Download Application Form for Financial Assistance for Educated Unemployed Persons

APPLICATION FORM FOR FINANCIAL ASSISTANCE UNDER PRIME MINISTER'S ROZGAR YOJANA (PMRY) SCHEME FOR EDUCATED UNEMPLOYED PERSONS 1. Name of the Applicant (in block letters) 2. Sex Male / Female 3. Father's/Husband's name 4. Address for correspondence Permanent address Whether resident certificate enclosed for a minimum period of 3 years where loan is going to be availed 5. Date of birth and age 6. Educational qualification a. Academic b. Technical 7. Present annual income of the family (as per the certificate received from Tahsildar office) 8. Category belongs to BC/SC/ST/PH/MC/ Ex­SM/General 9. Proposed activity/Avocation 10. Previous experience in the line of activity, if any 11. Place of proposed enterprises, if any Give details 12. Details of registration made in the employment exchange (No., date) 13. Details of the total amount of loan required a. Machinery and equipments b. Other fixed assets c. Working capital Total 14. Extent of margin money proposed to be invested by the applicant (5­16.25%) 15. a. Whether the applicant availed loan from any banking, financial institutions of State/Central Govt. b. If yes, whether all were repaid? c. If not, indicate the balance amount to be paid. Certified that all the informations furnished by me are true to my knowledge and I have not borrowed any subsidy linked loan from any Department/Bank/Financial Institutions. Signature of the Applicant. Place : Date : Details of the certificate to be enclosed Affix 6x4 cm of passport size photo. Two copies of filled in application of DIC copy and bankers copy should be signed and submitted in person in District Industries Centre, Thattanchavady, Pondicherry­605009. a. Birth certificate or School/College transfer certificate b. Educational qualification certificate c. Family income certificate, caste certificate & resident certificate obtained from the Tahsildar. For Office use only Recommended by the Task Force Committee for availing financial assistance up to Rs.____________ (Rupees __________________________ ______________________________only) CHAIRMAN PMRY TASK FORCE COMMITTEE ­CUM­GENERAL MANAGER, DIC PONDICHERRY.