DEPARTMENT OF ANIMAL HUSBANDARY AND VERTINERY SERVICES APPLICATION FORM FOR SPECIAL CALF REARING SCHEME 1) Name of the beneficiary ----------------------------------------2) Address----------------------------------------------------------3) Tel. No. or Contact Tel. No. -------------------------------------4) Educational Qualification: ---------------------------------------5) Profession: -------------------------------------------------------6) Ration Card No: ------------------------------------------------- (Copy to be enclosed having beneficiary) 7) whether benefit of scheme was availed earlier (YES/NO) (If yes, Give details below) 8) Identification Mark --------------Tag No. ---------Age ------ a. b. c. d. 9) Date of Birth of Calf ---------------------------------------------(for which feed assistance is applied) Identification Mark -------------------------------------------- 1) 2) Whether farmer has facility to rear calf -----------------------3) Previous experience in the field -------------------------------4) Present weight of calf and age ---------------------------------5) Registration number --------------------------------------------6) Whether member of Dairy Co-operative Society. Yes/No 7) If yes, Name of the Dairy Society. 8) I solemnly state and affirm that I will not take feed under any other Govt. Scheme or from any other organization/ Institution for this particular calf. Signature of Applicant I consider that the case is feasible and the beneficiary has the desire to rear the animal as per recommendation of the Department. Further, I verify that the Calf is not getting feed from any other scheme of the Govt/ other Institution. Signature of E.O.