1. Company Name: Presented by :

2. CHECK LIST FOR SEZ NEW UNIT REGISTRATION S. No.Description Compliance YESNO 1Covering Letter containing all the following 2 Application duly filled in Form-F along with Authorized Signatory and rubber stamp on each page of the application in five (5) copies 3 A challan for Rs. 5,000/- (Rupees Five Thousand only) to be paid in Central Bank of India, Khairatabad Branch, Hyderabad 4 Provisional offer of availability of space & other infrastructure support given by the Developer - Regd. Lease Deed 5Project Report 6Projected Balance Sheet for next 5 years 7Projected Cash Flow Statement for next 5 years 8Memorandum of Association (MoA) & Articles of Association (AoA) 9 Board Resolution for authorizing the person for signing the documents with regards to setting up SEZ unit on behalf of Company 10List of Board of Directors with proof of identity (as per the format given) 11Coloured copy of PAN of the proposed unit 12Copy of Form No. 32 13Copy of Form No. 18 14Copy of IEC / Acknowledgement 15Profile of the Directors 16Details of Export Order in Hand / Pipeline 17 Income Tax Returns along with Annexures of the Proprietor or Partners or in the case of a Private / Public Limited Company, Audited Balance Sheet for the last three years

3. Profile of the company

4. Brief background of Promoter / Director /CEO

5. Pattern of share holding in the paid-up capital (Rs. in Lakh) ExistingProposed SEZ Unit i) Foreign Holding ii) NRI Holding iii) Resident Holding

6. Imported CG : Indigenous CG : (Rs. in Lakh)

7. Proposed activities of the Unit

8. Turnover in five years : (Rs. in Lakh) 1 st Year2 nd Year3 rd Year4 th Year5 th Year TOTAL FOB Value of Software Exports in first Five Years Foreign Exchange outgo for the first Five Years Net Foreign Exchange Earnings for the Five Years (1) – (2)

9. Manpower : 1st Year2nd Year3rd Year4th Year5th Year MEN WOMEN TOTAL

10. Brief of Agreements/Contracts already signed

11. Name of the SEZ, Proposed area of operation

12. Complete contact details of Director Name Mobile Phone No. Fax Email ID

13. Contact Person Name Mobile Phone No. Fax Email ID

14. Export Obligation Statement