Form No :  
 
PERSONAL DETAILS
   
     
 
 
 
     
 
 
 
         
 
 
NAME AND LOCATION OF ENTERPRISE
     
 
 
 
 
 
 
 
 
 
CATEGORY AND ACTIVITY OF ENTERPRISE
 
 
 
PRODUCTS AND ACTIVITY OF ENTERPRISE
MAIN MANUFACTURING / SERVICE ACTIVITY  
 
PRODUCTS TO BE MANUFACTURED/SERVICE TO BE PROVIDED  
 
 
Approx. Value  
Approx. Value  
 
 
 
 
  PRODUCT QTY/Year UNIT
H.P K.W
 
    (a) (i)   OTHER SOURCE OF ENERGY / POWER [IF REQUIRED]
 
 
   
 
 
 
 
EMPLOYMENT
  MANAGEMENT AND OFFICE STAFF
    SUPERVISORY
    WORKERS
 
 
ENTREPRENEURS' PROFILE
17.
ENTREPRENEURS' PROFILE (OF ALL PARTNERS/DIRECTORS OF THE ORGANISATION)  
   
NAME GENDER CATEGORY KNOWLEDGE LEVEL PARTICIPATION (%) STAKE IN OTHER ENTERPRISES
MF
18.
 
 
  Date        
  Place       
This is to certify that the information furnished in the memorandum is true and correct to the best of my knowledge and belief.