FORM-IV

APPLICATION FOR ASSISTANCE FOR PUBLICITY

 

1Name of the SSI unit with full address and e-mail ID (if any).
2SSI registration number indicating place of issue (copy of registration certificate is to be enclosed)
3Membership number of FIEO/EPC (enclose proof of membership)
4Membership number of FIEO/EPC (enclose proof of membership)
5Value of exports during last 3 years at FOB (CA’s certificate to be enclosed)
6Title of publicity material proposed to be published (Dummy copy to be enclosed)
7Name and details of the event where publicity material is proposed to be distributed
8Anticipated date of release
9Number of copies of the publicity material to be printed (enclose detailed quotations from printers for production)
10Total estimated expenditure
11Whether the SSI unit has been charged/ prosecuted/debarred/blacklisted/under investigation under Exim Policy or any other law relating to export import business
12Whether any MDA assistance has been availed from any source for similar activity in this financial year

 

Date:
Signature Name & Designation
Encl:

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