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APPLICATION FOR INFRASTRUCTURE FACILITIES/OTHERS SERVICES PROVIDED BY THE REGIONAL INDUSTRY SERVICE CENTER
 
  01. INFORMATION OF INVESTORS
  Name :
  Address :
  Tel. No :
  Fax No :
Form of Business :
Public Company Partnership
Private Company Individual Ownership
Other
  Nature of Industry :
  Name & Address of Bankers :
     
  02. OWNERSHIP
  Full names and addresses of Directors/Partners/Sole Proprietors
 
num
Name :
Address :
Position
1
     
  Business Registration :
  Registration Authority :
  Registration Number :
     
  CONTACT PERSONS :
  Name :
  Address :
  Tel. No :
     
  03. DETAILS OF THE PROJECT PROPOSALS :
  Summary of Proposed project :
  Whether an expansion, a re-location or a new project :
   
  TOTAL INVESTMENT :  
  Fixed Capital (Rs.) :
  Working Capital :
     
  FIXED ASSETS VALUES(Rs.)
  Land :
  Building :
  Machinery & Equipments :
  Vehicles & Other :
  Working Capital :
     
  CAPITAL STRUCTURE
  Own Capital (Rs) :
  Loan Capital (Rs) :
  Others (Rs) :
     
  EMPLOYMENT
  Management :
  Skilled Workers :
  Other Factory Workers :
  Others (Clerical etc) :
  Space of Buildings (in sq.ft) :
     
  MAIN REQUIREMENT
  Extent of Land (in perches) :
  1st Preference (Industrial Estate) :
  2nd Preference (Industrial Estate) :
  Water (Liters per day) :
  Electricity (KVA requirement) :
  Telecommunication (No.of Lines) :
  Other Facilities :
     
  04. ENVIROMENT ASPECT :
  RAW MATERIALS :     for add more click here
 
num
Item
Kg. pr month
Local or Imported
1
  USE OF CHEMICALS : for add more click here
 
num Name of the Chemical Purpose Qty/Month
1
  MACHINERY : for add more click here
 
num Item H.P. No. of items Conditions
1
  (To be filled in respect of existing industries only)
  Programme of Implementation plot : How long from allocating the land :
  Commence Building Construction :
  Commence Installation of Machinery :
  Commence Test Production :
  Commence Commercial Production :
   
  Project Proposal :
  Cash Flow Statement :
  Name :
  Designation :
  Date :
I DO HERE BY CONFIRM ABOVE INFORMATION TO TRUST TO BEST OF MY KNOWLEDGE.   

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