
Kushlia r, Kushlia
KadanlaIi r, Clg
Khalungonj r, Clg
Laxnipur r, Laxnipu
LaIdighirpar r, SyIhel
Majhirghal r, Clg
MolijheeI r, Dhaka
MaIilagh r, Dhaka
Moglazar r, Dhaka
Mirpur r, Dhaka
Milford Rd, Dhaka
Madaripur r, M.pur
Madaldi r, Madaldi
Naogaon, Naogoan
Narayangonj r, N.gonj
Navalpur Rd r, Dhaka
Ialgran r, LaInonilhal
Iragali Sharani r, Dhaka
Rajshahi r, Rajshahi
Rangpur r, Rangpur
Savar r, Dhaka
ShaynoIi r, Dhaka
TangaiI r, TangaiI
Ullara r, Dhaka

Bank AsIa LImItcd
Agralad r, Clg
AnderkiIIa r, Clg
ashundhara r, Dhaka
agra ranch, ogra
ahadderhal r, Clg
Corporale r, Noor Tover
C.R. Dulla Road, Dhaka
CDA Avenue r, Clg
Dhannondi r, Dhaka
}essore ranch, }essore
Khalunganj r, Clg
KhuIna ranch, KhuIna
Moghlazar r, Dhaka
MohakhaIi r, Dhaka
Mirpur ranch, Mirpur
MC Sk. Mujil Rd r, Clg
MC DiIkusha r, Dhaka
MC anani r, Dhaka
Milford ranch, Dhaka
Norlh Soulh Rd r, Dhaka
IrincipIe Office r, Dhaka
Rajshahi r, Rajshahi
SyIhel Main r, SyIhel
SyIhel Uposhahar ranch
Scolia ranch, Dhaka
Shanlinagar r, Dhaka
Slalion Road r, Clg
CuIshan ranch, Dhaka
Ullara ranch, Dhaka

Onc Bank LImItcd
IrincipaI r, Dhaka.
MolijheeI ranch, Dhaka.
Kavran azar r, Dhaka
CuIshan ranch, Dhaka
Mirpur ranch, Dhaka
Ullara ranch, Dhaka
Dhannondi r, Dhaka
anani ranch, Dhaka.
KakraiI ranch, Dhaka
Irogoli Sharani r adda
LIephanl Road r, Dhaka
}alralari r, }alralari
Navalganj r, Dhaka
angshaI racnh, Dhaka
Canaklari (LIZ) r, Dhaka.
Inanganj ranch, Dhaka.
Narayanganj r, N.ganj
}oypara ranch, Dhaka
Agralad r, Clg
Khalunganj r, Clg
CDA Avenue r, Clg
Nanupur azar r, Clg
Coxs azar r, Coxs azar.
}uliIIe Road r, Clg
Chovnuhuni r, NoakhaIi
Chandraganj r, L.pur
Ieni ranch, Ieni
Raipur ranch, L.pur
Dagon huiyan r, Ieni
SyIhel ranch, SyIhel
Sherpur ranch, Sharpur
IsIanpur ranch, syIhel
}esspre ranch, }essore
ogra ranch, ogra
Sirajgonj r, sirajganj
Lakshan ranch, coniIIa
Ranganj ranch, Iaxnipur
Maijdee Courl r, NoakhaIi
anasree r, Dhaka

DBBL
LocaI Office, Dhaka
MolijheeI Ior. Lxch. r
Nalalpur r, Dhaka
anani ranch, Dhaka
Kavran azar r, Dhaka
Shanlinagar r, Dhaka
Dhannondi r, Dhaka
alurhal r, Narshingdi
Narayanganj r, N.ganj
. Road ranch, N.gonj
Agralad ranch, Clg
MohakhaIi r, Dhaka.
CuIshan ranch, Dhaka
Mirpur ranch, Dhaka
Ullara ranch, Dhaka
Ialherhal r, Clg
Halhazari r, Clg
IsIanpur ranch, Dhaka
Dania ranch, Dhaka
KhuIna ranch, KhuIna
SyIhel ranch, SyIhel
Dhaka LIZ r, Dhaka
oard azar r, Cazipur
Nelaiganj r, N.ganj
ogra ranch, ogra
LIephanl Road r, Dhaka
arisaI ranch, arisaI
SinraII ranch, N.ganj
CDA Avenue r, Clg
}oypara ranch, Dhaka
isvanalh r, SyIhel
Muradpur ranch, Clg
CoIapgonj r, SyIhel
Rajshahi r, Rajshahi
Naya azar r, Dhaka
Inangonj r, Dhaka
Savar azar r, Dhaka
Cazipur Chovrasla r
Ieni ranch, Ieni
ConiIIa r, ConiIIa
}uliIee Road r, Clg
KadanlaIi ranch, Clg
Mirzapur r, TangaiI
Coxs azar r, C. azar
Lohagara r, Clg
asundhara r, Dhaka
Ring Road r, Dhaka
Manikgonj r, Manikgonj
Ialikchori r, Clg
Konalari r, Cazipur
Chounuhani r, Ieni
Sonagazi r, Ieni
CoaIa azar r, syIhel
Khalunganj r, Clg
Mynenshing r, M.hing
Shahzadpur r, Sirajganj
eani azar r, SyIhel
Chhalak r, sunanganj
andura r, Dhaka
Saidpur r, NiIphanary
Rangpur r, Rangpur
}essore r, }essore
Mirpur r, Dhaka
HaIishahar r, Clg
MouIavi azar ranch
asurhal r, NoakhaIi
SrenangaI r, SyIhel
Kushlia r, Kushlia
Ialna r, Ialna
Narsingdi r, Narsingdi
Salnosjid Rd r, Dhaka
Dinajpur r, Dinajpur
hairal r, Kishorgonj
Dagonlhuiyan r, Ieni
Colindaganj ranch
huIla ranch, N.gonj
SCIC ranch, N.gonj
Rapura ranch, Dhaka
Tongi ranch, Cazipur

NatInna! Bank Ltd
anani r, Dhaka
alulazar r, Dhaka
angshaI Road r, Dhaka
Dhannondi r, Dhaka
DiIkusha r, Dhaka
LIephanl Road r, Dhaka
Ioreign Lx. r, Dhaka
CuIshan r, Dhaka
Inanganj r, Dhaka
IsIanpur r, Dhaka
}alralari r, Dhaka
Kavran azar r, Dhaka
Lake Circus r, Dhaka
MaIilagh r, Dhaka
Mirpur r, Dhaka
MohakhaIi r, Dhaka
Mohannadpur r, Dhaka
MolijheeI ranch, Dhaka
Narayanganj r, N.gonj
Nelaigonj r, N.gonj
Nev Lskalon r, Dhaka
N. rk HaII Rd r, Dhaka
Irgali Sarani r, Dhaka
Rokeya Sarani r, Dhaka
Savar azar r, Dhaka
Ullara ranch, Dhaka
Z.H Sikder r, Dhaka