TAIPEI 2023

39th Asian International Stamp Exhibition

Exhibit Application Form
11 - 15 August 2023

Fill in a separate form for each exhibit. Please print or write in block letters.
This Exhibit Application Form must be returned through the Commissioners
to reach the Commissioner General by 28 February 2023 at the address below:
Address PO Box 566 Taipei Nanhai, Taipei City 100905 Taiwan
Telephone (+886) 933649990
Email mike350822@mail2000.com.tw

First Time Entry :Yes XXX No

FIP IDENTITY NUMBER: Tel Fax Email
Mr Miss Surname First Name
X Busono Stephanus Judi D. sbusono@gmail.com
Pseudonym Date of birth (for youth exhibitors) Telephone
0811-950-5123
Address Jalan Jaya Mandala 2A No. 9 Email
Patraland, Kel. Menteng Dalam
Kec. Tebet, Jakarta Selatan 12870
Indonesia Fax

Title of this exhibit (in English)

Previous title

Short description of the exhibit (in English)

1) Introduction page included Yes No

2) Philatelic Literature Exhibit Information Form included (only applicable for Literature exhibit in Class 13) Yes No
Exhibit class Number of frames applied for Dimensions of sheets (in cm) A

B A=
B=
PAST AWARDS RECEIVED
International FIAP/FEPA/FIAF/ LG G LV V LS S SB B
World (FIP) Exhibitions

National Exhibitions

The undersigned (Exhibitor) hereby

(1) agrees to accept all FIP Regulations (GREX, GREV, SREVS) and the individual regulations (IREX) applying to TAIPEI 2023
(2) confirms that the exhibit is owned by me (GREX Article 11.2)
(3) confirms that my exhibit will be delivered to the Exhibition by my commissioner

Date 25 February 2023 Signature

Commissioner's declaration
Remarks

Date Signature