Download Application Form for Women Empowerment Scheme(WES)

J & K STATE WOMEN'S DEVELOPMENT CORPORATION JAMMU/KASHMIR APPLICATION FORM FOR "WOMEN EMPOWERMENT SCHEME" (WES) 1. Name of the applicant______________________________________ (in block letter) 2. Particulars of Father/Husband: (i) Name_____________________________________________ (ii) Permanent Address (residing for the last more than three years) 3. Particulars of Applicant: (a) Permanent Address__________________________________ (b) Village/Mohalla ____________________________________ (c) Post Office________________________________________ (d) Phone No._________________________________________ (e) Block_____________________________________________ (f) District____________________________________________ (g) Address for Correspondence___________________________ (h) Date of Birth________________________________________ (i) Academic & Technical Qualifications: S.No Examination Year of Division Name of the University/Board passed passing (i) (ii) (iii) (iv) (v) (j) Experience in the trade selected for Self­Employment (k) Specific training received (Give details of training Duration, name of institution) (l) What have you been doing after passing the last examination. (a) Service______________ Govt./Public Sector Undertaking Yes/No (b) Business/Agriculture (c) Self­Employment (d) Service in Private Establishment (e) Present employment status (f) Whether registered with Employment Exchange Space for photograph Attested by Gazetted Officer Yes/No Yes/No Yes/No Employed/Un­employed Yes/No (g) Whether a member of Scheduled Caste/Scheduled Tribe/OBC (Please specify) 4. Type of activity Proposed be undertaken ______________________________ 5. Previous experience in the activity___________________________________ 6. Place where the activity is to be undertaken____________________________ 7. Whether premises is available Yes/No (i) If yes, the specific arrangement made as under:­ (a) Rented ________________________________ (b) Owned ________________________________ 8. Whether construction of premises is a part of the project Yes/No 9. Project cost:­ (j) Machinery________________________________________________ (ii) Building _________________________________________________ (iii) Other fixed assets__________________________________________ (iv) Working capital___________________________________________ (v) Total____________________________________________________ 10. Amount of loan__________________________________________________ 11. Whether loan taken from any Bank or Financial Yes/No Institution so far. (i) If yes, State the purpose_____________________________________ UNDERTAKING BY THE APPLICANT I certify that the information furnished by me is correct and I have not so for made any arrangement for financing the project with any financial institution. SIGNATURE OF THE APPLICANT FOR OFFICE USE ONLY Serial No: Selection: Block: Constituency: IDENTIFICATION CERTIFICATE FROM A GAZETTED OFFICER Certified that Miss/Mrs._________________________________________________ D/o, W/o___________________________________________________________________ R/o________________________________________________________________________ Whose photograph has been attested by me and who has put her signature in my presence is personally known me. Place_______________ Signature of the Gazetted Officer Date_______________ Name______________________ Designation_________________ Official Seal. UN EMPLOYMENT CERTIFICATE Certified that Miss/Mrs._________________________________________________ D/o, W/o___________________________________________________________________ R/o________________________________________________________________________ Is not employed in Government/Public Sector Undertaking. Place_______________ Signature of the Gazetted Officer Date_______________ Name______________________ Designation_________________ Official Seal. Paste recent passport size photograph duly attested by a Gazetted Officer