Application for Enrolment by Banquet Halls, Farm Houses, Local Bodies, Clubs etc.

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..... 2. Type of Space/Building made available organizing Functions Farm House Banquet Hall Park Community Centre Club Dharamshala Others, specify 3. PAN (Other than Government Deptts/ Undertakings .....

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..... 6. Additional places, if any .....

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..... 14. Verification I/ We ________________________________________hereby solemnly affirm and declare that the information given hereinabove is true and correct to the best of my/our knowledge and belief and nothing has been concealed there from. Signature of Authorised Signatory _____________________________________________ Full Name (first name, middle, surname)________________________________________ Designation /Status _________________________________________________________ Date Day .....

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