ANNEXURE - III

Quarterly Performance Report of Non STP units

PERIOD OF REPORT ............................................................... (Q1/Q2/Q3/Q4)

I. NAME AND ADDRESS OF THE UNDERTAKING IN FULL (Block Letters)

Non STP Registration No. with date of registration _________________________________

Name of the Applicant Firm _________________________________

Full Address _________________________________

(Regd.Office in case of limited _________________________________

companies & Head Office for _________________________________
others _________________________________

Pin Code _________________________________

Tel. No. _________________________________

Fax No. _________________________________

Permanent E-Mail Address _________________________________

Web-Site, if any _________________________________

Name of Bank with Address & A/c No. _________________________________

Income Tax PAN _________________________________

The name and address of each _________________________________

Of the Director/Partner

IEC Code _________________________________

II. INVESTMENT

(a) Investment during the Quarter : $ ________________________

Rs._______________________

(b) Cumulative investment upto the Quarter : $ ________________________

Rs._______________________
III. EMPLOYMENT
(All figures in number)
During the Quarter Cummulative for the year
a) Technical Men________________ Men________________
Women_____________ Women_____________

b) Non-Technical Men________________ Men_______________

Women_____________ Women_____________

IV. NET FOREIGN EXCHANGE EARNING

During the Quarter Cumulative for the year

$_______________________ $_______________________
Rs.______________________ Rs.______________________

(Signature of Autorised Signatory)

with Seal of Co.
Name in Block Letters_____________________
Full Address :____________________________
Tel :____________________________________
Email : _________________________________