PROFORMA DETAILING PARTICULARS FOR VERIFICATION BY APPLICANT FOR  MANUFACTURE, PURCHASE, REGISTRATION AND OPERATION  OF MICROLIGHT AIRCRAFT/HOT AIR BALLOONS

WARNING : SUPPRESSION OF MATERIAL OR FACTUAL INFORMATION  IN THIS FORM SHALL BE A DISQUALIFICATION.
   

1.

(a) Name of Applicant in full (in block letters)

Surname :    Name :    Aliases, if any :
   

(b) Parentage :
  
Surname :    Name :    Aliases, if any :

2.

Present address in full, including Police Station

3.

1.  Permanent address in full, including Police Station:

2. If originally a resident of a country other than India, address  in that   country and the date of  migration to India:

4.

Nationality

5.

Date and place of birth, with full address

6.

Profession/occupation after the age of 18 years

7.

Particulars of  places, with  full  address,  where   the applicant has resided for more than a year during the preceding ten years:

8.

a.       Particulars  of  relatives  -  Indian  and  non-Indians working      in     foreign      Missions,  foreign organisations including foreign concerns,  with  full details :

2. Particulars of relatives living abroad with their  full address:

9.

Is the applicant or any of his relatives a member of  social or  cultural organisation which is associated       with  or assisted by a foreign Mission or organisation?

10.

Has  the applicant visited a foreign country  recently?   If so, details thereof:

11.

Has the applicant ever been arrested, prosecuted, kept under  detention, or convicted by a court?  Give  details

Certified that the information furnished in this proforma is correct and complete to the best of my knowledge and belief.  I am  aware  that  furnishing  of  wrong  information  or suppression  of  factual or material information  will  disentitle me from grant of the licence/permit.

Date :

Signature of the Applicant :