Form I: Form of Application for Certification for Public Exhibition of a Film Produced in India
[Rule 21(1)]
(No. and date of application (to be entered by Board’s office)
To
The Central Board of Film Certification through the Regional Officer at …………………………….. Application for certification for public exhibition of a film produced in India at …………………
(1)(a) Name of the film
(b) Language of the film
(c) Length of the film in ft. ………….. /meter
(d) Number of reels
(e) Gauge of the film
(f) Type of the film, i.e. whether it is 2-D, 3-D, cinemascope, vistavision, etc.
(g) Whether the film is silent or a talkie
(h) Colour of the film
(i) Name and address of the producer
(j) Name of the director
(2) State whether the film is a newsreel/ documentary/ scientific/ educational/ feature/ advertisement film.
(2A) Specify the certificate requested ‘U’, ‘UA’, ‘A’ or ‘S’
(3) State separately the number of negative and positive prints of the film
(a) Produced (negative …………………………………………………………….. Positive …………………)
(b) In the applicant’s possession (negative ……………………………………………………………….. Positive …………………)
(c) Name and address of the processing laboratory.
(4)(a) Whether the present film is a dubbed version or a re-make of any other film? If so, state the particulars along with full details of certificates issued to that film.
(b) Whether any pre-censorship advice was obtained and if so, the details thereof.
(c) Whether permission for any shooting abroad was obtained and, if so, the details thereof.
(d) Whether the film contains any dialogue/ commentary in any language other than the language of the film and, if so, specify the language and the reels in which they occur.
(5) Has any previous application been made to certify this film as suitable for public exhibition in India? If so,
(a) Where and to whom was it made ?
(b) What was the result of the application ?
*(i) A ‘U’ / ‘UA’ /an ‘A’ / ‘S’ certificate No……. dated……….. was granted subject to the following cuts…………
(ii) Certificate was refused.
(6) Has the exhibition of this film been at any time suspended or the film declared uncertified by the Central or any State Government? State particulars:
(7) Does the film contain any dialogue, Song, poem, speech or commentary in any language other than English, or an Indian language?
If so, specify that reel or reels in which the dialogue, song, poem, speech or commentary occurs and the language or languages used.
(8) Amount of fee accompanying the application on account of the fee prescribed in rule 36
Vide (i) Receipt No. ……………………. dated ……………………
(ii) Bank draft No. …………………… dated …………………. on………………… Bank
(iii) Postal order no. ………………….. dated………………. on ………………… post office.
(9) Name, address, and telephone number, if any of the applicant Telephone No.:
(10) I declare that the print of the film
is ready for examination by the Board and the statements recorded above are true in every particular.
Date …………….. Signature of applicant
*Score out the word or words which are not applicable.
