Applicant ID: KVAP227964-11275145

Office Name: KVIC-NTR -AP Agency: KVIC

1. Aadhaar Number 585766616435 2. Legal Individual
3. Applicant Name SMT. KAMBALA BABY RADHA
4. Gender : FEMALE 5. Date of Birth : 25-May-1988 Age 34
6. Social Category : Scheduled Caste 7. Special Not Applicable

8. Qualification : 10TH Pass 9. PAN No. : CTDPK8478G

17-4-42, DAVID STREET, PEJJONIPET

Address :
VIJAYAWADA

10. District: NTR Pin Code: 520010

State: Andhra Pradesh E-mail ID: kambalababyradha1988@gmail.

Mobile No.1: 8019733680 Mobile No.2:

Address of Proposed Unit: AMBAPURAM VILLAGE ROAD

VIJAYAWADA RURAL
11.
District: NTR Pin Code: 520012

State: Andhra Pradesh Unit Location : Rural

12. Type of Activity : Service SERVICE AND TEXTILE

Cable T.V. Network/ Computer Centre

13. Name of Activity :
NET CENTER SERVICES

14. Whether EDP Training No 15. Institution

16. Preferred Agency: KVIC

Capital 450000 Total:

17. Loan Required 500000
working Capital: 50000

CANARA BANK

1st Financing Bank Name and GANDHINAGAR

18.
Address 26-2-69,RAJLOK COMPLEX,ANDHRA RATNA ROAD,PO BOX- 575;

KRISHNA IFS Code: CNRB0013342

19. Alternative Bank IFS Code:

I, KAMBALA BABY RADHA Certify and declare that all the information provided above is true and correct. Any
information that may be required to be verified, shall be provided to the concerned authority.It is also certified that
me or my spouse has not taken any subsidy underPMEGP Scheme or any similar Scheme of the State / Central
Government.

Online Submission Date:12/23/22 11:02 AM Signature of Applicant

Report Print Date: 2023.January.19 AD 02:51 PM Page 1 of 1