FORM VI : Government of India Central Board of Film Certification this Certificate is Valid for Theatrical Release Only
PART I
[Rule 35(1)]
Certificate No. ………………………………. Dated ………………..
Category “UA ” ………………………………………………………..
Film …………………………. Gauge MM …………………. Length …………………………… MTS Reels
After examination of the film by the members of the Examining Committee/ Revising Committee/ Film Certification Appellate Tribunal mentioned below and on the recommendations of the said Examining Committee/ Revising Committee/ Film Certification Appellate Tribunal, the Board hereby certifies that the film is fit for public exhibition with an endorsement of caution that the question as to whether any child below the age of 12 years may be allowed to see the film should be considered by the parents or guardian of such child, and also subject to excisions and modifications listed in Part II on the reverse:-
PARENTAL GUIDANCE
Further certified that the excisions and modifications imposed by the Board have actually been carried out.
Name of the applicant
Name of the producer
CHAIRMAN
PART II
Particulars of excisions and modifications:
