FORMS –I
(See Rule – 5)
APPLICATION FOR LICENSE UNDER RULE 5 OF THE TRIPURA CINEMA (EXHIBITION BY VIDEO CASSETTE RECORDER) LICENSING RULE, 1984
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1. Name of applicant |
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2. Father’s Name |
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3. Age |
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4. Address |
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5. Name of place and description where exhibition of film for public shall be made by the VCR |
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6. Whether certificate from the Executive Engineer as required under Rule 5(1), from District Health officer under rule 5 (iii), Superintendent of Police under rule 5(iv) and Executive engineer, Electrical Division under rule 5(iv) have been obtained? |
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7. Certificate in original to be attached |
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8. Time schedule for exhibition of film |
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9. Seating arrangement in the building |
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10. Other details regarding building |
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11. Treasury voucher No. and date including deposit of licence / renewal fees |
I Sri ________________________________________________________ (applicant), hereby undertake the liability for any default in respect of payment of any amount payable for the entertainment under the provision of Tripura Entertainment Tax, 1997.
Date:
Place:
Signature of the applicant