FORM I-A

Form of application for certification for public exhibition of a video film produced in India

[See sub-rule (1) of rule 21]

No. and date of application (to be entered by Board’s office)

To

The Central Board of Film Certification through the Regional Officer at .......................

Application for certification for public exhibition of a video film produced in India at.......

1. 1. Name of the video film
   2. Language of the video film
   3. Running time
   4. Number of cassettes
   5. Any other particulars of the video conversion
   6. Type of the film i.e. whether it is 2-D, 3-D, cinemascope vistavision etc,
   7. Whether the film is silent or a talkie
   8. Colour of the film
   9. Name & address of the producer
   10. Name of the director
2. State whether the video film is a newsreel/documentary/scientific/educational/ feature/advertisement video film.

   2A. Specify the certificate requested, ‘U’, ‘UA’, ‘A’ or ‘S’.

3. State separately the number of negative and positive prints of the video film.
   
   1. produced (negative _____________ Positive ______________________)
   2. in the applicant’s possession ( Negative ___________ Positive ________)
   3. Name and address of the laboratory/company where copies were made.
4. 1. Whether the video film for which the application has been made is a replica/exact copy of a cicnematograph film on celluloid in respect of which a certificate has already been granted by the Central Board of Film Certification? Also state particulars of the film certified.
   2. Whether the video film is a modified version of a certified Cinematograph film on celluloid containing additions, deletions/other alternations (details of modification may be provided).
   3. Whether the application being made is in respect of an original video film and not a copy of an already certified Cinematograph film on celluloid.
   4. Whether the present video film is a dubbed version or re-make of any other video film? If so, state the particulars alongwith full detail of certificates
      issued to that video film.
   5. Whether any pre-censorship advice was obtained and if so the details thereof.
   6. Whether permission for any shooting abroad was obtained and if so, the details thereof.
   7. Whether the video film contains any dialogue/commentary in any language other than the language of the video film and, if so, specify the language and the cassette in which they occur.
5. Has any previous application been made to certify this video film as suitable for public exhibition in India? If so,
   
   1. Where and to whom was it made
   2. What was the result of the application
      
      1. A ‘U’/’UA’/An ‘A’/’S’ certificate No._________________________ at ____________________ was granted subject to the following cuts ___________
      2. Certificate was refused.
6. Has the exhibition of this video film/film been at any time suspended or the video film declared uncertified by the Central or any State Government?
   State particulars.
7. Does the video film contain any dialogue, song, poem, speech or commentary in any language other than English or an Indian language?
   If so, specify that Cassette or Cassettes in which the dialogue, song, poem, speech or commentary occurs and the language or languages used.
8. Amount of fee accompanying the application of account of the fee prescribed in rule 36.
   
   vide
   1. Receipt No.____________ dated ______________________________
   2. Bank draft No. __________ dated _________ on __________ Bank
   3. Postal order No. __________ dated ________ on ______Post Office.

   8. [(A) Whether any animal has been used in shooting of the film? If so, whether declaration specified in clause (bb) of sub-rule (3) of rule 21 has been filled?]1

9. Name, address and telephone number, if any, of the applicant.
   Telephone No :
10. I declare that the video film is ready for examination by the Board and the statements recorded above are true in every particular. I also declare that I own the rights of the video film in question. I further declare that I have the right to use in the video film the additional material in the feature film in the form of trailers, advertisement short, documentary films etc.

Date :

Signature of applicant

(Form added by G.S.R. 83-E dated 28.2.84 w.e.f. 1.3.84)

* Score out the word or words which are not applicable.

1. Inserted as per notification dated 12.11.97