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ATTACHMENT NUMBER: I-C.

Number : ..(domicile), ..(date/month/year)..


Attachment :
Re : Application for Listing Investment
Fund Participation Units in the Form of
Collective Investment Contracts

To the Honorable:
Director of Listing of Indonesia
Stock Exchange Inc
Attn. Head of Service Sector Listing
Division
Indonesia Stock Exchange Building
Jl. Jend.Sudirman Kav 52-53
Jakarta 12190, Indonesia

By this letter, we submit our intention to listing the Investment Fund Participation Units in the Form
of Collective Investment Contracts at Indonesia Stock Exchange inc, in relation to such matter we
submit application to obtain initial agreement from Indonesia Stock Exchange Inc as one of the
requirements for us to submit Registration Statement to Bapepam.

For consideration, we attach documents and information in relation to the company as follows:

I. General

1. Name of Investment Fund Participation Units in the Name : ……………….


Form of Collective Investment Contracts Address : ……………….
Phone : ……………….
Fax. : ……………….
E-mail : ……………….
2. Investment Manager : ………………………….
3. Participant Dealer Name : ……………….
(this may be more than Participant Dealers) Address : ……………….
Phone : ……………….
Fax. : ……………….
E-mail : ……………….
4. Initial Value : Rp ……………………...
5. Maximum Value of Participant Unit : Rp ……………………...

II. Attachments of document and information submitted:


1. Final draft of the Prospectus signed by the authorized parties;
2. Evidence of payment of registration fee of Listing application in the amount of
Rp10,000,000.- (ten million rupiah).

Yours sincerely,

(.............................)
Investment Manager