A PROFORMA APPLICATION FOR REGISTRATION OF A NEWSPAPER/PERIODICAL

(Should be submitted after publication of the first issue) The Registrar of Newspaper for India, West Block-8, Wing-2, R K Pram, NEW DELHI-110066 Subject: Registration of a newspaper/periodical entitled --------------------------- Sir, (i) (i) The Title ------------------------------------------------------------------------ had been got verified from RNI through the DM/ADM/DCP/CMM/City Magistrate/SDM/SDO concerned in ---------------------------------- (language) -----------------------------(Periodicity) ----------------------------------- (Place of Publication) on -------------------------(Date). A copy of the verification letter is enclosed. (ii) The declaration in the prescribed FORM-1 (See Rule 3) for starting the newspaper/Periodical was authenticated by the DM/ADM/DCP/CMM/City Magistrate/SDM/SDO on by a Gazetted Officer is enclosed. (Separate declarations should be filled in case the printer and publisher are different. All the columns of the declaration must be duly filled in). (iii) The first issue with the printing of Vol-1 and Issue-I, date line, Page No. and the title prominently and properly displayed on the first page and printed on every page was brought out in the same language and periodicity as given in the title verification letter declaration on -------------------------------------- within six weeks (in case of a daily or weekly/three months in case of other periodicity. One copy of the first issue is sent here with). (iv) The imprint-line on page ------------------- contains the names of the (a) publisher, (b) Printer, (c) Owner, (d) printing press with complete address, (e) place of publication with address, and (f) the name of the editor. (v) The owner of the newspaper/periodical is M/s/Shri/Smt -------------------------------------------- as indicated in the verification letter and declaration. An affidavit from the publisher to the effect that the owner(s) (vi) has/have no tie-up or collaboration with neither any foreign organization nor the owner will have it without the permission of the Government is enclosed. 2. 2. You are requested to register the newspaper/periodical and send the certificate of Registration at the earliest. Yours faithfully. Name and signature of the publisher Address of the Place of Publication:

(ii)

(iii)

(iv) (v) (vi)

Date:

STAMP PAPER AFFIDAVIT-D

1. -----------------------------------------------------------------------------Son/daughter/wife of --------------------------------------------------------------------------------- resident of (address) ---------------------------------------------------------------------------------certify that I am the publisher of -------------------------------------------------------------------------------------------(Language) --------------------------------(Periodicity) -------------------------------- (Place of publication with full address) ------------------------------------------------------------------------ solemnly affirm and declare as under. 1. 1. That the owner(s) of the Firm/join Stock/Trust/Co-operative Society/Association owning the newspaper is/are citizen(s) of India. 2. 2. That the owner(s) does/do not have any tie-up/Collaboration with any foreign organizations if so, please specify (a) (a) FDI by (b) (b) FDI and FII by (c) (c) License agreement/syndication with (d) (d) Any other 2. 2. That the owner(s) will not have any tie-up/collaboration with any foreign organization in future without the prior permission of the Government of India in respect of the publication of the above mentioned newspaper Place: Date: VERIFICATION I solemnly verify that the facts above are true and that nothing material has been concealed. Place: Date: DEPONENT ATTESTED DEPONENT

Classifications list to be sent along with a copy of the publication. Please tick mark the broad category under which the publication is brought out and return the list to this office

AAH Agriculture and Animal Husbandry ADM Administration ART Arts CAI Commerce and Industry CRI Crime EDU Education FAL Fashion and Lifestyle FIL Films IT Information Technology LAC Literacy and Culture MAH Medicine and Health NCA News and Current Affairs OTH Sex Magazine, Racing Guides, Price List, Catalogues, Directories, Lottery News, Journal to Promote Sale of Goods or Services SOW Social Welfare TAC Transport and Communication UNC Unclassified

AAD Architecture and Design AOC Any Other Category AST Astrology CHI Children EAT Engineering and Technology FAE Finance and Economics FIC Fiction IBC Insurance, Banking and Co-operation LAB Labour LAP Law and Public Administration MRB Market Reports/Bulletins PHO Publicity Journal/House Organs RAM Radio and Music RAP Religion and Philosophy SCI Science SCM School/College Magazines SPO Sports TOU Tourism WOM Women