Application for consideration under the Industrial Park Scheme, 2008

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..... _________ Fax No._____________________________Cable______________ E-mail_____________________________________ (b) Address for correspondence (if different from (a) above): Name of the Undertaking_____________________________ Name of the contact person____________________________ Postal Address______________________________________ Pin Code____________________________ Tel. No._____________________________ Telex_____________ Fax No._____________________________Cable______________ E-mail_____________________________________ 1.II. Registrar of Companies Registration No.__________ .....

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..... __________________________ Pin Code_____________________________ Tel. No.______________________________ Fax No.______________________________ Email________________________________ Permanent Account No._________________ Percentage of proposed equity holding___________________ 2.I Proposed location of the Industrial Park Address of location of Industrial Park (Indicate complete address):- Plot No._____________________________ Name of the Building (if any)__________________ Survey Number_____________________________ Village______________________________ .....

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..... i) Unskilled iv) Total 2.V (a) Proposed investment (Amount in rupees in lakhs) (b) Investment on Infrastructure Development (Amount in rupees in lakhs) (c) Percentage of (b) to (a) (d) Complete details of infrastructure facilities proposed to be provided in the industrial park S. No. Item of infrastructure Investment (Rs. In lakhs) .....

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..... the project is developed under Yes/No any agreement and if yes, the address ______________ of other parties (other than applicant) ______________ to such an agreement ______________ 3.V Whether the applicant undertaking has Yes/No powers to allow industrial and commercial ______________ units as proposed in the application to operate ______________ from the indust .....

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..... number of industrial units; all units of a person and his associated enterprises will be treated as a single unit. (e) The minimum constructed floor area shall Yes/No not be less than 50,000 square meters; (f) No industrial unit, along with the units of Yes/No an associated enterprise, shall occupy more than twenty five per cent of the allocable .....

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