Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697804212829.pdf (India)
Format of Self-declaration certificate by Publisher/Owner for import of Newsprint / Daughter I,……………….Son / Wife of ……………….., resident of …………………do hereby certify / owner of …………………(name and place of publication with full address )…..which is registered with Registrar of Newspapers for India (RNI) vide Registration No.

…………(self- attested copy of Certificate of Registration enclosed) and fulfill the criteria of ‘ Actual User’ condition laid down in the Notification No.
09/2015-2020 dated 3.6.2016 of Directorate General of Foreign Trade (DGFT) concerning import of newsprint.

the publisher I am that 2.

In terms of the above mentioned notification of DGFT, I solemnly affirm and declare that the afore-mentioned publication has imported a total of ……..Metric Tons of Newsprint for a value of Rupees ……….and has actually consumed…..Metric Tons from the above quantity of import during the FY……… 3.
I also certify that the Annual Statement for the year …..in respect of the above publication as per section 19D of Press and Registration of Books (PRB) Act, 1867 has been filed online to the RNI.

A self-attested copy of the Annual Statement filed is attached.

4.

Certified that the particulars given above are true and correct to the best of my knowledge and in accordance with the books of accounts / records maintained by the publication.
Place……….. Date……….. Signature of Publisher/owner Name in Block letters: Aadhar No: Office Seal: Note: Any false information shall disqualify the publication concerned from future import of newsprint besides any other action under any other law for making a false declaration against the publisher.

Authentication by RNI / Designated officer in regional / branch offices of PIB Certified that the above mentioned publication holds registration certificate from RNI in terms of DGFT’s Notification No.
09/2015-2020 dated 3.6.2016.

Place……….. Date……….. Signature of RNI/designated Officer Name in Block letters: Office Seal: Format of Letter of Authority for submission of the Self-declaration by Publisher/owner / Daughter I,……………….Son / Wife of ……………….., resident of …………………and publisher / owner of …………………(full address of the hereby publication authorize…………………S/o ……….
, r/o ……………..whose signature is appended below, to present the declaration furnish by the undersigned to RNI / designated PIB officer for its authentication. )

with RNI Registration No.

…………do (Signature of Authorized representative) Aadhar No…………… Place……….. Date………… Signature of Publisher/owner Name in Block letters: Office Seal: