Government of Andhra Pradesh- National Mission on Medicinal Plants Andhra Pradesh Medicinal & Aromatic Plants Board Application form for seeking financial assistance under National Mission on Medicinal Plants 1. Title of the project. 2. Applicant Name with full address (incl. Tel. No., Fax No., e- mail). 3. Status. 4. Project period. 5. Species selected for cultivation. 6. Area for cultivation (in acre) 7. Project Concept & Justification (in details). 8. Physical & Financial requirements. 9. Means of finance:- a) Total project cost. (Rs.) b) Own Resource. (Rs.) c) Bank Loan. (Rs.) d) Govt. assistance. (Rs.) 10. Details of financial assistance received from other agencies (including NMPB) by the applicant for the purpose Agency - Amount - Year - Purpose - Status of work - 11. Details of supporting documents:- a) MOU with buyer in 50 Rs. stamp paper b) Bank Appraisal Report c) Land documents (attested). 12. Draft to be issued in favour of ______________________________________________. 13. Certified that the information given above is correct and we agree to abide by the Rules and Regulations of the Board for utilization of the financial assistance sought for. No financial assistance/grant has been obtained from any Central of State Govt. organization for the purpose applied for Date: Signature of the applicant Counter signing of Financing Bank
