* Name of the Firm

* Address of the applicant.

(Registered Office in case of limited companies, and the head office for others)

For Branches

Name

Address

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For Factory

* Name

* Address

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IEC number

Date of issue

Issuing authority

(Please attach self-certified copy)

* Date of Firm establishment

If the registration is required

No. as a manufacturer / exporter / SSI Registration/Industrial License /IEM0

Issuing Authority:

If Others (specify)

(Please attach self-certified copy)

EH/Star EH/TH/Star TH/Premier TH

Certificate Number

Date

Valid From

Valid To

(Please attach self-certified copy)

Details of Directors/Partners/Proprietor/Karta to be given in the following manner:

Name

Father's Name

Residential Address

Telephone No.

(Use extra sheet, if space provided is not sufficient and attach as Annexure)

Name of export Product(s) for which participation in MP Exportech applied.(Product photographs and company literature along with countries of export.)

(Use extra sheet, if space provided is not sufficient and attach as Annexure) Product catalogues must be attached with the application.

(ITC HS Code Number(s) not required in the case of Services Exporters)

* Contact Name

:

* Address

:

* Designation

:

* Tele

:

* Fax

:

* Email id

:

   Website

:

I / We hereby agree to pay the rental charges for the space allotted to us, at the rates fixed by the organisers. (for 4 sqr.mtrs. Rs.4,500/- for 3 days + S.T.@ 10.30%, or in multiple there of.)