APPLICATION FORM FOR ASSISTANCE FOR PUBLICITY
| 1. | Name of the SSI unit with full address and e-mail ID (if any) | ____________________ | |
| 2. | SSI registration number indicating place of issue (copy of registration certificate is to be enclosed) | ____________________ | |
| 3. | Membership number of FIEO/EPC (enclose proof of membership) | ____________________ | |
| 4. | Value of exports during last 3 years at FOB (CA’s certificate to be enclosed) | ____________________ | |
| 5. | Title of publicity material proposed to be published (Dummy copy to be enclosed) | ____________________ | |
| 6. | Name and details of the event where publicity material is proposed to be distributed | ____________________ | |
| 7. | Anticipated date of release | ____________________ | |
| 8. | Number of copies of the publicity material to be printed (enclose detailed quotations from printers for production) | ____________________ | |
| 9. | Total estimated expenditure | ____________________ | |
| 10. | Whether the SSI unit has been charged/prosecuted/debarred/blacklisted/under investigation under Exim Policy or any other law relating to export import business | ____________________ | |
| 11. | Whether any MDA assistance has been availed from any source for similar activity in this financial year | ____________________ | |
| Date : | Signature | ||
| Name & Designation | |||
| Encl.: |
