1

Name of the MSME unit with full address and e-mail ID (if any).

2

Name & designation of person going for the trip.

3

MSME registration no. with date and place of issue (copy of registration certificate to be enclosed).

4

Membership number of FIEO/EPC (enclose proof of membership).

5

Value of exports during last 3 years at FOB (CA's certificate to be enclosed).

6

Details of fair/study tour/trade delegation.

7

Details of visit indicating date of proposed departure, date of anticipated arrival and countries to be visited.

8

If proposal is in respect of a fair, whether participation is in association with MSME-DO.

9

Whether the MSME unit has been charged/ prosecuted/debarred/blacklisted/under investigation under Exim Policy or any other law relating to export import business.

10

Whether any MDA assistance has been availed from any source for similar activity in this financial year.