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    DGFT Form

    Uploaded by

    Zankar R Parikh
    1) The document is a digital certificate subscription form for obtaining a 1 or 2 year digital certificate from SafeEXIM. 2) It requests basic subscriber details like name, designation, date of birth, gender, organization name, address, phone number, email, and identity proof details. 3) The subscriber declares that the information provided is true and correct and acknowledges their duties and responsibilities under the applicable laws. 4) An authorizer from the subscriber's organization also needs to sign to acknowledge the subscriber's role and responsibility to revoke the certificate if they leave the organization.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    DGFT Form

    Uploaded by

    Zankar R Parikh
    174 views1 page
    1) The document is a digital certificate subscription form for obtaining a 1 or 2 year digital certificate from SafeEXIM. 2) It requests basic subscriber details like name, designation, date of birth, gender, organization name, address, phone number, email, and identity proof details. 3) The subscriber declares that the information provided is true and correct and acknowledges their duties and responsibilities under the applicable laws. 4) An authorizer from the subscriber's organization also needs to sign to acknowledge the subscriber's role and responsibility to revoke the certificate if they leave the organization.

    Original Description:

    dgft form for filling details

    Copyright

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    1) The document is a digital certificate subscription form for obtaining a 1 or 2 year digital certificate from SafeEXIM. 2) It requests basic subscriber details like name, designation, date of birth, gender, organization name, address, phone number, email, and identity proof details. 3) The subscriber declares that the information provided is true and correct and acknowledges their duties and responsibilities under the applicable laws. 4) An authorizer from the subscriber's organization also needs to sign to acknowledge the subscriber's role and responsibility to revoke the certificate if they leave the organization.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    174 views1 page

    DGFT Form

    Uploaded by

    Zankar R Parikh
    1) The document is a digital certificate subscription form for obtaining a 1 or 2 year digital certificate from SafeEXIM. 2) It requests basic subscriber details like name, designation, date of birth, gender, organization name, address, phone number, email, and identity proof details. 3) The subscriber declares that the information provided is true and correct and acknowledges their duties and responsibilities under the applicable laws. 4) An authorizer from the subscriber's organization also needs to sign to acknowledge the subscriber's role and responsibility to revoke the certificate if they leave the organization.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    sify safescrypt

    SafeEXIM Digital Certificate Subscription Form


    Certificate Validity 1 year 2 years Request Id

    Section 1 : Subscriber Details


    NAME:
    Sign half across
    (of applying
    photo & half on
    individual)
    form with BLUE PEN

    Designation:
    Date of Birth: Gender: Male Female

    Organisation Name:

    IEC Code: Branch Code:


    · Use blue-ink only
    Organisation Address: including signature
    (as per Branch Code)
    · Ensure the Name,
    Road/Street/PO: Office:
    Road/Street/Post Designation, Address
    and Contact number
    Town/City/District: of the attesting
    officer is present in at
    State/Union Territory:
    : least one of the
    Country: attestation document

    Postal Code:
    Telephone Number (with STD Code):

    Mobile Number: (unique to the dsc):

    E-mail Id :(unique to the dsc):

    Section 2 : Identity Proof Details


    Photo Identity Proof Address Proof
    Identity Proof Name
    Address Proof Name
    (e.g. PAN or Passport or Driving Licence of
    (Organisation address proof )
    applying individual)
    Identity Proof Number
    Note: Subscriber’s signature should appear on the Photo ID Proof

    Section 3 : Declaration
    I hereby declare that all the information provided on this Subscription Form for the purpose of obtaining a digital certificate is true and correct to the best of my
    knowledge. I am aware, as a subscriber for a digital signature certificate, the duties and responsibilities are applicable under the IT Act, India and the SafeScrypt CA
    CPS https://www.safescrypt.com/ pdf/cps.pdf and also under the Section 71 of IT Act which stipulates that if anyone makes a misrepresentation or suppresses any
    material fact from the CCA or CA for obtaining any DSC such person shall be punishable with imprisonment up to 2 years or with fine up
    to one lakh rupees or with both.
    Signature of the Subscriber (Applying Individual): Use Blue Pen Only
    Date: Place:

    Section 4 : Authorisation
    I , _____________________________________________________acknowledge by my signature, that the Subscriber information in this document is complete
    and accurate as per our office records. I fully understand that the Subscriber is responsible to transact on the Organisation’s behalf and I will
    ensure timely revocation of Digital Signature Certificate in case the employee leaves the company in future.

    Signature of Authoriser with Organisation Stamp/Seal: Use Blue Pen Only

    -- FOR OFFICE USE ONLY --


    Partner Name: Sify RA: Date of Issuance:

    Safescrypt CA Service brought to you by: Sify Technologies Ltd.

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