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LTD.

Regd. Office: No.4, Taramani, – 600 113

Site: ELCOSEZ, Aerodrome Post Coimbatore – 641 014 Contact Ph: 0422-2513604 Fax: 0422-2513609 Web: www.tidelcbe.com Mail: [email protected]

APPLICATION FORM [FOR LEASING OF READY TO OCCUPY SME SPACE (IT / ITES)]

IT Park Location: ELCOSEZ Civil Aerodrome Post Coimbatore – 641 014

1.0 PARTICULARS OF APPLICANT

Name of Applicant

Name of the Authorised person

Designation

Address of Company / Firm

Telephone Number

Mobile

Fax

Email

Website URL

PAN No.

GST & TIN No.

Relevant Information, Local contact address and telephone number may be given in the case of a foreign firm or a company.

2. SPACE REQUIREMENTS ( sq. ft) : ______Sq.ft. (Super built-up area)

3. Module Preference : ______

4. Please specify the proposed usage / activities:

Approved

 Upgrade of software  Computer-related  Technical Service Centre services  CAD/CAM/CAE  IT Product  Data processing Support Demonstration  E-Commerce  IT Training  Data Warehousing  Computer Systems  Computer System  Communication Design Integration Equipment Design  Office Automation  Back office for  R & D Laboratory (IT and Equipment banks/financial institutes related) Design  E-Mail/Internet/Intranet/Extranet

SPECIFIC APPROVAL

 System Customizing  Publishing (with  Communication Service Centre printing)  Prototype Making  Project Planning & Management Audio / Video product Design  Engineering Design &  Equipment & component Applications Engineering Development Centre  Merchatronics Components Design & Development  Electronic Workshop-Repair System Integration of Data Comn. Equipment- Consultancy Services

6. Lease Period (Please indicate) :

7. Token Advance amount payable : Rs. ______along with application form (10 months rent)

8. UTILITIES SERVICE REQUIREMENTS

(i) Electricity (estimated) a. Average Daily energy Consumption (kWh)

b. Electrical Load Required (Connected) (KVA)

(ii) Communication (required)

Telephone lines Nos.

ISD Lines Nos.

Leased Lines kbps 9. EMPLOYMENT (expected)

No. of employees to be housed Nos

Projected man power to be required for operations at optimum level.

10. OTHER RELEVANT INFORMATION

(a) Two copies of the 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 the Certificate of Registration (Business Registration Act / Indian Partnership Act) and Registration Form showing the particulars of the sole proprietorship / partnership

(c) Necessary supporting documents in case of IT professionals / individuals.

(d) Brochures of Company, Products and Services, Nature of business

(e) Latest Company's Annual Report or Audited Accounts.

(f) Company's brief and the business plan for the next five years

(g) All shareholders / Partners and their respective shareholdings are to be clearly indicated.

(h) Copies of Company PAN and GST

(i) If a foreign company, the relevant documents for carrying out business in may be provided.

(j) Any other information relevant to support the application

11. Payment Details

a) Module No.

b) Area (super built-up)

c) Advance Payment Rs.

d) RTGS / NEFT details

Place : Signature :

Date : Name :

Designation :

Company Seal :