REGISTRATION FORM

ACMA

6thFloor, Last Date of Submission: 25thJuly, 2017

The Capital Court Building,

Olof Palme Marg, Online Form Available:

Munikra,or

New Delhi - 110067 Scanned form to be sent:

Dear Sir,

We are pleased to confirm our company participation at iAutoConnect 2017: ACMA Reverse Buyers – Sellers Meet, and would like to nominate the following personnel from our organisation.

Name*Designation*E-mail id* Mobile Number*

______

Products Manufactured*:

Products on Display during the event* (please tick):

Engine ComponentsDrive Transmission & Steering

Pistons Clutch Plate & AssemblyMaster Cylinder Repair kit

Piston Rings Brake Pads/Lining/Shoe Shock Absorbers

Cylinder Liners Crown Wheel Pinion Struts

Engine Gaskets Power Steering Universal JointWheel Cylinder Repair Kit

Engine Bearing Drive Axle Shaft Cooling Systems

Engine Valves Drive Shaft Slip Yoke Viscous Fan Assembly

Crank shaft Spider Kit Radiators

Chain sprocket UJ Cross Water & oil pump

Connecting Rods Ball Suspension Joints Electronics

Cylinder heads Control Arm Telematics

Tappets Suspension & BrakingSensors

Spark plugs Leaf Spring Navigation systems

Electricals Consumables & Misc. Injection Systems

Starter Rear view mirrors Diesel Pump Spares

Alternator Filters (Oil, Air, Fuel, Cabin)Gasoline Injection Spares

Lights / lamps Locks High Pressure Pipes

Switches Wheel Bearing Feed Pumps

Horns Wiper BladesLubricants

Armature Bulbs

Ignition coils

Batteries

Rubber Components

Hose Engine mountings

Strut mountings Transmission mountings

Molded rubber parts Exhaust rubber mounts

Extruded rubber - Profiles Control arm bushes

Oil seals Mechanical Control Cables

Any other Please specify______

**The List is illustrative

Value of Exports (in USD)* ______

Aftermarket exports to (please mention country names)*

______

Please provide us with the following information of the company*:

IEC CODE: ______;PAN NO: ______;DIN NO: ______

Participation fees: Rs. 40000 + applicable taxes (one delegate per company)

Additional delegate participation fees: Rs. 15000 + applicable taxes (per delegate)

DEMAND DRAFT / CHEQUE NO. ______Dated______
AMOUNT: ______
(NON-REFUNDABLE)
TDS:______BANK:______
DATED: ______
IN FAVOUR OF "AUTOMOTIVE COMPONENT MANUFACTURERS ASSOCIATION OF INDIA" / ACMA Bank detail for bank transfer :
Bank Account Name : Automotive Component Manufacturers Association of India
Account No. : 90561010001459
Bank Account Type: Current
Bank Name: Syndicate Bank
Bank Address: R.K.Puram, Delhi Tamil SangamBuidling, New Delhi-110022, India
SWIFT Code: SYNBINBB126
MICR Code: 110025043
IFSC Code : SYNB0009009
UTRNO. ______DATE:______
AMOUNT:______TDS______
Invoice to be sent to / Particulars
Name
Designation
Company
Address
Mobile no.

Coordinator’s Name*:______Designation*:______

Organisation*:______

Address*: ______

Tel. No*:______Fax No: ______

Mobile No*:______E-Mail id*:______

Signature:______Date: ______

  • Fields marked with * are mandatory.
  • The participation fee is non-refundable, however change in Nomination is allowed till two days before the program date.
  • Re-Confirmation email will be sent by ACMA.