FORM NO "D-I" VIDEO LICENCE 
FORM  NO "D-I"
(See Rule-24-D of Video Rules, 1987)
Form of application for Video Licence.
 

To,
        The District Magistrate,
        Amravati.
       1)Full Name of the applicant : 
      2)Age of the applicant  : 
      3)Full address of applicant : 
      4)Place where the proposed Video Cinema is to be located (Give detailed particulars of the city/village/wardno./Tq./Distt./building no. /name of 
      Road which is situated. : 
      5)The area in Square metre of enclosed of space to be used for Video Cinema  : 
      6)Seating capacity       : 
      7)The name of Manager, with address who will be in charge of the Video Cinema in the absence of the Licensee.: 
      8)Date from which applicant proposed to start the Video Cinema.: 

        
Date :
Place :                                                                                   Signature