ࡱ> kmjo bjbj 4B\\t9 8DL*>h^^nnn.DX =======$?HBJ=L%|L%L%=nn,=...L%nn=.L%=..7{9n\<%N8,==0*>+9PB('BX{9{9&B9dn.!d"Zddd==*ddd*>L%L%L%L%Bddddddddd > H:  The Secretary Automotive Component Manufacturers Association of India 6th Floor, The Capital Court Olof Palme Marg Munirka New Delhi-110 067 Dear Sir, ENROLLMENT AS AFFILIATE MEMBER We wish to be enrolled as a member of the Automotive Component Manufacturers Association of India under the Affiliate member category and are hence submitting this Application. We agree to abide by the Rules & Regulations of 17Թ and further agree to Provide data for the Annual Statistical Return, 17Թ Buyers Guide, Business outlook survey, 17Թ Membership survey and any other data / information which the Association or its authorized agencies may ask from time to time. We declare that the information provided by us in the Form is complete in all respects and true to the best of our knowledge. Company Name: Authorized Person Name: (Company Stamp) For and on behalf of Date : _____________________ ___________________________ Signature & Designation * Proposed by : * Seconded by : Name : ___________________________ Name : ______________________________ Company : ________________________ Company : ____________________________ Note : Both Proposer and Seconder should be an Ordinary member of 17Թ and this Form should be signed and stamped by their authorised representative only. ...... Encls. : 1) Cheque/D.D. No. ______________________dated____________________ Rs. ___________ drawn on ________________ towards admission fee and subscription for the current year and payable to Automotive Component Manufacturers Association of India. (See attached Eligibility Criteria for Charges) Certificate of Incorporation/ Registration Last Annual Report and Audited Accounts. Copy of Companys GSTIN Registration Certificate & PAN Card. Note : It is mandatory to provide details for all queries to ensure quick processing. Please ensure that the Form is accompanied with all relevant enclosures. FOR OFFICE USE ONLY (Secretariat) Admitted on : Date ______________________Place___________________ Rejected due to : __________________________________________________ Payment due (if any) : __________________________________________________ ____________________________________ (Signature: Head, Membership Department) ___________________________________ (Date) (Regional Office) Regional Chairpersons Approval : ________________________ (Signature) ________________________ (Date) Automotive Component Manufacturers Association of India (THIS FORM SHOULD BE SUBMITTED TO THE RELEVANT 17Թ REGIONAL OFFICE) MEMBERSHIP APPLICATION 1) a) Name of Society/ Association/: _____________________________________________ Chamber / Trust / Representative Offices of Intl Govt. ____________________________________________ b) Address to which : _____________________________________________ communications are to be sent _____________________________________________ _____________________________________________ Phone (s) : ___________________________________________________ Fax : ___________________________________________________ Note: Please provide Email IDs that are monitored, so as not to miss any important communications / notifications. E-mail (for 17Թ services): _________________________________________________ E-mail (for 17Թ membership matters) : _____________________________________ E-mail (for finance / taxation): ______________________________________________ Website : ____________________________________________________ c) Address of Registered Office : _____________________________________________ _____________________________________________ Phone (s) : ______________________ Fax ______________________________ E-mail : ________________________________________________________ d) Address of other offices: ___________________________________________________ in India ___________________________________________________ ___________________________________________________ e) Year of incorporation/ : _________________________________________________ Registration f) Legal Status:  Section 8 Company Society Trust International Bodies g) Name & Address of i) President* : ________________________________________________ ________________________________________________ ________________________________________________ ii) Vice-President* : ________________________________________________ ________________________________________________ ________________________________________________ h) Name of Director General/:_______________________________________________ Executive Director / Head of Representative office i) Name & Designation of : ____________________________________________ Person for liaison with 17Թ Election held yearly/ 2yearly : ____________________________________________ in the month of 3. Total Number of Members : ____________________________________________ 4. No. of permanent/temporary staff : _____________________________________________ on your roll 5. Membership with other Associations/ : _____________________________________________ bodies Signature: ___________________________ Form filled by: _________________________________ Date : ___________________________ Designation: ___________________________________ * Please inform whenever there is change in President & Vice-President      PM_33_F3 Rev. No. 02 PAGE  JL$ % * + , 5 ; = F J N p r t }   A Z j »vpjpd^ h(gCJ hCJ h7 CJ h\'CJh)hCJh)h[bCJh)h\'CJh)hXuCJhB [hB [CJ hB [5CJ h#5CJhhXu5CJ h5CJhhLI5CJ hLICJ h#CJ hB [CJ h#CJhXu5>*CJ h-CJ hXuCJH* hXuCJ"Ifv~ s t ! 0 H I { | ~   gd gd $a$gd(g$a$j ! 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