APPLICATION FOR VERIFICATION OF TITLE News Paper

  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.