Government of Karnataka

Department of Handlooms & Textiles
Weaver special package Scheme

Application for seeking financial assistance for purchasing of 2 loom, Electronic Jacquard and Knotting machine from Government.

YES NO

To,
Deputy Director /Assistant Director,
Department of Handloom & Textile
Zilla Panchayat,

District:



SL NO Profile Information
1 Applicant's Name & Address
Name:
House No: Ward No:
Cross No: Village:
District: Taluk:
PIN: Recent photo
Landline(including STD code): Mobile No:
2 Father/Husband/Wife Name
3 DOB & Age
DOB: Age:
4 Identity
Aadhaar: Aadhaar copy
Email:
5 Gender
  
6 Category of the applicant
(Certificate to be uploaded in case of SC/ST)
7 Facilities expected from govt.
Facility selection.
8 Annual income
(In rupees)
9 Space available for the unit
Built Up Area (in sft) SSI/MSME License
General License Copy
10 Building Details
Building type  
 
 
Building documents/
Rent agreement/
Lease agreement
11 Unit Address
12 Training Certificate
(certificate from state/central govt.)
13 Power details
R.R/Meter Number Connected Load/Power (HP) RR No Registration Date
14 MSME/SSI Registraion No
14 a Number of looms
15 Bank preference for scheme sponsorship
           
Bank name Amount of Sanctioned loan
(Rupees)
Branch PIN
Amount Sanctioned Date Sanction letter Copy
16 Beneficiary Account Details
Bank name Name as per bank
Branch name Account type  
Account No IFSC No
Branch PIN

I Hereby declare that all above furnished information is correct to the best of my knowledge and belief. I further declare that I have not availed any financial assistance under above scheme earlier. I also abide by all the terms and conditions of the scheme and amendments to it time to time.


Date:
 
Place: