APPLICATION FOR VERIFICATION OF TITLE
1. Name of the applicant :
(in CAPITAL LETTERS)
2.* a)Name of the Owner :
(If the owner is an Organisation/Trust
Pub/Pvt.Ltd etc. mention clearly)
b)Whether the applicant himself is owner : (Yes/No)
3. Nationality :
4. Complete Address :
5. Educational Qualification :
6. Profession/Income :
7. Name of titles (in order of preference) : 1. ___________________________________
NOTE: 2. ___________________________________
* Full Form for abbreviations to be given 3. ___________________________________
* Vague/Meaningless words should be avoided 4. ___________________________________
* Common spelling should be used 5. ___________________________________
8. Language of the proposed publication :
9. Periodicity :
10. Place of Publication with full address :
11. Whether the titles are same/similar to titles
of Prominent foreign publications. If yes, :
then attach copy of NOC from M/o I&B
or licence agreement with the foreign
title owner to publish the title in India. :
12. Pan Card No. :
13. Election ID card copy :
(duly attested by G.O)
14. Name and address of Printing Press :
15. a)Contact No. :
b) E-mail ID :
16. Does the owner have any titles previously
Allotted by RNI? If any, its status :
Applicant’s signature……….
Signature and seal of the forwarding authority with designation/date/place
*(Owner is the person in whose name title is to be verified. The title would be verified in the name of
owner only).
#Maximum 5 options can be given. Please attach separate sheet, if more space required.
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