The All India Plastics Manufacturers' Association

									Date :          /            /

To,

The Secretary,
The All India Plastics Manufacturers’ Association,
AIPMA House, A-52, Street No.1, 
M.I.D.C., Andheri (East),
MUMBAI – 400 093.                               
INDIA.

                                                                     
Dear Sir,

Please enroll us as an International Member of your Association, for the Year _____________________

We have transferred an amount of _______________________US$ on _________________________  

as per Banking details appended here below.  

Beneficiaries Details:            : 	The All India Plastics Mfgrs’ Association.
                                                   	AIPMA House, A-52, Street No. 1,M.I.D.C., Andheri (East), Mumbai-400 093, India.

Name Of  Bank Account,      : 	The All India Plastics Mfgrs’ Association

Bank Account Number         : 	Current Account No. 10606574463.

Bank Address,	       : 	State Bank of India  
   			MIDC Indl. Area, Plot No. B-1, Opp. ESIS Hospital, Central Road,   
                                               	M.I.D.C., Andheri (East), Mumbai- 400 093, India.

Branch Name,  	       :  	M.I.D.C. , Andheri (East)

Branch Code,  	       :  	7074

Swift Code, 	       :  	SBININBB363


The necessary information about our Company is on reverse.

Yours faithfully,






 			ALL BLOCK LETTERS


COMPANY NAME : _________________________________________________________________

BUSINESS ADDRESS : _____________________________________________________________

________________________________________________________________________________

PHONES _______________________________________     FAX NO. ________________________

Email______________________________________WEBSITE _____________________________ 

DATE OF COMPANY ESTABLISHMENT _________________________________________________


FACATORY ADDRESS :_____________________________________________________________

________________________________________________________________________________

PHONES ___________________     FAX NO. _______________  E_Mail_______________________


BRANCHES :______________________________________________________________________

________________________________________________________________________________

	
NAME OF AUTHORISED REPRESENTATIVES         DESIGNATION   	SPECIMEN SIGNATURE

1.  ___________________________________     ______________	______________________
	
2.  ___________________________________     ______________	______________________
	

DESCRIPTION OF PRODUCTS :

____________________________________________________________________________________

____________________________________________________________________________________


____________________________________________________________________________________
			(FOR OFFICIAL USE ONLY)

Received on				Accepted at the Managing Committee Meeting 


SECRETARY;				held on _______________________________



      							CHAIRMAN
____________________________________________________________________________________

Annual Subscription as per article 8(b) sub-clause iv.

·	INTERNATIONAL MEMBER : US$ 100   + US$ 13 (GOVERNMENT  SEVICE TAX  PAYABLE) 
              (ANNUAL SUBSCRIPTION FOR THE FINANCIAL YEAR APRIL TO MARCH).