COMMON APPLICATION FORM FOR FINANCIAL ASSISTANCE INCLUDING WORKING CAPITAL TO BE SUBMITTED TO THE J&K STATE DISTRICT INDUSTRIES CENTRE. 1. Name of the Unit with registration No. and date_______________________________________ 2. Business Address 3. A) Name (s) of Proprietor Age Address Past experience B) Whether the applicant is technically Qualified or experienced. C) Whether the applicant is educated, unemployed D) Whether the applicant belongs to Scheduled cast/tribe (required for statistical purposes) 4. Size and particulars of land holding, if any in the name of the applicant or family member___________________________________________________________ 5. Present income of the family with sources 6. Existing /proposed line of Industrial Activity with brief description 7. Number of persons employed/proposed to be employed in the unit 8. If the activity has been financed earlier details of (a) borrowings (b) Own sources Please specify details of borrowings like sources, security, repayment and rate of interest. 9. Purpose of new loan 10. Amount of loan required I /we certify that all the information furnished by me/us is true that I/We have no borrowing arrangement with any bank, that no legal action has been/is being taken against us that I/we shall furnish all the other information that may be required by you in connection with my/our application that this may also be exchanged with any agency you may deem fit and that you/your representative/representatives of Reserve Bank of India or any other agency authorised by you at any time to inspect/verify our assets, books of accounts etc. in our factory or business premises. Signature of the Borrower Date____________ Place___________ For official use