THE A.P STATE MINORITIES FINANCE CORPORATION LIMITED ...... DISTRICT DEVELOPMENT OF MINORITY WOMEN IN URBAN AREAS DOMWUA RECOGNITION CERTIFICATE This is to certify that ................................. ........... DOMWUA Association ................. ........ Mandal .............. District is recognized by the ..............Andhra Pradesh State Minorities Finance Corporation Limited., ........... District. This group is recognized through DOMWUA " DEVELOPMENT OF MINORITIES WOMEN IN URBAN AREA" programme. The Recognition member is PDM / DOMWUA / 1 / 98. The founder president is Smt./Kum ................... W/o .................R/o................ and Secretary is Smt./Kum ........................ W/o ........... R/o .............. Of this group. THE A.P.STATE MINORITIES FINANCE CORPORATION ...... DISTRICT DOMWUA GROUP DETAILS (for Office use Only) 1. Year : 2. Group ID No. : 3. Name of Group : 4. Address : 5. Town : 6. District : 7. NGO Involved : 8. Date of Saving Started : 9. Savings Accumulated : 10. Bank Balance as on Date : Rs. Dt: Month Year 11. Bank Account Number : 12. Name of the Bank : 13. Revolving Fund Amount : Amount Rs. ............... Sanctioned by H.O : Proc No. ................ : Date ................. : Cheque No. .............. : Cheque Date ................. 14. District Office Releases : Amount Rs. ................ : Proc No. ................ : Date ................... : Cheque No. ............... : Cheque Date ................ 15. Member Trained : Y / N 16. Common Work shed : Y / N 17. Marketing Linking : Y / N S.No. Name and Address Signature 1. Name........................... W/o............................ H/No............................. Lane............................. Area............................. 2. Name........................... W/o............................ H/No............................. Lane............................. Area............................. 3. Name........................... W/o............................ H/No............................. Lane............................. Area............................. 4. Name........................... W/o............................ H/No............................. Lane............................. Area............................. 5. Name........................... W/o............................ H/No............................. Lane............................. Area............................. 6. Name........................... W/o............................ H/No............................. Lane............................. Area............................. 7. Name........................... W/o............................ H/No............................. Lane............................. Area............................. 8. Name........................... W/o............................ H/No............................. Lane............................. Area............................. 9. Name........................... W/o............................ H/No............................. Lane............................. Area............................. 10. Name........................... W/o............................ H/No............................. Lane............................. Area............................. 11. Name........................... W/o............................ H/No............................. Lane............................. Area............................. 12. Name........................... W/o............................ H/No............................. Lane............................. Area............................. 13. Name........................... W/o............................ H/No............................. Lane............................. Area............................. 14. Name........................... W/o............................ H/No............................. Lane............................. Area............................. 15. Name........................... W/o............................ H/No............................. Lane............................. Area............................. OATH BY THE PRESIDENT I, Smt......... ........................ W/o.....................R/o........... Hereby agree to hold Presidentship of the .................... group and promise to abide for development and self-sufficiency of the group and proper utilization of funds. Signature of the President ....................... Witness: ......................... 1. ....................... 2. OATH OF THE SECRETARY I, Smt......... ........................ W/o.....................R/o........... Hereby agree to hold Presidentship of the .................... group and promise to abide for development and self-sufficiency of the group and proper utilization of funds. Signature of the President ....................... Witness: ......................... 1. ........... ........... 2. The A.P. State Minorities Finance Corporation Limited. District. DOMWUA Group - Member wise Bio - data District Town Group Name President Name : : : : Date of Group Recognized : Date of Savings started : Thrifted Bank Name : Thrifted Bank Account : Member Name & W/o 2 Age 3 Family No. of PHY Mental Status Community Literate Planning Children Immunised Children (Y/N) (Y/N) M F M F M F 4 5 6 7 8 9 10 11 12 13 School GoingM F 14 15 Note status: U: Unmarried M: Married W: Widow D: Divorce O: Others (Deserte.Destitute etc.) Community: M: Muslim C: Christian S: Sikhs B: Buddhist P: Parsis J: Jain The A.P. State Minorities Finance Corporation Limited. DOMWUA Group - Member wise Bio - data District. District Town Group Name President Name : : : : Date of Group Recognized Date of Savings started Thrifted Bank Name Thrifted Bank Account : : : : Member Name & Family No. of W/o Age Status Community Literate Planning Children Immunised (Y/N) (Y/N) M F M F PHY Mental SchoolChildren GoingM F M F 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Note status: U: Unmarried M: Married W: Widow D: Divorce O: Others (Deserte.Destitute etc.) Community: M: Muslim C: Christian S: Sikhs B: Buddhist P: Parsis J: Jain
