Application for booking of Industrial plot in upcoming Industrial Areas.

Instruction for filling application:
1. All fields are compulsory 2. All fields should be filled in Block Letters 3. In case of no information plesase fill N/A.
Please pay requisite Booking Amount through RTGS/NEFT to Kotak Mahindra Bank, Bhopal A/C No. 4911201624, IFSC Code KKBK0000753
Sub. : Allotment of land at (Name of the Industrial Area) in District
Dear Sir,
I / We propose to establish our industry / unit at (Name of the Industrial Area) in District
The necessary details are as under :-  

 

1. (a) Full Name of the Applicant/Company :- Roc No. If any
(In case of proprietary concern, full name with Father's Name and surname should be given)
(b) Address for Communication:-      
(i) Present Address :-
   
Pin Code
Phone
Fax no. Mobile No.
Mail ID
Website
(c)Name/details of the authorized signatory who is submitting form:-
Name
Father's Name
Address
Pin Code
Phone
Fax no.
Mobile No.
Website
Mail ID
2. (a) Constitution of the Applicant :-
(b) In case of other, specify
3. Nature of the proposed activity :-
4. Type of the proposed venture:-
5. Items to be manufactured (in case of phased program, please indicate phase wise)
S.No Name of Item (s)
Annual capacity Proposed year of implementation
1.
2.
3.
4.
5.
6. Details of the proposed Employment (No.)
 
7. Details of proposed Investment :-
(Rs. in Lakhs)(Please fill 200000 to fill 2 lakhs of amount.)
a. Land / site development
b. Sheds and building
c. Plant and machinery
d. Misc. fixed assets
e. Others
   
Total
   
8. Details and area of land required/ envisaged for the project with justification :-
Covered Area (Appoximate construction cost should be as per current market rates) -
Sl. No Purpose Dimensions in meters Area in Sq. mts. Approx. cost (Rs. in lacs)
1.
2.
3.
4.
5.
6.
7.
Total (A)
9. Approximate time for implementation of the projects :-
(In Months)
 
10. Requirement of Power   For the Present / First Phase     
(a) Connected load (in KW)
   
(b) Maximum demand (in KW)
   
11. Requirement of water :-
(in thousand liters)
   
12. Any information, if necessary to be furnished additionally .
I/We here by solemnly affirm that the above particulars/ details given in the application are true to the best of my / our knowledge and belief and no fact has been suppressed.
I/We confirm that we are aware that this application is governed under the provision of " MADHYA PRADESH STATE INDUSTRIAL LAND AND INDUSTRIAL BUILDING MANAGEMENT ACT- 2008", issued by the Department of Commerce , Industrial & Employment, Madhya Pradesh vide No. F-11-87/06B-11:- Bhopal Date 01.07.2009, which shall be binding on me / us.
I / We therefore, request for allotment of Square Meters of land / built up space in / at (Name of the industrial Area)
13.Payment Details (Click here to see the list of amount to be paid as a booking amount)
25% of Advance Premium UTR No.
Processing Fee    
Date of Payment PAN Card No
 
DECLARATION
1. I / We here by soemnly declare that the applicant unit / firm / company and its proprietor (s) / partners / Directors have not been allotted any shed or land or plot in any of the industrial Area (may be known by other name), managed by any AKVN / DTIC / Other Authority, under the control of the Department of Commerce, Industry & Employment , Government. of Madhya Pradesh.
OR
I / We have been allotted and are in possession of land / shed / plot no measuring sq. mts. in
( Name of the Industrial area ) in the name of and I / We are complying with all the provisions of respective lease deed, rules and regulations.
2. I / We confirm that our proposed activity / industry is not coverd under the category of highly polluting / hazardous industry as mentioned in Annexure "B" of the Madhya Pradesh Rajya Audyogik Bhumi Evam Audyogik Bhawan Prabandhan Niyam,- 2008.
3. I / We confirm that our proposed activity / indutry is not covered under the category of banned activity as mentioned in Annexure 'C' of the Madhya Pradesh Rajya Audyogik Bhumi Evam Audyogik Bhawan Prabandhan Niyam - 2008 and as amended from time to time.
4. I have Read the terms and conditions as per Annexure 'D' and i agree with them.
5. I/we here by soemnly declare that I/we know that this is only booking and not the allotment,I will only be eligible if I complete the formalities as per Madhya Pradesh Bhumi Evam Audyogik Bhawan Prabandhan Niyam 2008,as and when asked by MPAKVN Bhopal.
I / We further solemnly affirm that the a forementioned declaration is correct to the best of my / our knowledge and belief and no fact has been suppressed in this connection.
Place : Date :
Note: All further correspondance will be done on given address through email and R/AD.