Form VI-A

PART II
Particulars of excisions and modifications :

Form VI-A
( See Rule 35(1)
GOVERNMENT OF INDIA
CENTRAL BOARD OF FILM CERTIFICATION
THIS CERTIFICATE IS VALID FOR VIDEO FILMS ONLY
Part I

CERTIFICATE NO. DATED CATEGORY “V/UA”
FILM GAUGE MM LENGTH MTS REELS

After examination of the film by the members of the Examining Committe/ Revising Committee/ Film Certification Appellate Tribunal mentioned below and on the recommendations of the said Examining Committee/ Revising Committee/ Film Certification Appellate Tribunal, the Board hereby certifies that the film is fit for public exhibition with endorsement of caution that the question as to whether in child below the age of twelve years may be allowd to see the film should be considered by the parents or the guardian of such child and also subject to excisions and modifications listed in Part II on the reverse :-

PARENTAL GUIDANCE VIDEO

Further certified that the excisions and modifications imposed by the Board have actually been carried out.

Name of the applicant

Name of the Producer
  CHAIRMAN