Application Format for Claiming Reimbursement of Certification Charges of acquiring ISO-9000 Certificate under the Incentive Scheme of O/o

Development Commissioner (SSI), M/o Small Scale Industries, Nirman Bhawan, New Delhi-110001.
1. (a) Name and address of the unit

b) Telephone No. Factory & Office (c) E-mail & Fax 2. Details of PMT SSI Registration No.; date of issue; Directorate of Industries/ GM, DIC of the State Concerned 3. Item(s) of manufacture/processing as indicated in the PMT SSI Registration 4. Proof of SSI status and functional status of the unit as on date of submission of Application. The following document(s) to be submitted i)A certificate (in original) from State DI/GM, DIC confirming SSI and functional status of the unit at the time of acquiring ISO9000/ ISO-14001 certificate; as on date as per Format at Annexure I OR ii)An Affidavit (in original) from Managing Director/Director/Proprietor/Partner of the SSI unit duly sworn before a Notary Public confirming the SSI status and functional status of the unit at the time of acquiring ISO-9000/ ISO-14001 certificate; as on date, (As per Format Annexure II) accompanied by CA certificate of the total investment in plant & machinery as on date (original purchase value) (As per Format Annexure III) 5. Details of ISO-9000/ISO-14001 Certificate Name & address of Certification agency; The Certificate must have address of the site/location certified; Scope of certification, Certificate No, date of issue & period of validity (or date of expiry), Name & Logo & Number of the Accreditation Body/Board.

6. Details of expenditure incurred in acquiring ISO-9000/ISO-14001 Certificate (excluding hotel & travel expenses & surveillance charges). Furnish a CA certificate of expenditure (in original) giving the details (as per the Format Annexure IV) 7. Details of reimbursement/grant/subsidy already received, if any, from Central Govt (including DC(SSI) /State Govt./Financial Institution etc. ) for acquiring ISO-9000/ISO14001 Certificate. Furnish, an Undertaking /declaration (in original) from the Managing SSI/ancillary units duly sworn before Notary Public as per the Format Annexure V) 8. Pre-receipt to be furnished as per Format at Annexure VI. Declaration: I, Mr. Pradeep Kabra s/o of Shri ?????????, Director of M/s Kabra Industries.,address???????????????? hereby declare that the particulars given in the application are correct. In case any of the statement/information furnished in the application/documents later found to be wrong or incorrect or misleading, I do hereby bind myself and my unit to pay to the Government on demand the full amount received as reimbursement in respect of above mentioned activity, within seven days of the demand being made to me in writing. Director/Director/ Proprietor/ Partner of the

For????????????????

Director (????????????)

ON Rs.20/- STAMP PAPER duly attested by NOTARY BY AFFIXING Rs.25/NOTARIAL STAMP ON IT

AFFIDAVIT
I, Pradeep Kabra s/o ??????????, Director, M/s Kabra Industries with their Regd. Office located at ????????? & Factory located at???????? with permanent SSI Registration No. ?? dt. ??? do hereby solemnly affirm and declare that under: 1. The Company has been a SSI/ancillary/Tiny/SSSBE unit as per Govt. of India definition; and has been functional & in production at the time of acquiring ISO-9000 certification No. ????????????? dated ????????????. 2. The Company/Firm/Establishment continues to be a SSI/ancillary/Tiny/SSSBE unit; and functional & in production as on date. 3. As per books of account, the total investment (original purchase value) in plant & machinery in the Company as on 31.03.2005 is Rs. ??????? /(Rs. ???????????????????only) (Chartered Accountant Certificate dated ????????? to this effect is attached).

Signed on this day of June, 2005 dt. DEPONENT VERIFICATION: I do solemnly affirm that the contents of the Affidavit are true to the best of my knowledge & belief.

DEPONENT Date: Place:

ON Rs.20/- STAMP PAPER duly attested by NOTARY BY AFFIXING Rs.50/NOTARIAL STAMP ON IT

(DO NOT DELETE THE WORDS ISO-14001) UNDERTAKING/DECLARATION

I, Pradeep Kabra s/o Shri ???????, Director, M/s Kabra Industries with Regd. office located at ?????????? & factory located at ??????? and with Permanent SSI Registration No. ?? dt. ??? do hereby solemnly affirm and declare that under: (a) That the aforesaid Company have not availed reimbursement/subsidy/ grant/incentive for acquiring, ISO-9000/ISO-14001 Certification under any Scheme operated by Central Govt. (including o/o DC(SSI), M/o SSI)/ State Govt. / Financial Institution etc. (b) That the aforesaid Company have not applied to any Central Govt./ State Govt./Financial Institution (except O/o DC (SSI), Ministry of SSI), for reimbursement/subsidy/ grant/incentive, for acquiring ISO-9000/ISO-14001 Certification. (c) That after availing reimbursement for ISO-9000/ISO-14001 Certification from Office of DC(SSI), Ministry of SSI, in respect of the said Company, I shall disclose this fact on behalf of the said Company/Firm/Establishment(s) at the time of claiming/ receiving reimbursement/subsidy/grant/incentive, if any, under any other similar scheme run by Central / State Govt. / Financial Institution etc. (d) I hereby solemnly affirm that the information given above is correct. In case above declaration is found wrong or incorrect or misleading, I do hereby bind myself & my unit and undertake to pay to the Government on demand the full amount received as reimbursement in respect of above mentioned activity, within seven days of the demand being made to me in writing.

Partner/proprietor/Director In the presence of :Name signature and address of 2 witnesses. 1. (Write name, ADDRESS and have SIGNATURE of concerned person)

(On CA letter head) 2 copies TO WHOM IT MAY CONCERN

Verified from the Books of Accounts of M/s Kabra Industries with their Regd. Office located at ????????? and Factory located at ??????? with permanent SSI Registration No. ?????????? dt.?????????, that the total investment in plant & machinery (original purchase value) of the Company as on date 31st March, 2010 stands at Rs. ?????????/- (Rs. ???????????????????only).

For Chartered Accountants Place: Dated: (Name of Partner) Membership No.

(On CA letter head) 2 copies To Whom It May Concern

The documents and records of M/s Kabra Industries with their Regd. office located at ??????? and factory located at ?????????, Permanent SSI Registration No. ?????????? dated ???????, in respect of the expenditure incurred by them in acquiring ISO-9000 Certificate (or its equivalent) have been verified; and it is certified that the said Company has incurred a total expenditure of Rs. ?? /- (Rupees ???? Thousand ???Hundred ????only) towards; Application fee; Assessment/Audit fee; Annual fee/License fee; Training; Calibration; and Technical Consultancy etc. (excluding hotel & travel expenses & Surveillance charges) in obtaining ISO-9000/ISO-14001 from the Certification Agency namely ?????????????????????????; as per the following details of payments:

Details of Payments
a) Application Fee paid to ???????? ????????

Amount in Rupees

b) Assessment/Audit Fee paid to c) Annual Fee/License Fee paid to d) Calibration charges paid to

???????? ?????

e) Technical Consultancy charges paid to f) Training expenses paid to ???????

TOTAL

For Chartered Accountants Place: Dated: (Name of Partner) Membership No.

ON YOUR LETTER HEAD (3COPIES) (DO NOT FILL THE AMOUNT) PRE-RECEIPT

Received a sum of Rs. _____________________________(Rupees _______________________ __________________________________________ only) from the Development Commissioner (Small Scale Industries) towards the reimbursement of expenses incurred for obtaining International Quality Certification ISO-9000/ISO-14001 AFFIX RE.1/- REVENUE STAMP, THEN PUT RUBBER STAMP OF DIRECTOR, THEN SIGN ON IT (ON ALL THE THREE COPIES) SIGNATURES SHOULD BE ON THE STAMP

(on letter head)

To, The Industrial Adviser, Office of the Development Commissioner (SSI), Ministry of Small Scale Industries, 7th Floor, A Wing, Nirman Bhavan, New Delhi-110001 Sub: Application for reimbursement of ISO-9001 Certification Charges Dear Sir, We are a small scale unit registered with DIC, Vasai, Thane District. We have undergone an ISO certification from URS Certifications Ltd. and have incurred Rs. 55,000/- as expenses .Now we are enclosing following documents for claiming ISO subsidy from your esteemed office. 1. Application. 2. Copy of Permanent SSI Registration Number duly attested by Chartered Accountant. 3. An Affidavit duly sworn before a Notary Public. 4. Chartered Accountants Certificate of investment in Plant and Machinery. 5. Copy of ISO-9001 Certificate duly attested by Chartered Accountant. 6. Chartered Accountants certificate of the details of the Expenses incurred by the unit in acquiring ISO-9001 Certificate. 7. Undertaking of the Incentive/grant/subsidy already received, if any, on a NonJudicial Stamp paper, with witnesses name & their addresses & signatures, Notary Seal, Notarial Stamp & Notary Registration Nos. 8. Pre-receipt in triplicate. 9. Copy of receipt and bill of Certification body duly attested by C.A.

You are requested to reimburse our certification charges at the earliest and oblige.

Thanking you, Yours faithfully, For ??????? Director