Form No.2 APPLICATION FORM FOR SUPPLY OF E.F.R. MATERIALS & LIFE SAVING APPLIANCES ON SUBSIDY 1. Name of the Applicant : 2. Father's name : 3. Address / Locality : 4. Fishing & Dinghy License No. : ANF / ANB / 5. Duration of fishing license in A&N Islands: 6. Whether fishing license for the current year/ renewed. 7. Whether member of any Coop.Society, if so /name of the Society. 8. Fishing Gears & type of boat available with the applicant : 9. Items required : 1) 3) 2) 4) 5) 6) 6) 8) 9) 10) LTI / Signature of Applicant UNDERTAKING I hereby undertake that the fishing materials & life saving appliances which are going to be supplied to me on subsidized rate will not be disposed or misused for at-least 5 years without the specific permission of the Director of Fisheries in writing. In case I fail to do so, the Director of Fisheries will have the right to recover the amount of subsidy allowed to me on supply of the above items. I also undertake that the fish catch landed by me will be sold out to the public as per the rate fixed by the Fisheries Department / Administration. LTI / Signature of Applicant Inspection / Field Verification Report of the field staff Signature & date of the field staff with designation Recommendation of the Section Incharge Signature of the Section Incharge Signature of the Sanctioning Authority Receipt of the items Received the following items:- 1. 2. 3. 4. 5. 6. 7. 8. Signature of Fisherman / Applicant
