Nomination form for Award- Last Date 30 November 2022 Kindly fill in the form show below to submit your details for the PMFAI-SML Annual Agchem Award Name of the Award: Name of the Organization & Year of Establishment Type of Organization: SmallMediumLarge Address Telephone no: Fax no: Email Address: Website Address: Contact Detail of applicant: Company Turnover (last Three Years): Exports Turnover (last Three Years) Applicable for Export award: Names of Exporting Country Applicable for Export award: Efforts made to Increase exports.Applicable for Export award: Member of any Association/trade body: Major Achievement & Accolades Received if any : Summary Justifying for the Award not more than 500 words: I (Name in Full), (Designation) hereby confirm having read & understood the Rules & Regulations by the PMFAI for the Awards, and will abide to the same. I also confirm the information provided by me in the Application form is correct to the best of my knowledge. Date I Agree Rules and Regulations Note: An entry form will be considered complete and valid, only if the following are duly completed and couriered to the PMFAI Office FOR EXPORT CATEGORY AWARD: Certificate from CA for Turnover and Export Turnover or Bank Certificate stating the export turnover or CA Certificate certifying the export turnover for crop protection chemicals only Other relevant supporting documents or information deemed appropriate Duly filled Nomination form along with the enclosures as prescribed in the Nomination Form Please read & Regulations before applying to the Award Nomination. Use Separate sheet to fill the details if required.