EMDA-IPA Application Form

Annexure 1
APPLICATION FORM FOR SEEKING IN-PRINCIPLE APPROVAL FOR
EXPORT MARKET DEVELOPMENT ASSISTANCE
Note: The form should be filled in keeping in view the scheme approved by the National Jute
Board, Ministry of Textiles. The application form duly filled in should be submitted to
The Secretary, National Jute Board, 3A Park Plaza,
71, Park Street, Kolkata-700 016.
Participation proposed :
(Please put √ in the Box)
• International Fair (Own Choice)
• International Fair Organised / Participated by NJB
• Delegation& BSM led by NJB
1.
Name of the Registered Unit with
full address & contact details
(Mobile No., Ph. No. & Email)
:
2.
RCMC No. (copy to be enclosed)
• Issued by
• Valid upto
:
:
:
3.
Status of Regd. Unit
(Please put √ in the Box)
:
Manufacturer-Exporter
Merchant-Exporter
Manufacturer & Merchant- Exporter
4.
Export of Jute Goods (in value) during
last Financial Year (2011-12)
:
5.
Details of previous IPA applications
submitted in the current financial year
:Sl. No. Application No.
6.
Particulars of fair proposed for
participation
• Name of the Fair
:
:
• Date of the Fair
:
• Venue & Place
:
• The fair organized by :
• Participation under
:
Name of Event
Period
7. Particulars of Delegation & BSM
(led by NJB) propose for participation
Countries
:
From (Date)
To (Date)
1.
2.
3.
8.
Jute products proposed for promotion in
Fair/ Delegation & BSM.
:
Jute Products
Jute Content
1.
2.
3.
9.
Name & Designation of the person/s
participating in Fair /Delegatation/ BSM :
10. Particulars of visit
11. Estimate of expenditure to be incurred
:
• Date of Departure from India
:
• Date of Return to India
:
:
(i)
Space rent
:
US$ / Rs.
(ii)
Stand construction & decoration
:
US$ / Rs.
(iii) Economy Airfare for the sector
(For one/two persons)
:
US$ / Rs.
(v)
:
US$ / Rs.
Hotel @US$ - …….. per x night
……. nights. (For one/two persons)
12. Please enclose a pay order / DD in
favour of National Jute Board for
• Participation in the fair organized
by NJB – Rs.25,000/• Delegation & BSM led by NJB (for
each country Rs.10,000/-
:
DD / Pay order No. & Date: ………………...
DD / Pay order No. & Date: ………………….
Signature
:
Name
:
Designation
:
Company Seal :

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