FORM - IX

APPLICATION FOR LICENSE OF FILMING OPERATION AT PROTECTED MONUMENTS(UNDER RULE 43)

1. Name of the applicant and address:

2. Name of the Monument at which theproposed filming operation is to becarried out:

3. Part of the monument proposed to befilmed:

4. Nature and purpose of the proposedfilming operation and the context inwhich the monument is proposed to befilmed: (Relevant extract of the scriptshould be attached in triplicate anddetails of the scenes to be filmed shouldbe furnished in triplicate):

5. Number of persons in the Cast:

6. Approximate duration and date ofcommencement of proposed filmingoperation:

I declare that the above information is correct. I also undertake to observe the provisions of theAncient Monuments and Archaeological Sites and Remains Act, 1958, and the rules madethereunder.

Seal of the organisation Signature of the applicant

Place:

Date:

Note:1. If the application is on behalf of an organisation, the name thereof should be given.2. If the application is on behalf of an organisation the signature/seal should be that of the organisation.

INSTRUCTIONS :

Checklist of enclosures to be submitted with the video/ film shooting application is: 1. Duly filled application (in Form-IX ) completed in all respect must be submitted atleast 15 days prior to date of shooting.

2. Two demand drafts, one each for fee and security deposit. 3. Script of the video/film shooting. 4. In case of Foreigner/ Foreigner cast, No objection/ clearance letter of Ministry of External Affairs, New Delhi .

Details of Fee and Security Deposit: a. Fee for filming operation = Rs.5,000/- per day per monument.

b. Security Deposit for filming operation = Rs.10,000/- per monument.

c. Mode of Payment of Fee and Security Deposit is through Demand Draft, drawn in favour of "Superintending Archaeologist, Archaeological Survey of India, Vadodara Circle"

d. The Security Deposit will be refunded on submission of No-damage certificate and CD/copy of the un-edited version of video shooting.

Procedure for Release of Security Deposit: (i) No-damage certificate is to be submitted.

(ii) Un-edited version of the video/film shooting to be submitted for verification of the fact that monument of National importance has not been defaced or ill reported in the verse of shooting.

(iii)No-damage certificate can be obtained from the concerned Sr. C.A., C.A., Caretaker/ Foreman of ASI under whose jurisdiction the monument falls.