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Application
Format for Claiming Reimbursement of Certification Charges of
acquiring ISO-9000/ISO-14001 Certificate under the Incentive
Scheme of O/o Development Commissioner (SSI), M/o Small Scale
Industries, Nirman Bhawan, New Delhi-110011.
13.
(a) Name and address of the unit
[Office & Factory Location (s).]
(b) Telephone No. Factory & Office
(c) E-mail & Fax
14.
Details of E.M. No.;
date of issue; Directorate of Industries/
GM, DIC of the State concerned
(Enclose an attested copy of all pages
of SSI Registration Certificate)
15.
Item (s) of manufacture/processing
as indicated in the E.M.Certificate.
16.
Proof of SSI status and functional status of the unit
as on the 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 ISO-9000/ 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 SSI status and functional
status of the unit at the time of acquiring ISO-9000/ISO-14001
certificate; and 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)
17.
Details of ISO-9000/ISO-14001 Certificate
Name and 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.
(Enclose an attested copy of the Certificate)
18.
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).
19.
Details of reimbursement/grant/subsidy
already received, if any, from Centre Govt (including
DC(SSI) /
State Govt./Financial Institution etc. for acquiring ISO-9000/
ISO-14001Certificate ( Furnish, an Undertaking/declaration
(in original) from the Managing Director/Director/
Proprietor/ Partner of the SSI/ ancillary units duly sworn
before
Notary Public (as per the Format Annexure V)
20.
Pre-receipt to be furnished as per Format at Annexure VI.
Declaration:
I (full name) ……..,,S/o of ………. ……Managing Director/
Director/Proprietor/Partner of M/s. ………………. (complete 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.
Name and Signature of
Managing Director/
Director/Proprietor/Partner of SSI unit.
(Full Name)
Note:
The copy of SSI Registration, ISO-Certification must be attested
by any one of the followings:
(1)GM (DIC) or (2) Director, SISI of the Region or (3)
Chartered Accountant (with name of the signatory, CA Stamp, and
CA Membership No. )
Annexure ‘I’
CERTIFICATE
This is to certify that
M/s-------------------------------------------------------- With
their office at
-------------------------------------------------------------- &
factory located at
---------------------------------------------------------------------------
with E.M.No.-----------------------------------------------
dated---------------is an SSI/Tiny/SSS BE unit as per Govt. of
India definition and has been functional & in production at the
time of acquiring ISO-9000/ISO-14001 Certification
No---------------------dated-------------------and also
continues to be functional & in production as on date.
Dated
Director of
Industries/
GM (DIC)
Name & Rubber Seal
Annexure ‘II’
AFFIDAVIT**
I,-------------------------------------------------------s/o--------------------------------------
Managing Director/Director/Proprietor/Partner,*
M/s.-------------------------------------------
---------------------with their Regd. Office at
-------------------------------- & Factory located
at---------------------------------------------------------------
with E.M. No.-------------------------------------------dt.---------------
do hereby solemnly affirm and declare as under:
xxi.
The Company/Firm/Establishment has been a SSI/ancillary/Tiny/SSSBE*
unit as per the Govt. of India definition; and has been
functional & in production at the time of acquiring
ISO-9000/ISO-14001* certification
No.------------------------dated-------------
xxii.
The Company/Firm/Establishment continues to be a SSI/ancillary/Tiny/SSSBE
unit; and functional & in production as on date.
xxiii.
As per books of account, the total investment (original
purchase value) in plant and machinery in the
Company/Firm/Establishment as on ----------------------is Rs-----------------------------------------(Chartered
Accountant Certificate dated----------------to this effect is
attached).
Signed on this day of-------------------------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:
(Note) * Strike out whichever is not applicable.
**On a Stamp paper (of Rs.10/- min) in Delhi /amount as
applicable in the respective State duly sworn before a Notary
Public( duly affixed with Notarial Stamp; and with Notary Seal;
and Notary Registration number) or First Class Magistrate
Annexure 'III'
Certificate from
Chartered Accountant about investment in Plant & Machinery (on
C.A. Letter Head)
To Whom It May
Concern
Verified from the Books of Accounts of M/s._____________________________________with
their Regd. Office at
________________________________________________ and Factory
located at _________________________________and E.M.
No._________________________dt. ________________that the total
investment in plant and machinery (original purchase value) of
the company as on date*_________________ stands as
Rs.__________________________(Rupees____________________________
_________________________________________________________)
Name & Signature of
the
Chartered Accountant with stamp
and Membership number.
Place:
Date:
* Date of Application or 31st March of Preceding financial
year.
Annexure'IV'
Certificate from
Chartered Accountant in respect of Proof of Expenditure incurred
for acquiring ISO-9000/ISO-14001
(on a C.A Letter Head)
To Whom It May
Concern
The documents & records of M/s._______________________________________with
their
Regd. office at __________________________________________and
factory located at
__________________________________________________and E.M.
No.__________________________ dt. _________________)
in respect of the expenditure incurred by them in acquiring
ISO-9000/ISO-14001 Certificate (or its equivalent) have been
verified; and it is certified that the said company have
incurred a total expenditure of Rs._____________ (Rupees
_____________________ ____________________________________)
towards ; Application fee; Assessment/Audit fee; Annual fee/Licence
fee; Training; Calibration; and Technical Consultancy etc.
(excluding hotel & travel expenses & Surveillance charges) in
obtaining ISO-9000 /14001 from the Certification Agency
namely_________________________________; as per the following
details of payments:
Details of Payments (Name of Certification Agency/Orgn.)
Amount paid(in Rupees)
* a) Application Fee paid to ------------------
* b) Assessment/Audit Fee paid to ---------------------
* c) Annual Fee/Licence Fee paid to ---------------------
d) Calibration charges paid to----------------------------
e) Technical Consultancy charges paid to-------------------
f) Training expenses paid to----------------------------------
Total
-----------------------------------
Place----------------
(Signature of the
Chartered Accountant
with Name CA Stamp & CA
Membership Number)
Dated--------------
* Payments at (a),(b) & (c) above should be supported by
copies of receipts of payments made to the Certification agency
duly attested. The payment receipts must indicate the purpose
for which the payments have been made to the Certification
Agency.
Note: Payments made to the Certification agency directly
shall only be eligible for consideration of reimbursement.
Annexure 'V'
To be submitted by the Applicant on a Non-judicial Stamp
paper of Rs. 50/-(Min) in Delhi /amount as applicable in the
respective State duly sworn before a Notary Public (duly affixed
with Notarial Stamp; and with Notary Seal & Notary Registration
number) or First Class Magistrate
UNDERTAKING/
DECLARATION
I,-------------------------s/o---------------------Managing
Director/Director/Proprietor/Partner,
M/s.------------------------------with Regd. office
at--------------------------- & factory located
at-------------------------------------------------and with E.M.
No.---------dt.--------------- do hereby solemnly affirm and
declare as under:
(a) (i) That the aforesaid Company/Firm/Establishment(s) have
not availed reimbursement/subsidy/grant/incentive for acquiring,
ISO 9000/ISO-14001 Certification under any Scheme operated by
Central Govt. (including o/o DCSSI, M/o SSI)./ State Govt./
Financial Institution etc.
OR
(a) (ii) That the aforesaid Company/Firm/Establishment(s)
have claimed & received reimbursement/subsidy/ grant/incentive
for acquiring ISO 9000/ISO-14001 Certification amounting to Rs__________
(Rupees __________ from _____________(Name of the Central Govt/State
Govt Deptt./Financial Institution vide draft/cheque
No-----------dt---------- of------------(Name of Bank).
(b) (i) That the aforesaid Company/Firm/Establishment(s) have
already applied to--------Name of the Central Govt (other than
O/o DCSSI)/ State Govt/ Financial Institution ) vide application
dated--------for reimbursement/ subsidy/ grant/incentive for
acquiring ISO- 9000/ISO-14001 Certification .
OR
(b) (ii) That the aforesaid Company/Firm/Establishment(s)
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-14000 Certification.
( c) That after availing reimbursement for ISO-9000/14001/HACCP
Certification from Office of DC(SSI), Ministry of SSI, in
respect of the said Company/Firm/Establishment(s), 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 Govt./State Govt. /Financial Institutions 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/
Managing Director/ Director
In the presence of:
1. (Full Name and addresses of the two witnesses also
to be indicated along with signatures)
2.
Note: The factual status as on date under the respective
paras at (a); (b) & (c) above must be clearly indicated
Annexure 'VI'
Name of the Industry : ____________________________
Address : ____________________________
____________________________
____________________________
Phone Number : ____________________________
PRE – RECEIPT (in Triplicate)
Received a sum of
Rs.__________________(Rupees ____________
________________________________________) from the Development
Commissioner (Small Scale Industries) towards the reimbursement
of expenses incurred for obtaining International Quality
Certification ISO – 9001 / ISO – 14001. •
Rubber Stamp of the
Unit
*Signature of the
Authorized Person (on Revenue Stamp)
(B) FOR OFFICE USE ONLY
Passed for the payment for
Rs.__________________(Rupees_________________
_____________________________________) Vide sanction
No._____________ ______________dated_________________.
Asstt. Director
Office of the
Development Commissioner (SSI)
Nirman Bhavan, New
Delhi – 110 011.
Note: Please
read the instructions on pre-page carefully before filling this
Annexure VI i.e. Pre-Receipt.
INSTRUCTIONS
Note: - Please follow the following
instructions while Preparing this Annexure VI given in next
page.
1. Please ensure you prepare the Annexure VI in A-4 size paper
only.
2. Please ensure you give Annexure VI in triplicate.
3. Please type the name of your industry, full address and
telephone numbers as indicated in the sample format, in the
portion marked A.
4. Please do not fill in the amount in the pre-receipt. Leave
the portion blank. The office of DC (SSI) will fill it up after
calculating the amount due to you.
5. Please ensure the authorized person of your unit signs at the
places indicated for signatures of the authorized person on
revenue stamp.
6. Please type portion ‘B' yourself in the A-4 size paper as
indicated in the format.
7. Office of the DC (SSI) will fill up the amount and the
sanction no. in the spaces provided for the same.
8. The Assistant Director concerned will sign at the place
earmarked for his signature.
Annexure 'VII'
Check List of documents to be annexed along with the
Application for claiming reimbursement of expenses of ISO-
9000/14001 certification.
24.
Copy of E.M.No. duly attested (each page of the
Registration Certificate duly attested) by General Manager,
District Industries Centre (DIC) or State Director of Industries
or Director, Small Industries Service Institute (SISI) or
Chartered Accountant (Name, Signature, Membership number; and
Seal)
25.
Letter (in original) from General Manager, District
Industries Centre, (DIC) or Director of Industries confirming
SSI status and functional status of the unit at the time of
acquiring ISO-9000/14001/HACCP as per Format at Annexure I.
Or
26.
An Affidavit( In original) on a non judicial stamp paper
of Rs. 10 (Min.) in Delhi/Amount as applicable in the respective
State) duly sworn before a Notary Public as per Annexure ‘II’(
with Notary Seal, Notarial Stamp & Noatry Registration no. ; and
Chartered Accountant’s Certificate of investment in Plant and
machinery as per Annexure ‘III’.
27.
Copy of ISO-9000/ ISO- 14001/HACCP Certificate duly
attested by General Manager, District Industries Centre (DIC) or
State Director of Industries or Director, Small Industries
Service Institute (SISI) or Chartered Accountant (Name,
Signature, Membership number and Seal.)
The Certificate must have address of 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.
28.
Chartered Accountant’s certificate of the details of the
Expenses incurred by the unit in acquiring ISO-9000/ISO-14001/HACCP
Certificate in Annexure ‘IV’. The payments made to the
Certification agency must be supported by copies of Receipts
duly attested ( The payments Directly made to the
Certification Agency shall only be eligible for reimbursement )
29.
Undertaking/Declaration of the Incentive/grant/subsidy
already received, if any, in Annexure ‘V’ on a Non-Judicial
stamp paper of Rs.50/-,(Min) in Delhi/Amount as applicable in
the respective State. with witnesses name & their addresses
&signatures, Notary Seal, Notarial Stamp & Notary Registration
nos.)
30.
Pre-receipt in Triplicate on Company’s Letter head with
company’s Rubber Stamp and affixed with Revenue Stamp in
Annexure ‘VI’
Any other documents annexed to be mentioned.
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