Membership Application Form s1

MEMBERSHIP APPLICATION FORM STICK PHOTO HERE

------Reg & Head Office: 5, Ground Floor, Samruddhi Venture Park, Adjoining Hotel Tunga Paradise, SEEPZ – MIDC Central Rd, Andheri (E), Mumbai – 93. Tel: + 91 – 22 –6667 4444 / 6150 9800 / 2832 7219 | Fax: +91 – 22 – 2825 0414 Email: [email protected] | [email protected] | [email protected] | Web: www.smechamberofindia.com ------

Name of the GSTIN No: Company Name of the Applicant Designation: (Chairman, MD, CEO, ED, Director, Partner & Proprietor) Education: Date of Birth: Contact Details: Tel: Mobile No: E-mail: Name and Designation of the Coordinator Contact Details: Tel: Mobile No: E-mail: Name of the Other Directors / Partners: Registered Office Address: Company Registered as:

 Private Limited  Partnership Firm  LLP  Proprietorship  Public Limited  Others ______Date of Incorporation of the Company Udyog Aadhar Registration Number

Industrial or Business Sector :  Manufacturing  Engineering  Auto & Auto Ancillary  Energy 

Infrastructure  FMCG  Exports  IT  Hospitality  Retailing  Electronics  Electricals  Finance  Realty &

Construction  Agro Based Industries  ICT  Service Sector  Consumer Durables  Textiles  Healthcare 

Chemicals  Metal & Mining  Oil & Gas  Packaging  Paper  Plastic  Printing  Advertisement  Media  Allied

Industrial Sector  Others ______Industrial or Business Sub – Sector: Details of Products Manufactured: Details of services: Turnover of Company for last 3 years (in Rs. Previous Year 2 Previous Year 1 Last Year Lakh) Total Investment in Plant and Machinery: (Rs. Lakh) Number of employees Management Skilled Unskilled

Current Market (Regional, National or International) Export Business Activity (Details of products exported) Import Business Activity (Details of products imported)

July 2017 Name of the Associate Companies, if any Any Joint Ventures / Technology Transfers / Contract Manufacturing tie-ups with Foreign or Indian Companies? If not, are you interested to avail our support? Are you looking for support for enhancement of business in domestic market or supply to MNCs, Government PSUs and SMEs? Please provide details. Are you looking for any specific support or assistance for business growth and expansion? Would you like to participate in various events, activities and overseas visits, Please specify Are you interested to join delegation to attend B2B, Conference and Exhibition in various countries? Reason for becoming member of the Chamber? Awards and recognitions (Company and Individual)

MEMBERSHIP CATEGORIES & FEE

Sr Annual 7 years . Membership Who Can Apply for Membership? Membership Membership N Category Fee Fee o Small All kinds of Manufacturing firms, Service Industries, Rs.7,500/- Rs.45,000/- Industries Infrastructure, Energy, IT, ICT, Exports, Agro-Based I (Turn Over less +GST @18% +GST @18% Industries, Logistics, Imports, Distributors, (Payable (Payable than Rs 25 Marketing, Consumer Durables, Auto & Auto Rs.8,850/-) Rs.53,100/-) crore) Ancillary, Electronics, Electricals, Realty & Medium Construction, Textiles, Metal & Mining, Oil & Gas, Packaging, Paper, Plastic, Printing, Advertisement, Industries Rs.30,000/- Rs. 1,75,000/- II (Turn Over Media, Professionals, Law Firms, Tourism, +GST @18% +GST @18% Above Rs 25 Healthcare, Pharmaceutical, Sports, Retail, (Payable Rs. (Payable Rs. crore to Rs. 300 Hospitality, Start–Ups, Young & Women 35,400/-) 2,06,500/-) crore) entrepreneurs and other registered companies. Corporate & As per above Industrial & business Sectors, Private MNCs Limited, Public Limited, Multinational Companies, Rs.50,000/- III (Turn Over Banks & FIs, Co-operative Sector, SEZ, 100% +GST @18% NA (Payable Rs . above Rs. 300 EOUs, Overseas Companies & Organisations 59,000/-) crore) Functioning in India & other registered companies.

We would like to apply for the Membership of Chamber under the Category of ______and submitting herewith true and correct information about our Company along with Membership Fee in favour of “SMALL & MEDIUM BUSINESS DEVELOPMENT CHAMBER OF INDIA”, Mumbai. We also agree to abide by the rules and regulations of the Chamber as the member.

July 2017 Amount: Cheque or Demand Draft Number: Date: Bank Details: UTR Number: Bank Details of Name of Account Holder :Small and Medium Business Development Chamber Chamber: of India Name of the Bank :Allahabad Bank Address :Mumbai Khar Branch, Vasu Smriti, Plot 383A 13TJ Rd, Khar (W), Mumbai – 52 Account No. :50149797945 IFS Code :ALLA0210302 GSTIN No. :27AAOCS8618K1ZL

Yours sincerely, Applicant's Signature (with Company Seal) Name: ______Designation: ______------Important Note: . Please Attach Company Profile & Photograph of Applicant along with the proof of Membership Fee payment or Cheque / Demand Draft . Photocopy of Certificate of Company Registration . Request on Company Letter Head for obtaining Membership. . Acceptance / refusal of membership will be at the sole discretion of the Managing Committee of the Chamber. . No refund will be given for cancellation of any type of Membership for any reason whatsoever. . Incomplete Application Forms will not be accepted. . Member should approach Chamber for business requirements and support services & attend various events for Networking and Knowledge. ------

(For office use only) Membership Approval Membership Category ______Membership No. ______Date of Approval ______Authorised Signatory______

July 2017