Form 80 IAC

Name of the Startup

Date of Incorporation/ registration of Startup

Incorporation No./ registration No

Address and business location

Nature of business

DIPP Number

Contact details of Startup

Phone No.

Please enter a valid phone number.

Email Address

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Permanent Account Number

Please enter a valid PAN.

Existing/Proposed Activities

Memorandum of association (for Pvt Ltd) or LLP Deed (for LLP)^*

Please upload pdf file upto 5 mb

Board Resolution (if any)

Please upload pdf file upto 5 mb

Annual Accounts of the startup for the last three financial years

S.NO	Financial Year	Balance Sheet	Trading and Profit & Loss Account
1		Please upload pdf file upto 5 mb *	Please upload pdf file upto 5 mb *

Income Tax returns for the last three financial years

S.NO	Year	Income
1		Please upload pdf file upto 5 mb *

Details of certificate granted under Section 56 of Income-tax Act, 1961 (if any)

I/ We hereby certify that the above information furnished by me is true and no relevant information has been concealed. ^*

For

Name of the authorised signatory:^*

Please enter a valid name.

Designation:^*

Place:^*

Date:^*