APPLICATION FORM FOR TRACTOR UNIT UNDER CM SAMAGRA GRAMYA UNNAYAN YOJANA (CMSGUY)

Group Details

Name of the Group *

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Registration authority (if registered)

Registration No. (if registered)

Registration Date (if registered)

Contact No. *

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E-Mail

Post Office *

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Police Station *

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District *

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Block *

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Village *

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Name of authorized signatory (Contact Person) *

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Total No. of members *

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Name of Census Village

Legislative Assembly Constituency

Bank Account Details

Bank Type *

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Bank Name *

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Bank Account No. *

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IFSC Code *

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Branch Name *

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E-Mail Id of Bank branch

Contact No. of Bank branch

Current Bank balance(in the said account) along with date *

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Details of Members

Details of members of the Group

Name of Members *

Father's/Husband's name *

Declaration

We hereby declare that we have gone through the modalities and terms & conditions for availing the subsidy for procuring a Tractor Unit under the Chief Minister SamagraGramyaUnnayan Yojana (CMSGUY) prior to submission of this application and all the information and statements furnished in/with this application are true and accept that any misinterpretation contained in it may lead to our disqualification. We understand that decision of according approval or rejection of our application shall be binding on us

I Agree *