“INTERESTED PERSONS ARE ENTITLED TO A PROSPECTUS, IF THEY SO DESIRE, AND THAT COPIES OF

PROSPECTUS MAY BE OBTAINED FROM THE ISSUER AND THE ISSUE MANAGER.”

Deshbandhu Polymer
Limited
APPLICATION FORM
APPLICATION FOR SHARES BY INVESTORS OTHER THAN NON-RESIDENT BANGLADESHI (S)
Warning: Please read the instruction at the back of this form. Incorrectly filled application may be rejected.
The Managing Director
Deshbandhu Polymer Limited Banker’s Sl. No.
Mostafa Centre H#59, R#27, Banani, Dhaka - 1213
Dear Sir,
I/we apply for and request you to allot me/us the …….… number of Shares and I/we agree to accept the same or any
smaller number that may be allotted to me/ us upon the terms of the company’s approved Prospectus and subject to the
Memorandum and Articles of Association of the company. Further, I/we authorize you to place my/our name(s) on the
Register of Members of the company and deposit the said shares to my BO (Beneficiary Owner) Account and/or Crossed
(Account Payee only) cheque in respect of any application money refundable by post/courier at my/our risk to the first
applicant’s address stated below:

1. No. Ordinary shares ………. of Tk. 10 each.

2. Amount of Tk. (in figure): …………………., Taka (in words): ……………………………………………………
only deposited vide Cash/ Cheque/ draft/ pay Order No…………………………………
Dated……………………………..
on………………………………………………. Bank………………………………..Branch.
3. Depository (B/O) Account Number
(If you do not mention your valid BO (Beneficiary Owners) account, your application will be treated as in
valid)
4. I/we agree to fully abide by the instruction given herein.
5. Particulars of Applicant(s):
a) Sole/First Applicant
Name:
Father’s / Husband name:
Mother’s name:
Postal Address:
Occupation: Nationality: Telephone No.(if any):
For refund warrant (Application will not be treated as valid if anyone uses a non-scheduled bank. To avoid this complication,
investors are requested not to use the name of any non-scheduled bank) Please write the correct and full name of bank and
branch.
For refund purpose: I/we wants refund through □ Bank Account* □ Hand delivery/Courier (please put tick marks in which refund will be made).
The applicant shall provide with the same Bank Account number in the application form as it is in the BO account of the
applicant. Otherwise the application will be considered invalid and the subscription money may be forfeited.

Applicant’s Bank A/C No:

Name of the Bank: Branch:
b) Second Applicant
Name:
Father’s / Husband name:
Mother’s name:
Postal Address:
Occupation: Nationality: Telephone No.(If any):
6. I/we hereby declare that I/we have read the Prospectus of Deshbandhu Polymer Limited and have willingly subscribed for
……… no. of shares of Tk 10.00 each.
7. Specimen Signature(s):
(i) Name ( in block letters): Signature:
(ii) Name ( in block letters): Signature:
*In case of deposit into the applicant’s bank account, the applicant will bear the applicable charge, If any, of the applicants
banker, and the issuer shall simultaneously issue a letter of intimation to the applicant containing, among others, the date and
amount remitted with details of the bank through and to which bank such remittance has been effected.
…………………………………………………………………………………………………………………………………………..……………………
BANKER’S ACKNOWLEDGEMENT
Certified that this Bank has received Tk. ………….……….….. (in word) ……………..
………………………………….. only form Mr./Mrs./Ms………………………..……………………………………being
the application money for …………..nos. of Ordinary Shares of Deshbandhu Polymer Limited.
Banker’s Sl. No. Seal and Date Authorized
Signature
(Name
& Designation)
 INSTRUCTIONS
1. As per provision of Depository Act, 1999 and regulations made there under shares will only be issued in dematerialized condition.
Please mention your BO (Beneficiary Owner) Account number in the application form. If you do not mention your valid BO (Beneficiary
Owner) Account, your application will be treated as invalid.
2. All information must be typed or written in full (in Block letters) in English or in Bengali and must not be abbreviated.
3. Application must be made on the Company’s printed form/photocopy or typed copy/hand written form thereof.
4. Application must not be for less than 500 Ordinary Shares and must be for a multiple of 500 Ordinary Shares. Any Application not
meeting this criterion will not be considered for allotment purpose.
5. Remittance for the full amount of the Shares must accompany each Application and must be forwarded to any of the Bankers to the
Issue. Remittance should be in the form of Cash/ Cheque/ Bank Draft/ Pay Order payable to one of the Bankers to the Issue A/C
“Deshbandhu Polymer Limited” and crossed “A/C Payee only” and must be drawn on a Bank in the same town as the Bank to which the
Application form has been sent.
6. In the case of Joint Application Form, the Allotment Letter will be dispatched to the person whose name appears first on this
Application Form.
7. Joint Application form for more than two persons will not be accepted. In case of joint Application, each party must sign the Application
Form.
8. Application must be in full name of individuals or companies or societies or trusts and not in the name of firms, minors or persons of
unsound mind. Application from financial and market intermediary companies and Private Company must be accompanied by
Memorandum and Articles of Association and Certificate of Incorporation.
9. An applicant can not submit more than two applications, one in his/her own name and another jointly with another
person. In case an applicant makes more than two applications, all applications will be treated as invalid and will not be
considered for allotment purpose. In addition, whole or part of application money may be forfeited by the Commission.
10. No receipt will be issued for the payment made with Application, but the bankers will issue a provisional acknowledgment
to the Issue for Application lodged with them.
11. In the case of non-allotment of securities, if the applicant’s bank accounts as mentioned in their IPO Application Forms are
maintained with the Bankers to the Issue, refund amount of those applicants will be directly credited in to the respective bank account as
mentioned in their IPO Application Forms. Otherwise, refund will be made only through “Account Payee” cheque(s) showing bank account
number and name of bank and branch as mentioned in the Application payable at Dhaka or Chittagong, as the case may be.
12. Allotment will be made solely in accordance with the instructions of the Securities and Exchange Commission (SEC).
13. Making of any false statement in the application or supplying of incorrect information therein or suppressing any relevant information
shall make the application liable to rejection and subject to forfeiture of application money and /or forfeiture of share (unit) before or after
issuance of the same by the issuer. The said forfeited Application money or share (unit) will be deposited in account specified by the
Securities and Exchange Commission (SEC). This may be in addition to any other penalties as may be provided for by the law.
14. Applications, which do not meet the above requirements, or applications, which are incomplete, shall not be considered for allotment
purpose.
15. The Banker’s to the Issue Banks shall be obliged to receive the A/C Payee Cheque(s) on the closing day of the subscription of the IPO.
16. No sale of securities shall be made, nor shall any money be taken from any person, in connection with such sale until
25(twenty five) days after the prospectus has been published.

BANKERS TO THE ISSUE

Name of the Branches Name of the Branches Name of the Branches Name of the Branches Name of the Name of the
Branches Branches
Investment Rangpur Br, Rangpur Baraiyarhat Br, Ctg CDA Avenue Br, Ctg Sirajgonj Br, sirajganj Sonagazi Br, Feni
Corporation Bogra Branch, Bogra Baralekha Br. Sylhet Dhanmondi Br, Dhaka Laksham Branch, comilla Goala Bazar Br, sylhet
Of Bangladesh (ICB) Khulna Branch, Khulna Bogura Br, Bogura Jessore Branch, Jessore Ramganj Branch, Khatunganj Br, Ctg
Head Office, Br, Dhaka Barisal Branch, Barisal Cakaria Br., Cox’s Bazar Khatunganj Br, Ctg laxmipur Mymenshing Br, M.hing
Chittagong Br, Ctg Rajshahi Br, Rajshahi CEPZ Br., Chittagong Khulna Branch, Khulna Maijdee Court Br, Shahzadpur Br, Sirajganj
Rajshahi Br, Rajshahi Naogaon Br, Naogoan Chowhatta Br., Moghbazar Br, Dhaka Noakhali Beani Bazar Br, Sylhet
Khulna Br, Khulna Sunamgonj Mohakhali Br, Dhaka Banasree Br, Dhaka Chhatak Br, sunamganj
Barisal Br, Barishal Mercantile Bank Ltd. Chowmuhuni Br, Mirpur Branch, Mirpur Bandura Br, Dhaka
Sylhet Br, Sylhet Dhanmondi Br, Dhaka Noakhali MCB Sk. Mujib Rd Br, DBBL Saidpur Br, Nilphamary
Bogra Br, Bogra Kawranbazar Br, Dhaka Comilla Br., Comilla Ctg Local Office, Dhaka Rangpur Br, Rangpur
Local Office, Dhaka Agrabad Br, Ctg Cox’s Bazar Br, Cox’s MCB Dilkusha Br, Dhaka Motijheel For. Exch. Br Jessore Br, Jessore
Joypara Br, Dhaka Bazar MCB Banani Br, Dhaka Nababpur Br, Dhaka Mirpur Br, Dhaka
Southeast Bank Ltd Banani Br, Dhaka Dhanmondi Br, Dhaka Mitford Branch, Dhaka Banani Branch, Dhaka Halishahar Br, Ctg
Principal Br, Dhaka Rajshahi Br, Rajshahi Dilkusha Br, Dhaka North South Rd Br, Kawran Bazar Br, Dhaka Moulavi Bazar Branch
Corporate Br, Dhaka Naogaon Br, Naogoan Elephant Rd Br, Dhaka Dhaka Shantinagar Br, Dhaka Basurhat Br, Noakhali
Imamgonj Br, Dhaka Sylhet Br, Sylhet Foreign Ex. Br, Motijheel Principal Office Br, Dhanmondi Br, Dhaka Sremangal Br, Sylhet
Dhanmondi Br, Dhaka Board Bazar Br, Gazipur Feni Br, Feni Dhaka Baburhat Br, Narshingdi Kushtia Br, Kushtia
Uttara Branch, Dhaka Nayabazar Br, Dhaka Gulshan Br, Dhaka Rajshahi Br, Rajshahi Narayanganj Br, N.ganj Pabna Br, Pabna
N. Elephant Rd Br, Khatunganj Br, Ctg Gazipur Br, Gazipur Sylhet Main Br, Sylhet B.B Road Branch, N.gonj Narsingdi Br, Narsingdi
Dhaka Mohakhali Br, Dhaka Hajigonj Br, Chandpur Sylhet Uposhahar Agrabad Branch, Ctg Satmosjid Rd Br, Dhaka
Kakrail Branch, Dhaka Mirpur Branch, Dhaka Halishahar Br, Ctg Branch Mohakhali Br, Dhaka. Dinajpur Br, Dinajpur
Banani Branch, Dhaka Ashulia Branch, Dhaka Islampur Br, Dhaka Scotia Branch, Dhaka Gulshan Branch, Dhaka Bhairab Br, Kishorgonj
Bangshal Branch, Dhaka Uttara Branch, Dhaka Jessore Br, Jessore Shantinagar Br, Dhaka Mirpur Branch, Dhaka Dagonbhuiyan Br, Feni
New Eskaton Br, Dhaka Jubilee Rd Br, Ctg Joydebpur Br, Gazipur Station Road Br, Ctg Uttara Branch, Dhaka Gobindaganj Br,
Agargaon Br, Dhaka Elephant Rd Br, Dhaka Jatrabari Br, Dhaka Gulshan Branch, Dhaka Patherhat Br, Ctg Gaibandha
Pragati Sarani Br, Dhaka Motijheel Br, Dhaka Jubilee Rd Br, Ctg Uttara Branch, Dhaka Hathazari Br, Ctg Bhulta Branch, N.gonj
Shamoli Branch, Dhaka Madam Bibir Hat Br, Ctg Kawran Bazar Br, Dhaka Islampur Branch, Dhaka BSCIC Branch, N.gonj
Sat Mosjid Br, Dhaka Khulna Branch, Khulna Khulna Br, Khulna One Bank Limited Dania Branch, Dhaka Rampura Branch, Dhaka
Madhabdi Br, N.shingdi Rangpur Br, Rangpur Kushtia Br, Kushtia Principal Br, Dhaka. Khulna Branch, Khulna Tongi Branch, Gazipur
Ashulia Branch, Dhaka Satmasjid Br, Dhaka Kadamtali Br, Ctg Motijheel Branch, Sylhet Branch, Sylhet
Narayanganj Br, N.ganj OR Nazim Rd Br,, Ctg Khatungonj Br, Ctg Dhaka. Dhaka EPZ Br, Dhaka National Bank Ltd
Joypara Br, Dhaka Bogra Branch, Bogra Laxmipur Br, Laxmipur Kawran Bazar Br, Dhaka Board Bazar Br, Gazipur Banani Br, Dhaka
Savar Branch, Dhaka Konabari Br, Gazipur Laldighirpar Br, Sylhet Gulshan Branch, Dhaka Netaiganj Br, N.ganj Babubazar Br, Dhaka
Mouchak Branch, Dhaka Gulshan Br, Dhaka Majhirghat Br, Ctg Mirpur Branch, Dhaka Bogra Branch, Bogra Bangshal Road Br,
Konabari Br, Gazipur Feni Br, Feni Motijheel Br, Dhaka Uttara Branch, Dhaka Elephant Road Br, Dhaka Dhaka
Tongi Branch, Gazipur Moulvibazar Br, M.Bazar Malibagh Br, Dhaka Dhanmondi Br, Dhaka Barisal Branch, Barisal Dhanmondi Br, Dhaka
Bashundhara Br, Dhaka Bijoynagar Br, Dhaka Mogbazar Br, Dhaka Banani Branch, Dhaka. Simrail Branch, N.ganj Dilkusha Br, Dhaka
Mohammadpur Br, Moghbazar Br, Dhaka Mirpur Br, Dhaka Kakrail Branch, Dhaka CDA Avenue Br, Ctg Elephant Road Br,
Dhaka Barisal Br, Barisal Mitford Rd, Dhaka Pragati Sharani Br Badda Joypara Branch, Dhaka Dhaka
Madambibir Hat Br, Ctg Comilla Br, Comilla Madaripur Br, M.pur Elephant Road Br, Dhaka Biswanath Br, Sylhet Foreign Ex. Br, Dhaka
Comilla Branch, Comilla Greeen Rd Br, Dhaka Madabdi Br, Madabdi Jatrabari Br, Jatrabari Muradpur Branch, Ctg Gulshan Br, Dhaka
Bandar Bazar Br, Sylhet Sheikh Mujib Rd Br, Ctg Naogaon, Naogoan Nawabganj Br, Dhaka Golapgonj Br, Sylhet Imamganj Br, Dhaka
Moulavibazar Br, M. Eng. Inst. Br, Dhaka Narayangonj Br, N.gonj Bangshal Branch, Dhaka Rajshahi Br, Rajshahi Islampur Br, Dhaka
Bazar Mazar Road Br, Dhaka Nawabpur Rd Br, Dhaka Ganakbari (EPZ) Br, Naya Bazar Br, Dhaka Jatrabari Br, Dhaka
Hatimgonj Br, Sylhet Dinajpur Br, Dinajpu Patgram Br, Lalmonithat Dhaka. Imamgonj Br, Dhaka Kawran Bazar Br, Dhaka
Chouhatta Br, Sylhet Jessore Br, Jessore Pragati Sharani Br, Imamganj Branch, Dhaka. Savar Bazar Br, Dhaka Lake Circus Br, Dhaka
Laldighirpar Br, Sylhet Pragati Sarani Br, Dhaka Dhaka Narayanganj Br, N.ganj Gazipur Chow Br, Gazipur Malibagh Br, Dhaka
Shajalal Uposhar Br, Chittagong EPZ Br, Ctg Rajshahi Br, Rajshahi Joypara Branch, Dhaka Feni Branch, Feni Mirpur Br, Dhaka
Sylhet Narayangonj Br, N.gonj Rangpur Br, Rangpur Agrabad Br, Ctg Comilla Br, Comilla Mohakhali Br, Dhaka
Kulaura Br, Moulvibazar Patia Br. Chittagong Savar Br, Dhaka Khatunganj Br, Ctg Jubilee Road Br, Ctg Mohammadpur Br,
Pathantula Br, Sylhet Shaymoli Br, Dhaka CDA Avenue Br, Ctg Kadamtali Branch, Ctg Dhaka
Agrabad Br, Ctg NCC Bank Limited Tangail Br, Tangail Nanupur Bazar Br, Ctg Mirzapur Br, Tangail Motijheel Branch, Dhaka
Khatunganj Br, Ctg Agrabad Br, Ctg Uttara Br, Dhaka Cox’s Bazar Br, Cox’s Cox’s Bazar Br, C. Bazar Narayanganj Br, N.gonj
Jublee Road Br, Ctg Anderkilla Br, Ctg Bazar. Lohagara Br, Ctg Netaigonj Br, N.gonj
Halishahar Br, Ctg Banani Br, Banani Bank Asia Limited Jubille Road Br, Ctg Basundhara Br, Dhaka New Eskaton Br, Dhaka
Chowmuhani Br, N.khali Babubazar Br, Dhaka Agrabad Br, Ctg Chowmuhuni Br, Noakhali Ring Road Br, Dhaka N. Brk Hall Rd Br, Dhaka
CDA Avenue Br, Ctg Bijoy Nagor Br, Dhaka Anderkilla Br, Ctg Chandraganj Br, L.pur Manikgonj Br, Manikgonj Prgati Sarani Br, Dhaka
Cox’s Bazar Br, C. Bazar Bangshal Br, Dhaka Bashundhara Br, Dhaka Feni Branch, Feni Fatikchori Br, Ctg Rokeya Sarani Br,
Chhagalnaiya Br, Feni Bogra Branch, Bogra Raipur Branch, L.pur Konabari Br, Gazipur Dhaka
Feni Branch, Feni Bahadderhat Br, Ctg Dagon Bhuiyan Br, Feni Choumuhani Br, Feni Savar Bazar Br, Dhaka
Pahartali Br, Ctg Corporate Br, Noor Sylhet Branch, Sylhet Uttara Branch, Dhaka
Bashurhat Br, Noakhali Tower Sherpur Branch, Sherpur Z.H Sikder Br, Dhaka
Momin Road Br, Ctg C.R. Dutta Road, Dhaka Islampur Branch, sylhet
Jessore Branch, Jessore
Bogra Branch, Bogra