Personal details

Name of the Applicant *

Father's/Husband's Name *

Gender * Select Gender Male Female Other

Community (category) * Select category BC MBC General SC ST Other

Date of Birth *

PAN Number

Aadhaar Number

Educational Qualification * Select Qualification 10th 12th Diploma/ITI Under Graduate Post Graduate Others

Permanent Address *

Village *

District * Select AriyalurChengalpattuChennaiCoimbatoreCuddaloreDharmapuriDindigulErodeKallakurichiKancheepuramKanniyakumariKarurKrishnagiriMaduraiMayiladuthuraiNagapattinamNamakkalPerambalurPudukkottaiRamanathapuramRanipetSalemSivagangaiTenkasiThanjavurTheniTheNilgirisThiruvannamalaiThoothukudiTiruchirapalliTirunelveliTirupatturTiruppurTiruvallurTiruvarurVelloreVillupuramVirudhunagar

Pincode *

Mobile Number 1 *

Mobile Number 2

Email Id *

Are you already employed? Yes      No

Give details of your Work experience
Provide Company name, Position held, Period and Years of experience

Do you have any Trained skills or self learned skills related to proposed project?

What business activity do you like to propose/apply in the scheme?
Expansion of existing activity/ diversification, whether value addition/ Processing involved, Product involved, domestic or export sales

Previous experience in the proposed business activity

Address of proposed business location

Village

District Select AriyalurChengalpattuChennaiCoimbatoreCuddaloreDharmapuriDindigulErodeKallakurichiKancheepuramKanniyakumariKarurKrishnagiriMaduraiMayiladuthuraiNagapattinamNamakkalPerambalurPudukkottaiRamanathapuramRanipetSalemSivagangaiTenkasiThanjavurTheniTheNilgirisThiruvannamalaiThoothukudiTiruchirapalliTirunelveliTirupatturTiruppurTiruvallurTiruvarurVelloreVillupuramVirudhunagar

Pincode

1. I/We hereby certify that all information furnished by me/us is true, correct and complete. I/We have no borrowing arrangements for the unit except as indicated in the application form. There is/are no overdue / statutory due owed by me/us. I/We shall furnish all other information that may be required by Bank in connection with my/our application. The information may also be exchanged by you with any agency you may deem fit. You, your representatives or Reserve Bank of India or Department of Agricultural Marketing and Agri Business, Tamil Nadu, or any other agency as authorized by you, may at any time, inspect/ verify my/our assets, books of accounts etc. in our factory/business premises as given above.
2. I/We hereby declare that I/We am not one of the Board of directors or office bearers of any Farmer producer company
3. I/We hereby declare that I/We will contribute minimum 20% of project cost

Yes      No

File Upload

Upload PAN

Upload Aadhaar

Passport Size Photo

Quotation for the machineries for the proposed business activity

Cibil report

Company Details

Company Name (Full name without acronym)

Type of Entity Select Entity Sole proprietorship Partnership firm LLP Private limited company

PAN of Company

Certificate of incorporation number

Date of incorporation / Registration

Company Address

Village

District Select AriyalurChengalpattuChennaiCoimbatoreCuddaloreDharmapuriDindigulErodeKallakurichiKancheepuramKanniyakumariKarurKrishnagiriMaduraiMayiladuthuraiNagapattinamNamakkalPerambalurPudukkottaiRamanathapuramRanipetSalemSivagangaiTenkasiThanjavurTheniTheNilgirisThiruvannamalaiThoothukudiTiruchirapalliTirunelveliTirupatturTiruppurTiruvallurTiruvarurVelloreVillupuramVirudhunagar

Pincode

Personal Details

Relationship with Company/Unit/Firm/Concern *
Propreitor      Partner
Director      Other

Name of the Applicant

Father's/Husband's Name *

Gender Select Gender Male Female Other

Date of Birth

PAN Number

Aadhaar Number

Permanent Address

Village

District Select AriyalurChengalpattuChennaiCoimbatoreCuddaloreDharmapuriDindigulErodeKallakurichiKancheepuramKanniyakumariKarurKrishnagiriMaduraiMayiladuthuraiNagapattinamNamakkalPerambalurPudukkottaiRamanathapuramRanipetSalemSivagangaiTenkasiThanjavurTheniTheNilgirisThiruvannamalaiThoothukudiTiruchirapalliTirunelveliTirupatturTiruppurTiruvallurTiruvarurVelloreVillupuramVirudhunagar

Pincode

Mobile Number 1

Mobile Number 2

Email Id

Community (category) Select category BC MBC General SC ST ST

Educational Qualification Select Qualification 10th 12th Diploma/ITI Under Graduate Post Graduate Others

Trained skills or self learned skills which can used in proposed project

Proposed business activity
Expansion of existing activity/ diversification, whether value addition/ Processing involved, Product involved, domestic or export sales

Address of proposed business location

Village

District Select AriyalurChengalpattuChennaiCoimbatoreCuddaloreDharmapuriDindigulErodeKallakurichiKancheepuramKanniyakumariKarurKrishnagiriMaduraiMayiladuthuraiNagapattinamNamakkalPerambalurPudukkottaiRamanathapuramRanipetSalemSivagangaiTenkasiThanjavurTheniTheNilgirisThiruvannamalaiThoothukudiTiruchirapalliTirunelveliTirupatturTiruppurTiruvallurTiruvarurVelloreVillupuramVirudhunagar

Pincode

1. I/We hereby certify that all information furnished by me/us is true, correct and complete. I/We have no borrowing arrangements for the unit except as indicated in the application form. There is/are no overdue / statutory due owed by me/us. I/We shall furnish all other information that may be required by Bank in connection with my/our application. The information may also be exchanged by you with any agency you may deem fit. You, your representatives or Reserve Bank of India or Department of Agricultural Marketing and Agri Business, Tamil Nadu, or any other agency as authorized by you, may at any time, inspect/ verify my/our assets, books of accounts etc. in our factory/business premises as given above.
2. I/We hereby declare that I/We am not one of the Board of directors or office bearers of any Farmer producer company
3. I/We hereby declare that I/We will contribute minimum 20% of project cost

Yes      No

File Upload

Upload PAN

Upload Aadhaar

Passport Size Photo