Form -A [ See sub-rule (I) of rule 3] FORM OF APPLICATION FOR THE GRANT OF MONEY LENDERS LICENCE 1.Name of the applicant : 2.Address in full (any subsequent change should be notified) : 3.Father's Name : 4.If the applicant is a native of Indian State : (i) Full address in such Indian State;and (ii) Details of immovable properties owned insuch states by the applicant, with their estimated value. 5.Address of the shop or place of business in : respect of which the licence is applied for (Any subsequent change should be notified) 6.If the applicant has more than one shop or : place of business, the address for each such shop or place of business 7.Has the applicant applied for a separate : licence in respect of each shop or place of business mentioned against ithem 6 and if so with what result? 8.Date of commencement of business : 9.Financial year for which the licence is applied for : 10.The amount of money proposed to be lent during : the financial year. 11.Has the applicant paid the prescribed fee : for the licence (The chalan receipt or other evidence of payment of fee should be enclosed) 12. Whether the declaration in Form AAA has been appended. Signature of the applicant. I declare that the particulars stated above are correct to the best of my knowledge and belief. Signature of applicant.
