Application Form 2022

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Sambad Awards

Section 1

All fields are mandatory. Kindly fill all the fields properly before submitting the form.

Name of the Organisation

Registered Address

Odisha HQ Address

Contact Number

Email ID

Year of Establishment

Type of Organisation

Organizations opting for Corporate Social Responsibility(CSR) may also apply for any other type of organization in another Application Form.

CSR

Large

Medium

Small

Emerging/Start Up

Line of Activity

Key Products/Services

Name of CMD/MD/Key Promoter

Section 2

Authorised Contact Person

Authorised Person Contact Number

Authorised Person Email ID

Vision/Mission of the organisation

Number of Employees in the organisation

Financial Data ( In Lacs)

2018-19

Gross Turnover (Excluding Tax - In Lacs)

Export Turnover (If Any In Lacs)

Sales Turnover Outside Odisha (In Lacs)

2019-20

Gross Turnover (Excluding Tax - In Lacs)

Export Turnover (If Any In Lacs)

Sales Turnover Outside Odisha (In Lacs)

2020-21

Gross Turnover (Excluding Tax - In Lacs)

Export Turnover (If Any In Lacs)

Sales Turnover Outside Odisha (In Lacs)

Location/s of Operation Outside Odisha

Achievements /Awards ( if any)

Upload the awards/ Certificates Images

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Documentary Proof(Pls Attach) Financial Statements filed with ROC for Last 3 Years / (Audited Financial Statements)

Max file size: 256.00 MB. | Allowed file types: zip,tar,rar | Max number of file: 1

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Organization Opting for CSR - Provide details of CSR Activities conducted, Amount Spend, Awards, Certificates and Photos.

CSR Activities Awards, Certificates and Photos.

Max file size: 122.18 MB. | Allowed file types: zip,tar,rar

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Name of Authorised Signatory

Designation of Authorised Signatory

Scanned Signature with Organisation Seal

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I/We do hereby declare that above information is true to the best of my/our knowledge & belief.

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Application Form 2022

Section 1

All fields are mandatory. Kindly fill all the fields properly before submitting the form.

Section 2

Financial Data ( In Lacs)

2018-19

2019-20

2020-21

Upload the awards/ Certificates Images

Documentary Proof(Pls Attach) Financial Statements filed with ROC for Last 3 Years / (Audited Financial Statements)

CSR Activities Awards, Certificates and Photos.

Scanned Signature with Organisation Seal

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