APPENDIX-I

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FORM OF APPLICATION VERIFICATION OF TITLES.

To

The CMM/DM/ADM/RDO/DC/SDO/SDM

............................................

Subject:-      Verification of titles.

Sir,

                  I/We proposed to publish a newspaper / periodical for which I /We suggest the following title(s).My /Our application may please be forwarded to RNI, Wing -2 West Block -8 R.K. Puram, New Delhi 110 066 to get the title(s) verified under para-5 of the PRB Act.1867 , as amendment from time to time before I/We am/are allowed to fill the declaration to you for starting a newspaper/periodical as required by the above noted Act. Details are below .

a) Name of the title(s)...................................

b) Language(s)

c) Periodicity.

d) Full address of the place of publication.

..............................................

.............................................

District.............Date/U.T.......

Pin Code ...............

e) Name of the owner(s) with addresses (Who will own the news papers/ periodical.

Place.....

Date. Signature of the owner/applicant

authorized by the owner(s)

If the number of the proposed titles are more than one3 then same may be indicated in a separate list & enclosed the signature of the5 owners)/ applicant authorise4d by the owner(s)

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