GOVERNMENT OF INDIA

MINISTRY OF INFORMATION & BROADCASTING

APPLICATION FORM FOR PERMISSION FOR PUBLISHING INDIAN EDITION OF, AND/OR, FOREIGN INVESTMENT IN INDIAN ENTITIES BRINGING OUT, SCIENTIFIC/TECHNICAL/SPECIALITY MAGAZINES/PERIODICALS/JOURNALS

	For office use only APPL. No.------ APPL. DATE SIGNATURE

GENERAL INFORMATION

(Seven Copies, duly filled in, are to be submitted)

1. (i) State the purpose of Application

(For Publication of Indian Edition of a foreign magazine/journal/periodical with/without Foreign Investment; For Foreign Direct Investment and/or Foreign Investment under Portfolio Investment Scheme – by Foreign Investor/Non Resident Indian/Overseas Corporate Body*/Foreign Institutional Investor, in a new/existing company publishing scientific / technical / specialist magazine/periodical/journal

*(An overseas entity with at least 60% equity held by NRIs, directly or indirectly)

___________________________________________________________________

(ii) State whether New application / Extension/Renewal of existing approval

(give details of previous approvals)

_______________________________________________

2. Payment Details of Application Fee. Please attach Demand Draft of a scheduled bank made in favour of Pay & Accounts Officer, M/O Information & Broadcasting to be payable at New Delhi.

Demand Draft No. and date_______________

Amount Rs.___________ __________________________ rupees

(in figures) (in words)

Issued by _________________

(Name of the Bank)

………………………………………………………………………………………………

Received Application No. ­­­­__________ on ___________ from ______________ for publishing Indian edition of, and/or, foreign investment in Indian entities bringing out, scientific/technical/speciality magazines/periodicals/journals.

3. Name and Address of the applicant Indian entity in full (Block letters please)

(i) Name _____________________________________________

Postal Address _____________________________________

PIN Code_______________ Telephone _________________

E-Mail _____________________ Fax ___________________

(ii) Name _____________________________________________

Postal Address _____________________________________

PIN Code_______________ Telephone _________________

E-Mail _____________________ Fax ___________________

(iii) Name _____________________________________________

Postal Address _____________________________________

PIN Code_______________ Telephone _________________

E-Mail _____________________ Fax ___________________

4. (i) Registrar of Companies (ROC) Registration number, if any, of the applicant __________

(ii) Corporate Identity Number (CIN) given by ROC

5. Please specify status of the Indian entity (whether Individual/Partnership firm/Government Company as defined u/s 617 of the Companies Act/Joint Sector Company/Public or Private Ltd. Company/Co-operative Undertaking/State Government Industrial Corporation/Other) _________________________________________________

6. Activities of the Company/Firm etc (Please provide details in an attached sheet where necessary and attach copy of partnership deed/Memorandum and Articles of Association of the Company)

Existing Company

Proposed Company

7.(i) State the nature of contents of the magazine / journal / periodical to be published__________________

(ii) Please attach copies of preceding six issues/editions in case of an existing publication. If this application is for allowing Indian edition of a foreign magazine/journal/periodical, three copies of the parent issue/edition, one for each of the preceding three years, may be enclosed.

8. Names of any other newspaper/magazine/journal/periodical published by the applicant. Please attach one copy of the preceding issue/edition of each.

9.(i) Please indicate whether the Indian entity has/has had foreign collaboration earlier? If yes, please specify whether for the same or similar or different activity. Please also indicate the Approving Authority and date and number of the appropriate Approval Letter.

__________________________________________________

__________________________________________________

(ii) Whether the foreign entity/NRI/OCB has/has had collaborations with any other Individual/Company in India for the same or similar or different products/activities? If so, please furnish details

__________________________________________________

10. Copy of draft agreement proposed to be entered into with foreign entity may be attached.

11. In case of existing agreement, please indicate the period for which the agreement has already run and attach the copy of the previous approval.

No. & Date of Date of commencement of Date of expiry of

Approval agreement agreement

_________ ______________________ ______________

Name _________________________________________

Address ________________________________________________

12. Capital structure of the Indian Company

				Authorised Equity		Paid Up Equity
				Ordinary Amount & % to total	Preference Amount & % to total	Ordinary Amount & % to total	Preference Amount & % to total
Existing Equity structure	Indian* (resident)
	Foreign (No-n Res-dent		FDI
			NRI/OCB
			FII (includi-ng FFI)
Propos-ed Equity structure	Indian* (resident)
	Forei-gn (No-n res-ide-nt)	FDI
		NRI/OCB
		FII (inc-ludi-ng FFI)

* Give details separately for equity held by the 10 largest equity holders including individuals, Government (Central/State), Government Companies as defined by the Companies Act 1956, Public Financial Institutions, Nationalised/Other Banks.

13. Please indicate in brief:

(i) The background of the Indian Promoters/Company including Proprietors/Promoter/Directors (attach separate sheet, if necessary).

(ii) The background of the Foreign/NRI/OCB Collaborator/Promoter, if any (attach separate sheet, if necessary).

14. Please attach copies of Profit and Loss Account and Balance Sheet for the last three years.

15. (i) Location of the operating office

Address ____________________________________________

_________________________________________________

District ____________________________________

State ___________________________________

Pin Code __________________ Telephone ____________

E-Mail ________________ Fax_____________

(ii) Regional office of RBI to whom copy of the approval letter is to be endorsed

________________________________________________________

DECLARATION

1. I/We are duly authorised to sign this application for and on behalf of___________________________________________

2. I/We hereby certify that the above statements are true and correct to the best of my/our knowledge and belief.

3. I/We hereby undertake to inform Ministry of Information & Broadcasting if any of the facts furnished above undergo a change in the future.

Signature of Applicant _________________________________

Name in Block letters Sh/Smt/Ms ____________________________

Designation of the signatory _____________________________

Place: ____________ Date: _______________________