1. Last date for submission : June 13, 2013 9 th Indo-American Corporate Excellence Awards 2013 Application for Indian Companies in the US

2. Directions: Please complete the nomination form as completely and as best as possible and return it to the address given at the end of this form. The financial information included on this Nomination Form will be considered confidential. Eligibility: To be eligible to receive the award, INDIAN COMPANIES must have operated in the US for a minimum of two years and must be either a subsidiary of an Indian company or be managed and controlled by an INDIAN Corporation Recognition: Award winners will be honored at the American Independence Day Celebrations on Tuesday, July 2, 2013 from 1830 hrs onward in Regal Room, Trident, Nariman Point, Mumbai, in front of an anticipated audience of over 500 Award Decision: The final determination of the number of categories and awards to be presented will be decided by a panel of judges based on the quantity and quality of the completed forms received. The Jurys decision is final. Applicant feedback will be welcomed, but the verdict determinations are not appealable. Award Categories: This year's categories are: Overall Best, Corporate Social Responsibility (CSR), Financial Services, FMCG, Gems & Jewelry, Innovation, Manufacturing, Media & Entertainment, NGO, SME, Technology & Communications, Woman Corporate Leader and Other Services Application Details

3. Name of Company : Company Representative : Position / Title : Tel. : Cell Phone: Fax : Email: Company Address: Company Website: Please tick against the awards category for which you are applying (You can tick as many as you feel appropriate ) Overall Best Corporate Social Responsibility (CSR) Financial Services FMCG Gems & Jewelry Innovation Manufacturing Media & Entertainment NGO SME Technology & Communications Woman Corporate Leader and Other Services

4. Please tick the industry sector in which your business operates (Tick as many as appropriate) Financial Services FMCG Gems & Jewelry Manufacturing Media & Entertainment * SME Technology & Communications Other Services To apply in the SME Category, the organization should have an investment in plant and machinery (excluding land and building) of above Rs. 10 Lakhs / $ 25,000 but not exceeding Rs. 10 Crores / $ 2.5 million Please provide a brief description of the company's business activity (include primary products or services) A. GENERAL INFORMATION

5. Provide the name and address of your US based company In which year was the company founded in India? A. GENERAL INFORMATION

6. For how long has the company been operating in the US? Is the company publicly held? Yes No Briefly describe the history of the company and its establishment in the US A. GENERAL INFORMATION

7. Discuss the significant obstacles that were overcome, initiatives taken and discoveries made in building the company Please provide promotional/marketing information about the company A. GENERAL INFORMATION

8. Describe briefly the value your company has added to Indo-US trade. Please give data on import and export achieved and also give examples of programs and initiatives that your company has undertaken to promote Indo-US trade and commerce. B. PROMOTION OF INDO-US TRADE

9. Please send scan copies of financial statements for the past two years and complete the following: All figures should be in rupees million only. 201220112010 Number of Employees Net Annual Sales #Please tick the appropriate category your organization falls into ABCDABCDABCD Annual Sales Growth (in %) Annual Growth in Net Profit Before Taxes (in %) C. FINANCIAL DATA # A: 0 to 500 million B: 501 to 2000 million C: 2001 to 5000 million D: Above 5000

10. Kindly describe how your company encourages performance from its employees, especially initiatives unique to your company. Provide details of best practices undertaken by the company in areas of human resource. D. HUMAN CAPITAL MANAGEMENT

11. Kindly detail what the company does to benefit the community and what success it has had (e.g., employment for the disabled / poor, education, health care, protection of girl child, women empowerment, water supply, social infrastructure, environmental protection, etc.) E. CORPORATE SOCIAL RESPONSIBILITY

12. F. NGO Kindly detail what the NGO does to benefit the community and what success it has had (e.g., employment for the disabled / poor, education, health care, protection of girl child, women empowerment, water supply, social infrastructure, environmental protection, etc.)

13. G. IMPACT IN THE MARKET Briefly discuss the employment generated in the US and the initiatives undertaken to promote Brand India

14. H. BEST WOMAN CORPORATE LEADER AWARD All those who are applying for Best Woman Corporate Leader Award are requested to provide the name and designation of the person in their company who has made the most contribution to the promotion of all or most factors from B to G (mentioned in previous slides) with specific details as available

15. I. INNOVATION AWARD All those who are applying for the Innovation Award are requested to list new products produced/marketed by your company and new processes initiated which have had a successful impact on the market and/or contributed to society/ human welfare

16. I, ________________________________________________________ hereby represent that all the information contained in the foregoing Application is true and accurate to the best of my knowledge. I understand that the Indo-American Chamber of Commerce may choose not to take steps to verify the information contained therein, and responsibility for any harm or damages caused by my fraudulent or negligent misrepresentations will be my own. All nominations must be received by June 13, 2013 and must be sent to : trishla@iaccindia.com, / wic@iaccindia.comtrishla@iaccindia.comwic@iaccindia.com Warm Regards, Rakhi Panda Regional Director Indo-American Chamber of Commerce 1-C, Vulcan Insurance Building, Veer Nariman Road, Churchgate, Mumbai - 400 020. Tel : +91-22-2282 1413 / 2283 6340 /22044531 Fax : +91-22-2204 6141 Email : trishla@iaccindia.com / wic@iaccindia.com www.iaccindia.com VERIFICATION