• Company Name: ____________________ • Lic No: __________
• Facility Type: ____________ • Existing License Type: __________
• Groups Name: ☐ Group (1) Code / Name: ____________________
☐ Group (2) Code / Name: ____________________
| NO | Code | Proposed Activity (New) |
|---|---|---|
| 1 | ||
| 2 | ||
| 3 | ||
| 4 | ||
| 5 | ||
| 6 | ||
| 7 | ||
| 8 | ||
| 9 | ||
| 10 | ||
| 11 | ||
| 12 | ||
| 13 | ||
| 14 | ||
| 15 | ||
| 16 | ||
| 17 | ||
| Current Activities (To Be Deleted) / Comments | ||
| For Free Zone Authority | For Free Zone Authority | Applicant Details |
| Management sign | Recipient Request | Licence Holder sign |
| ☐ No Objection | • Name | • Name |
| ☐ Awaiting / Need Correction | • Signature & Stamp | • Signature & Stamp |
| ☐ Reject | • Date: | • Date: |