APPENDIX 29

PROFORMA FOR SUBMISSION OF GRIEVANCE REPRESENTATION

1.	Name of the Applicant	:........................................................................................
2.	Address:	:........................................................................................
3.	Grievance subject:	Details may be mentioned (use additional sheets, if required)
4.	Particulars of file/ correspondence Ref No./date of DGFT or its regional office, if any:	:........................................................................................
5.	Whether the head of the concerned regional licensing office has been approached if so, furnish particulars/ decision, if any, taken .	Yes [ ] No. [ ] :........................................................................................
6.	Any other remarks	:........................................................................................

	Signature of the Applicant	:	......................................................
	Name in Block Letters	:	......................................................
	Designation	:	......................................................
Place: …………………	Tel. No.	:	......................................................
Date: …………………	E-mail Address	:	......................................................