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Sanction of incentives(Industries) Application Form
Incentive Category :Incentive Applied for*:        

Investment Subsidy
Pavala vaddi
Power cost Reimbursement
Sales tax Reimbursement
Stamp duty/land cost/land conversion charges/Mortgage duty
Cleaner production Measures
Skills up gradation
ISO/BIS certification

Enterprise Details:Name of the Enterprise *:: ______
________________________________________________________
_______________________________________
Name of the Proprietor/Managing Director/partner
Director/partner*: ________________________
________________________

Location of Enterprise:-Plot No/survey no*: _________ Locality/Land Mark*:: __________________________________
_____________________________
District*:: __________________ Mandal
Mandal*: ______________ Village/Ward*:: ________________
Pin Code: _________________pan card of the Enterprise
Enterprise*: __________________
____________

Address for Communication
Communication:Door No*: _________________
________________ Locality/Land Mark
Mark*:: __________________________________
_____________________________
State*:_____________________
_____________________District*: __________________ Mandal*: ______________
____________
Village/Ward*:: _______________ Pin Code: __________Mobile Number*: _________________
____
Email ID: ____________________
_____________________________ Land phone No: ____________________
____________
Fax : ________________________
______

Service specific Details :Sector/ line of activity*: ________________
_______________ category
category*: 
service
Installed capacity/ Annum*:______________
______________ 
Metric tons 

Manufacturing
facturing 

kiloliters 

Numbers 

cubic meters
Date of commencement of commercial production*: _____________(DD/MM/YYYY)
Social status*: ___________
__________ Fixed capital investment on land
land*:: _________________________
_________________
Fixed capital investment on Building
Building*:_______________________________________________
_______________________________________________
Fixed capital investment on plant machinery *:_______________________________________
_______________________________________
Nature of Enterprise*:  Micro
Constitution of Enterprise*: 

small 

Proprietar 

medium 

Large 

Partnership 

Mega 

Pvt Ltd 

Public Ltd 

Others

Number of Employees*: __________________________
Enterprise*: 

New 

Expansion 

Diversification 

Modernization

EM part 2 Acknowledgement Number
Number*: __________________________

Applicant Details:Applicant Name*: _____________________ Father/Husband Name*: ________________
Delivery Type*:  Manual

Document List: Meeseva Application Form
Form* 
Department Application Form
Form*

Applican
icant’s Signature