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DGFT Hand Book of Procedures Forms & Appendix (wef 08/04/2006) APPENDIX 29

APPENDIX 29

PROFORMA FOR SUBMISSION OF GRIEVANCE REPRESENTATION

1.	Name of the Applicant	:..........................................................................
2.	Address:	:..........................................................................
3.	Grievance subject:	Details may be mentioned (use additional sheets, if required)
4.	Particulars of file/ correspondence Ref No./date of DGFT or its regional office, if any:	:.............................................................................
5.	Whether the head of the concerned regional licensing office has been approachedif so, furnish particulars/ decision, if any, taken .	Yes [ ] No. [ ] :.............................................................................
6.	Any other remarks	:.................................................................................

	Signature of the Applicant	:	.................................................
	Name in Block Letters	:	.................................................
	Designation	:	.................................................
Place: ЕЕЕЕЕ	Tel. No.	:	.................................................
Date: ЕЕЕЕЕ	E-mail Address	:	..........................................

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