Application Form

Dear Sir,

I / We hereby apply for the allotment of industrial plot in GREATER NOIDA. A draft of Rs. 5,100/- (Rupees five thousand one hundred only) towards processing fee and a draft amounting to 2% of the total cost of the plot towards reservation amount is enclosed. The said bank draft is in favour of GREATER NOIDA Industrial Development Authority and drawn on a scheduled bank of New Delhi / NOIDA, the requisite details of which are given below :

1.	Name of the applicant
2.	Address of the applicant alongwith Telephone No., if any.


	(a) Office
	(b) Residence
	(c) Telefax
3.	Proposed constitution of the unit viz., proprietorship / partnership/private limited / public limited company.
4.	Owner(s)/Directors / Promotors of the proposed unit with full name, father / husband's name, residential address & their bio-date (if more than one attach separate sheet).
5.	Designation of the applicant of proposed unit in GREATER NOIDA (in case the applicant is Pvt. Ltd. / Public Ltd. Co.)
6.	Products to be manufactured (a) Detailed product description (b) Detailed process description (Process flow chart to be included - a separate chart for each product)
7.	Size of plot required
8.	Details of the bank draft in favour of GREATER NOIDA Industrial Development Authority and drawn on any scheduled bank of New Delhi / NOIDA Complex.
	(a) No.
	(b) Date
	(c) Amount
	(d) Name of Bank
9.	State whether the partners / proprietor/directors of the applicant company or the company itself have any association with other industrial unit. If so, give details of the name/location/product/turnover for the past three years.
10.	Total Project Cost :
11.	(a) Investement in Plant & Machinery
	(b) Investment in Land & Building
12.	Financing Pattern
	(a) Foreign Equity
	(b) Proprietor's Investment
	(c) Lending from Public Financial Insitution
	(d) Any Other
13.	In case of Foreign Equity :
	(a) Name and country of collaboration
	(b) Details about the collaboration
	(c) Terms and conditions of JV
	(d) Date of FIPB Clearance (Enclose copy)
14.	Details of
	(a) Power requirement
	(b) Water requirement
	(c) Any other
15.	Proposed Implementation Schedule
16.	Proposed Employment Generation :
17.	Proposed Marketing Plans
	(a) Domestic
	(b) Export
18.	Enclose detailed project report with a separate section, on the pollution aspects, if any.
	(a) Volume of waste water if any to be discharged into the system.
	(b) Percentage of waste water recycling
	(c) Volume of solid waste
	(d) Discharge into the air, etc.. Specify proposed methods of treatment / control / disposal


I/We hereby declare that the information(s)/document(s) with the application from are true to the best of my/our knowledge and belief and no material fact(s) have been concealed/suppressed. I/We are fully aware of the consequences of concealing/suppressing material facts. I/We are also fully aware of the terms and conditions of allotment which are acceptable to me/us. I/We shall abide by the same.
Date	Signature of the Applicant/ Applicant's Authorised Signatory