FORM-II

 

CLAIM FOR PARTICIPATION IN FAIR/STUDY TOUR/TRADE DELEGATION

 

1Name of the SSI unit with full address and e-mail ID (if any).
2In principal approval letter number and date
3Name & designation of person who participated
4Details of travel including date of departure from India and arrival in India
(copy of passport to be attached)
5Name of airline by which journey was made and actual expenditure incurred
on return airfare (original air ticket to be enclosed)
6Whether the SSI unit has been charged/ prosecuted/debarred/blacklisted/
under investigation under Exim Policy
or any other law relating to export import business.
7Whether any MDA assistance has been availed from any source for similar activity in this financial year.
8Amount claimed for reimbursement

 

Declaration:
 

I declare that the particulars given in the above statement are correct. I also undertake that any financial assistance granted to me/my unit on the basis of this declaration shall be liable to be refunded to the Government if at any time any information furnished in this application is found to be wrong or incorrect or misleading and I do hereby bind myself and my unit to pay the Government on demand a sum equal to the amount claimed as SSI-MDA in respect of above mentioned activity, within seven days of the demand being made to me in writing
 

Signature
Name & Designation

Date:
Encl: