APPLICATION FOR INCLUSION OF SSI UNITS UNDER WOMEN'S INDUSTRIES PROGRAMME. 1. Name & address of the Unit : (with telephone No. if any) 2. No. and date of SSI Registration : 3. Name & Residential address of the Proprietrix with Phone No. if any : 4. No. and date of Registration with other Departments : 5. Whether the Proprietrix belongs to SC/ST (specify) 6. Capital Investment (a) Land : (b) Building : (c) Plant and Machinery : (d) Working Capital : 7. Products manufactured : 8. Details of financial assistance received from : (a) Government Departments (b) Kerala Financial Corporation (c) Banks (d) Other Agencies 9. Details of Machinery : 10. Installed capacity : 11. No. of workers (1) Skilled (2) Unskilled (3) Casual 12. Sales particulars for the last two years : Sl. Name of Makers Name & Value Remarks No. Machinery Name & address of Specification Address suppliers Sl. Name of Product Qty./ No. Year Value Qty./ Year Value No. (Rs. ) No. (Rs.) I.............................. hereby declare that the particulars furnished above are based on the books and accounts maintained in the unit and are true to the best of my knowledge. PROPRIETRIX Place: Signature : Date: Name : Note: (1) Proprietrix belonging to SC/ST should furnish Caste Certificate from the Tahsildar. (2) List of workers with job specification and full address should be separately furnished. RECOMMENDATION OF ADIO / MANAGER On receipt of the application in the District Panchayat, on the basis of advertisement published by the District Panchayat, the same shall be handed over to the General Manager, District Industries Centre for scrutiny. After scrutiny the GM, DIC shall forward the application to the District Panchayat to place it before the District Panchayat committee for getting sanction. The sanction proceedings shall be issued by the Manager (Industries) of the District Panchayat The grantee shall execute a bond in favour of the Government as prescribed in Form C and also an agreement in Form D. FORM C Application for Grant To be executed by a grantee This bond executed on this the ......................... day...................................... by...................................... ... (hereinafter called the bounden) in favour of the Governor of Kerala (Hereinafter called the Government) witneseth as follows: Whereas in pursuance of the application dated ........ submitted by the bounden an amount of Rupees ...................was sanctioned to the bounden by way of grant in aid (hereinafter called the grant) under the scheme for vide G.O. No. ............. dated by ....... as per sanction order No. .............. dated ........... and the said grant has been received by the bounden as evidenced by the bounden's Acknowledgement dated ..... ........ delivered to the said General Manager. Now, therefore, this Bond witneseth as follows: 1. The Bounden is aware of the provisions of the said scheme and binds himself to abide by 2. the said provisions. 3. The Bounden binds himself to abide by the conditions in the said sanction order. 4. The Bounden hereby declares that the grant will be utilised only for the purpose for 5. which it has been sanctioned. 6. The Bounden declares that the equipments in respect of which the grant has been given 7. will not without prior approval by the General Manager be transferred or otherwise 8. disposed of for five year from the date of execution of this Bond. 9. (1) Bounden hereby binds himself to repay to the Government the entire grant in case 10. of violation by the Bounden of any of the provisions of the scheme or of the conditions herein. 11. (2) The bounden further binds himself to make the repayment on demand by the 12. General Manager and in case of default. Bounden binds himself to repay the 13. amount with interest at .... % per annum from ...... until actual 14. repayment by the Bounden . In witness whereof ............................ .................................... has hereby set his hand hereunto on behalf of .................. ........................ in the presence of witnesses. FORM D This agreement executed on this the ..................... day of ..................by ................ (Hereinafter called the granted and the Government of Kerala) Whereas in pursuance of the application dated ......... ..... submitted by the grantee an amount of Rupees ................. ...............was sanctioned to the granted by way of grant in aid (Hereinafter called the grant) under the scheme for ........ vide G.O. No.............. dated by ........... as per sanction order No. ............ dated ..........and the said grant has been received by the grantee as evidenced by his acknowledgement dated .......delivered to the .......... Whereas the grantee has executed bond No........... .. dated ........ . In favour of the Governor of Kerala binding himself to abide by all provisions of the scheme and the conditions of the sanction order and has by the said bond bound himself to repay the amount with interest at .............. % in case of default. Now, it is hereby mutually agreed and this Deed witnesseth as follows: - In case default on the part of grantee to pay on demand by the General Manager the entire grant amount with interest at ......... % from the date of the sanction order until the date of actual repayment shall be recoverable in the manner provided in the law relating to recovery of arrears of Revenue due to the Government.
