Advance Payment towards reservation of stall at China Interdye 2025 Exhibition to be held from April 16-18, 2025 at Shanghai, China

CHEMEXCIL Basic Chemicals, Cosmetics & Dyes Export Promotion Council 4th Floor, Jhansi Castle, 7, Cooperage Road, Mumbai 400001 Tel       :+91-22-2202 1288/ 1330 Fax      :+91-22-2202 6684 URL     : www.chemexcil.in Twitter : @chemexcil Application Form for Exhibition / BSM

• All Fields are mandatory Name of the BSM : Date: Country : Part ‘A’ Name of the Company : ____________________________________________ Type of company: Private Ltd/Proprietorship/Partnership Firm/ State/Central Govt. Chemexcil Membership No. _________________________________________ Address : ________________________________________________________

Tel. : _______________________ Fax:________________________ Email : _______________________ Mobile No: __________________

Website : _______________________ Products for display/Sale/Trade (with 6 digit HS Codes): Sr. No. 6 digit HS Code No. Name Of The Product ( if more products then enclosed separate sheet ) Passport details of the participants who will attend the exhibition : Sr No. Name of Person Passport No. Designation Date of Issue Date of Expiry

ct ( if more products then enclosed separate sheet ) Passport details of the participants who will attend the exhibition : Sr No. Name of Person Passport No. Designation Date of Issue Date of Expiry

Place of Issue Date of Birth & Nationality Are you a member of any other EPC/Commodity Board / Federation? if yes please specify :______________________________________________________ Details of earlier participations in the same exhibition under MAI assistance from F.Y. 2019-20: If yes (Tick):- 1st time 2nd time 3rd time More than 4 times Details of your participation in the same financial year under MAI Scheme through CHEMEXCIL

Number of events participated with MAI support during the current year _______________ Name & place of the fair __________________________________ Name & place of the fair __________________________________ Part ‘B’ Company PAN No. : _____________________________ COMPANY CIN : _____________________ IMPORT/EXPORT CODE (IEC) NO. _____________________ Whether belongs to MSME ?(Tick) YES ______ NO _______ GST NO.___________________________ Company Directors Details:- Sr. No. Name of the Director DIN NO. Whether belongs to SC / ST / GENERAL 1 2 3

4 ( If additional Directors, then enclosed the filled sheet as per above format ) Part ‘C’ Total Turnover of Company last 3 years Year (Rs. In Cr.) 2023-24 2022-23 2021-22 Export Turnover last 3 years Year (Rs. In Cr.) 2023-24 2022-23 2021-22

he filled sheet as per above format ) Part ‘C’ Total Turnover of Company last 3 years Year (Rs. In Cr.) 2023-24 2022-23 2021-22 Export Turnover last 3 years Year (Rs. In Cr.) 2023-24 2022-23 2021-22

Part ‘D’ Space requirement : Shell Scheme: Sq. Mtrs. Raw Space: Sq. Mtrs. ii) Payment Details: Amount: Rs. ____________________________________________________ (If TDS Deducted then please specify the % of TDS deduction) Amount paid by (Tick the option and fill the details ) RTGS ____________________ dated _____________ DD No. ____________________ dated ____________ Demand Draft should be drawn on : “CHEMEXCIL SBI A/c No 10996680758” We have read the Council’s Rules & Regulations for participation in exhibitions and hereby agree to accept and abide by the same. (Signature of authorized signatory of the company) Name: ________________________ Designation: ________________________

Date: Company Seal: _______________________

• ALL FIELDS ARE MANADATORY
• PLEASE READ THE RULES OF PARTICIPATION IN EXHIBITIONS OF THE COUNCIL WHICH IS ATTACHED WITH CIRCULAR.