Hubli-Dharwad Municipal Corporation
	Advertisement Tax
Application form for fresh permission / renewal 1 Name of the applicant, address & Contact No. Name Address Mobile No. Land No. E-mail id 2 Adertisement Agency enrollment No.and Date (xerox copy to be enclosed) Enrollment No. Date Day Month Year 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 3 a. Whether permission is sought on  private land/building Select Private Land Private Building b. Details of Loaction Area name Geo co-ordinates Langitude Latitude c. Whether consent of the owner is taken? If so, affidavit to be enclosed. Select Yes No Upload affidavit in pdf.   4 a. Whether any permission has been obtained by the applicant from HDMC for any other hoarding in the past ? If yes, mention no.of such advertisement hoardings. Select Yes No Past advertisemnt details b. Whether the details of each hoarding licence no. and date are enclosed ? (see note below) Select Yes No c. Whether up-to-date tax has been paid for  the permitted hoardings? Select Yes No Note : If yes for columns a, b, c above , separate statement showing the nature of advertisement, location , size , amount paid, balance shall be enclosed in PDF format. 5 Deatils of the advertisement hoarding being applied for fresh permission/ renewal. Particulars Descriprion Location, ward no and name Size in feet 1. Non-illuminated advertisement on land, building , wall etc Location Ward Length Width Heigth 2. Illuminated advertisement on land,building, wall etc. Location Ward Length Width Heigth 3. Neon sign on land,building , wall, etc. Location Ward Length Width Heigth 4. Glow sign on land, building, wall, etc. Location Ward Length Width Heigth 5. Others a. Cable TV advertisements Location Ward Length Width Heigth 5 b. Cinema sides Location Ward Length Width Heigth 6. Non-illuminated advertisements carried on the vehicles Location Ward Length Width Heigth 7. Advertisements exhibited on screens in cinema houses and other public places by means of slides or short film similar devices Location Ward Length Width Heigth 8. Others Location Ward Length Width Heigth 6 Enclosers: a. Sketch map showing the location of the advertisement,etc. b. Copy of the design showing the size, dimensions, etc., of the hoarding and supports and design and color scheme of the matter to be advertised. c. NOC issued by the property owner where advertisement hoarding is to be erected by an agancy. d. Indemnity Bond to take care of any loss or injury due to accedent etc. e. Stability Certificate of the building and the structure of the hoarding from the approved Civil Engineer. f. If illuminated, Certificate from a Certified Engineer erg. electrical wiring including  earthing of the hoarding. g. Copy of the Tax paid receipt in respect of the private property. h. Copy of building completion certficate i. Copy of last 3 years advertisement tax paid receipt Declaration : I hereby declare that the above submitted information is correct.I also agree to abide by all the rules and regulations and the terms and conditions of HDMC, whatsoever may come in to force from time to time.