Regd. Office: No.4, Rajiv Gandhi Salai Taramani, Chennai – 600 113
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TIDEL PARK COIMBATORE LTD Regd. Office: No.4, Rajiv Gandhi Salai Taramani, Chennai – 600 113. India APPLICATION FORM (For Leasing of IT / ITES Space) IT Park Location: ELCOT-SEZ IT/ITES Villankurichi Aerodrome Post Coimbatore – 641 014. 1.0 PARTICULARS OF APPLICANT Name of Company / Firm Name of the Authorised person Designation Address of Company / Firm Telephone Number Mobile Fax Email Website URL Relevant Information, Local contact address and telephone number may be given in the case of a foreign firm or a company. 2.0 Layout Plan : The Layout Plan for the commercial area (enclosed) is tentative and subject to change of size, area, location based on nature of activities, availabilities, technical and administrative requirements, etc., at the time of allotment by TIDEL Park Coimbatore Limited (TPCL). 3.0 SPACE REQUIREMENTS ( sq. ft) : ______________ Sq.ft. (Super built-up area) Floor Preference : Ground / 1st / 2nd / 3rd / 4th Floors 4.0 Expected date of occupation - - - (DD / MM / YYYY) 5.0 Please specify the proposed usage / activities: Approved Upgrade of software Computer-related services Technical Service Centre CAD/CAM/CAE Support IT Product Demonstration Data processing E-Commerce IT raining Data Warehousing Computer Systems Design Computer System Integration Communication Equipment Design Office Automation & Equipment Design Back office for banks/financial institutes R & D Laboratory (IT related) E-Mail/Internet/Intranet/Extranet On Specific Approval System Customizing Centre Publishing (with printing) Communication Service Prototype Making Project Planning & Management Audio / Video product Design Merchatronics Components Design & Development Engineering Design & Development Centre Equipment & component Applications Engineering Electronic Workshop-Repair System Integration of Data Comn. Equipment-Consultancy Services 6.0 Lease Period : (Please indicate) : 7.0 Advance amount payable : Rs. _______________ (10 months rent) 8.0. UTILITIES SERVICE REQUIREMENTS 8.1 Electricity (estimated) a. Average Daily energy Consumption (kWh) b. Electrical Load Required (Connected) (KVA) 8.2 Communication (required) Telephone lines Nos. ISD Lines Nos. Leased Lines kbps 9.0 EMPLOYMENT (expected) No. of employees to be housed Nos Projected man power to be required for operations at optimum level. 10.0 OTHER RELEVANT INFORMATION a) Two copies of your Certificates of incorporation (Companies Act) and the Memorandum & Articles of Association of the company are to be attached (for Private Limited Company) b) Two copies of your Certificate of Registration (Business Registration Act / Indian Partnership Act) and Registration Form showing the particulars of the sole proprietorship / partnership. c) Brochures of Company, Products and Services, Nature of business d) Latest Company's Annual Report or Audited Accounts. e) Company's brief and the business plan for the next three years: f) All shareholders and their respective shareholdings are to be clearly indicated. g) If is a foreign company, the relevant documents for carrying out business in India may be provide. h) Any other information relevant to support the application 11.0 Payment Details a) Module No. b) Area (super built-up) c) Advance Payment INR. d) DD/Cheque No. e) Drawn on Bank /Branch, etc. DD / Cheque to be drawn in favour of “Tidel Park Coimbatore Ltd” payable at Chennai / Coimbatore. Place : Signature Date : Name : Designation : Company Seal : .