Government of Jammu and Kashmir Industries and Commerce Department Composite Application Form for setting up of an Industrial Unit in the State. Name of Unit : ______________________________________________________ Address for communication : Tel No : PIN Code : Category of Unit : SSI-1,ANS-2,SSSBE-3,TINY-4,EOU-5,M&I-6 _________________ Location : Place : ________________________________________________________ Tehsil : ________________________________________________________ District : _______________________________________________________ Revenue Survey Number /Plot Number _______________________________ Area of Location : Rural -1 Urban -2 Metroplotian-3 ___________________________ Type of organization Proprietary -1,Partnership-2, Pvt.Ltd-3, Cooperative -4, Others -5 ________________________ Project Status New Project ____ Expansion ____ Promoter(s) Profile : Name : _________________________________________________________________ Address of Project Promoter : _____________________________________________ TEL : _______________________ PIN Code : _________________ Male -1 Female-2 _____________________ SC-1 ST-2 _____________________ Engineering Graduate -1 MBA-2 __________________ Post Graduates-3 Others -4 Background of Promoter(s) indicting the Net worths & details with financial institutes , if any ________________________ Past Experience ( enclosed last three Years balance sheets) ________________________ Remarks (other Details) ________________________ Means of financing : _____________________ a. Promoter's Contribution b. Term Loan c. Subsidy d. Other Loans, if any Nature of Activity : __________________ Manufacturing/Assembly -1, Processing -2,Job work -4, Repairing/servicing -8 Whether foreign tech collaboration is required ______________ Main items of Manufacturing/ activities : i. Name : _______________________________________________________ ii. Code : _______________________________________________________ iii. Name : _______________________________________________________ iv. Code : _______________________________________________________ v. Name : _______________________________________________________ vi. Code : _______________________________________________________ vii. Name : _______________________________________________________ viii. Code : _______________________________________________________ ix. Name : _______________________________________________________ x. Code : _______________________________________________________ Investment in Fixed Assets (Rs in . 000) (i) Land (ii) Building (iii) Plant and Machinery (iv) Other Fixed Assets Total :- Investment in Plant and Machinery ___________________________ (Original Value in thousands) Raw Material Requirement Name * Item Code Imported-1 Annual consumption Indigious-2 (value in .000) (i) (ii) (iii) (iv) Water Requirements in Phases : Employment Details : Total a. No. of Workers (Semi-Skilled/Unskilled) b. No. of Skilled Persons c. No. of supervisory Staff d. No. of Executive/Managerial staff e. Total Are the Workers available locally ? Yes/No Which is the category of workers where You feel workers from outside the state Shall be employed ____________________________ Which are the specific technical Trade where you feel the local Workers are lacking and require further Training/ skill up gradation ____________________________ Total Number of Shifts ________________ Whether Registered under Factories Act Yes/No Date :
