Form No.7 APPLICATION FORM FOR PURCHASE/CONSTRUCTION OF IMPROVED DESIGN OF FISHING CRAFT (8 M TO 12.8 M OAL) BY FISHERMEN/ TRIBE AND THEIR COOP. SOCITIES 1 Name and Address of Applicant/Fisheries Coop. Society (FCS) /Self Help Group (SHG) (with Regn. No. and Date) ( In the case of FCS/SHG, copy of the resolution of the Governing body to be enclosed) : 2. Permanent Address : 3. Address for communication : 4. Details of Fishing Licence : ANF ANB (a) Current year (2002-03) (b) Previous years 5 Whether a fishermen settler/any other settler/Schedule Tribe/Member of FCS/Member of Self Help Group or an Islander , If so, details thereof : 6 Size of the boat proposed to be purchased/constructed (length, breadth, width, draft, wooden/fiberglass or any other material- Specify) : 7. Name and address of proposed manufacturer/firm. 8. Approximate cost of the boat (a) Total cost (b+c+d+e) : Rs. (b) Hull : Rs. (c) Engine & accessories : Rs. (d) Fishing gear : Rs. (e) Life Saving and fire fighting appliance : Rs. 9 Source of Finance (a) Total cost (b+c+d) : Rs. (b) Applicants contribution (not less than 10% of the total cost) : Rs. (c) Bank loan :Rs. (d) Subsidy :Rs. Place : Signature of the applicant Date : Recommendation of the members of the respective Panchayati Raj Institution/Counsellor of Municipal Ward (with name, signature, seal and date) Recommendation of A&N Fisheries Cooperative Federation Ltd. with name, signature, seal and date (in case of fishermen/ Tribal Coop. Societies) For Office Use Only (i) Date of receipt of application (ii) Field verification report and specific recommendation of the Officer In-charge (with signature, date and seal) (iii) Recommendation of Zonal Officer Incharge (with signature, date and seal) (iv) For use in the Directorate of Fisheries
