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package of incentives and concessions under karnataka ...

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Annexure-FDetailed Statement <strong>of</strong> Expenditure incurred for adoption <strong>of</strong> TechnologyAs per the documents <strong>and</strong> records <strong>of</strong> M/s.with registered <strong>of</strong>fice at____________________________________________________ <strong>and</strong> factory is located at______________________________________<strong>and</strong> EM / SSI Registration number:Dated:. The enterprise has incurred a totalexpenditure <strong>of</strong> Rs. _______________________ (RupeesOnly) for adopting Technology fromthe Certifying Agency / Organization viz., .The categorization <strong>of</strong> expenditure is as follows:Sl.No.Details <strong>of</strong> Payments Certifying Agency /OrganisationAmount (Rs.)Remarksa) Premium Technology Feeb) Technology Royalty Feed) Calibration/Testing Chargese) Technical Consultancy Chargesf) Training ExpensesTotal(Note:The above details <strong>of</strong> payments must be supported by the duly attested copies <strong>of</strong> invoices<strong>and</strong> receipts <strong>of</strong> payments made towards adopting Technology.)Place:Date:Signature <strong>and</strong> Seal(Proprietor/Mg. Partner/Chief Executive)132

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