Photo of Photo of head of

Proposed RC In- Organization

Application format for
Charge Authorization of NAC as Regional Council
Under PGS-India Programme

1. Name of the Applicant

Organization
Address

City, State

Pin code

Telephone No with STD 1.

code 2
3

Mobile No (if any) 1.

2.
Fax No.
Email

2. Name of the head of

organization
Designation
Address

Phone No 1
2
3
Email

3. Name of the Person

responsible for operation
of Regional Council
Address

Phone No
Email

4. Status of Organization Central Govt

State Govt
Central/State Govt Agency
Cooperative
NGO
Company
Other

1
5. In case of Cooperative/
NGO/ Pvt. Company etc
Registration No with act
under which Registered
(Attach copies of
Registration, bye laws)

6. Financial category Government

(In case of Cooperative/ Govt Funded
NGO/ Pvt. Company etc Self financed
attach last 3 years Other (Pl specify)
audited balance sheets)

7. Facilities available Technical staff

(Attach list with photos, qualifications and experience)

Computer

Internet

Vehicles

Office
(Own building or rented)
Specify area
Total staff strength
(Attach list of staff members with photos, designation and
qualifications and assigned work)

8. Experience / competence
in Organic farming
(Attach proof)

9. Whether worked as
service provider of
Central/state Govt/ other
agency for organic
adoption and certification
(Attach proof)

10. Experience in any

Participatory Guarantee
System (Attach proof)

11. Experience in organic

certification system or
ICS (Attach Proof)

2
12. Knowledge in organic PGS-India
standards NPOP
NOP
EU standards
Others (Pl specify)

13. Proposed area of

operation

14. Whether already have

registered farmers as per
the requirement of PGS
guidelines (If yes then
provide details, Group
wise with list of farmers
in each group and their
organic status)

15. Regional Council

Operational manual
prepared or not
(If yes then provide a
copy)

16. Local Group operational

manual prepared or not
(If yes then provide a
copy)

17. Detailed strategy of

operation as Regional
Council.

(If required attach on

separate sheets)

3
18. Approximate time for
making Regional Council
functional

19. Any other information

20. List of enclosures

attached

I/We the members of the organization hereby declare that the information provided above
is true to the best of my/ our knowledge.

I/ We have read the PGS-India operational Guidelines and are convinced that the
proposed organization ………. (Give name of Organization) …….. fully meets the
eligibility criteria prescribed in PGS-India guidelines.

I/We understand that PGS-India Programme do not provide any financial assistance and
the entire operation shall be taken up from the organization’s sources

I/We declare that the organization is in sound financial health and capable of meeting the
expanses needed for operation of Regional Council.

I/ we declare that on being selected as Regional Council under PGS-India programme we

undertake to abide by the PGS-India guidelines and instructions issued by the NAC/ PGS
secretariat from time to time and shall implement the programme in true spirit of PGS
Principals

Signature Signature

Name Name

Designation Designation