Details required for UID Creation (al fields are mandatory else data can not be submitted online| Name of the unit [Address of the factory Taluka/Tahasil/Mandal: District} State; Pin code: Mobile No. E-Mail ID PAN No. N Existing/New Unit @ IMSME/ Non-MSME_ MSME * fa) SSI Registration / EM No. & Date b) Registering Authority pic 9 2 9 se enains spo Loan Details Segment Type Individual Segments \Subsidy Type 8% 115% | 30% MMS-RRTUFS Banker Type individual Project cost (in Rs. ) Term Loan Sanctioned (in_Rs.) Term Loan eligible lunder TUFS (in_Rs.) .|Term Loan Account No. {Term Loan Sanctioned “Date. ; |Implementation/ "(Moratorium Period From To Repayment period From To Bank Details of the unit Name & Address of Lending Agency Phone No. of the Bank Branch IFSC MICR Current Account No.6 Loan Disbursement Schedule Date wise disbursement & Amount (in Rs. ) U Subsidy Schedule a.|Quarter p [Eligible Capital Subsidy “\(cs) Machines applied for with details Country of | Basic Price of Name of TUFS compatible tee Annex! Name & Address of | Import in case of| the Machinory machinery along with aaa machinery manufacturer imported (excluding ‘Specification RRTUFS GR Fj eeu | & ke @, (nRs.) (0) 9 ‘Accessories applied for with details @ (b) () @ © | Whatever Iie furnished the above information/details/documents to R. O., Ahmedabad for UID creation are true and correct. If found any false or incorrect information at any stage the undersigned will be held responsible and liable for any action imposed by competent authority. Note: Application once submitted can not be reopened for any modification Date: Place: Signature of Prop./Partner/Director Name of the Prop./Partner/Director & Seal of the unit Certified that the particulars furnished above are correct as per our records. Name & Signature of authorised signatory with Bank Seal