RIICO

THE INDUSTRIAL CATALYST

RAJASTHAN STATE INDUSTRIAL DEVELOPMENT AND INVESTMENT CORPORATION LIMITED,

UDYOG BHAWAN, TILAK MARK, JAIPUR-302 005

APPLICATION FOR ALLOTMENT OF LAND

To,

The Sr. Dy. General Manager / Sr. Regional Manager/ Regional Manager,

Rajasthan State Industrial Development and

Investment Corporation Limited,

____________________________________

Industrial Area _______________________

1. I /We hereby offer to take on lease a plot for industrial purpose measuring approximately ________ sqm. on the terms and conditions of RIICO Disposal of Land Rules, 1979 and also agree to abide by the said rules and amendments made therein from time to time and agree to pay all taxes, charges etc. as fixed and revised from time to time.

2. I / We hereby enclose a DD / Bankers cheque no. ___________ dated _________ for Rs. _________________ ( Rupees ___________________________________ _______________________________________ ) towards 25% amount of development charges amounting to Rs. _____________ calculated @ Rs. _______ per sqm. and security money of Rs. ______________ in favour of RIICO Ltd. _______ with understanding that, no interest will be payable to me / us on this amount.

I / We agree that the lease period shall commence from the date of allotment of plot and obligations and liabilities under lease agreement (Form 'C' / 'D') shall be deemed to have commenced from the date of allotment.

Requisite details of the proposed project are given hereinafter.

1.	Name of the firm / company	M/s____________________________________ ________________________________________
2.	Full Address	________________________________________ ________________________________________ ________________________________________
3.	Telephone No. if any
4.	Constitution of the firm	Proprietorship / Partnership / Pvt. Ltd. Co./ Public Ltd. Co. etc.
	a ) For Proprietorship firms : Name of Proprietor
	b ) For Partnership Firm / Private Ltd. Company	S.No Name of partners/promoters %age of capital
		1.
		2.
		-
		-
5.	Type & cost of the Project
6.	Category for concession, if any	SC/ST/Electronics/Ex-Serviceman/War Widow/ Physically Handicapped / Women entrepreneur / Solar Energy
7.	Land Requirement and Utilisation : a ) For main production shed b ) For Godown / Office etc. c ) Any other details
8.	Activity on the plot a ) Product to be manufactured b ) No. of workers to be engaged. c ) Production capacity per day
9.	Requirement of Power ( in HP ) and Water ( in Liters / per day )
10.	Are there any effluents ?	If yes, details regarding quantity and quality of effluents alongwith NOC from State Pollution Control Board are to be given.
11.	Copies of documents enclosed	a. Partnership-deed / Memorandum and Articles of Association ( if available ) b. Provisional Registration in case of SSI units c. Certificate required for concession d. NOC from Pollution Control Board and details of effluents.

Applicant (s)

Name & Designation Signatures

Place 1.__________________________ __________________

Date 2.__________________________ __________________

3.__________________________ __________________

4.__________________________ __________________

FORM A-I

PROJECT OUTLINE FOR DECIDING REASONABLE QUANTUM OF LAND FOR PROJECTS HAVING LAND REQUIREMENT OF LESS THAN 2000 SQM.

Sl.No	Particulars	Details
1.	Name & Address.
2.	Registered Office Address.
3.	Site
4.	Phone/Fax/E-mail
5.	Name of products & specifications
6.	Capacity
7.	Sector
8.	Employment
9.	Names of Proprietor / Partners / Directors.
10.	Built up area required and its justification.
11.	Requirement of open space for specific purposes.
12.	Building layout.(tentative sketch plan showing layout of proposed constructions and open spaces to be enclosed).
13.	Utilities
	a. Power in KWH
	b. Water in Kiloliters.
14.	Cost of the project (Rs. in lacs) and means of finance. a. Land & Site Development. b. Building. c. Plant & Machinery. d. Misc. Fixed Assets.
15.	Copy of SSI Registration/ License/Copy of Memorandum & Articles of Association/Copy of Registration of Society/Trust/Copy of Partnership Deed.
16.	*Polluting/Non-polluting.
17.	Land area required for future expansion.

FORM A-1

GUIDELINES FOR FILLING LAND APPLICATION.

1. Complete address of correspondence and registered office should be indicated.

2. Please provide names of all products, by products.

3. Type of construction like Steel /RCC column with AC /Steel sheet roofing etc. should be clearly indicated.

4. Tentative building layout should clearly indicate set backs of the plot area, dimensions of the main factory building, dimensions of ancillary buildings. Utilization of open space should be clearly specified.

5. Brief description of the process should be provided.

6. In case of project is under orange & red category or prescribed by State Pollution Control Board, provide detailed ETP report which may also include quantity & type of effluents, process, process layout, equipment to be installed, quantity of effluents discharged etc. and land requirement for ETP.

7. Implementation schedule proposed.

FORM A-II

BRIEF PROJECT PROFILE FOR DETERMINING REASONABLE QUANTUM OF LAND FOR PROJECTS HAVING LAND REQUIREMENT OF 2000 TO 10000 SQM.

Sl.No	Particulars	Details
1.	Address.
2.	Registered Office Address.
3.	Site
4.	Phone/Fax/E-mail
5.	Sector
6.	Product
7.	Capacity
8.	Employment
9.	Names of Proprietor / Partners / Directors.
10.	Built up area required and its justification.
11.	Requirement of open spaces for specific purpose(s)
12.	Building layout
13.	Utilities
	a. Power in KWH
	b. Water in Kiloliters.
14.	Cost of the project (Rs. in lacs) a. Land and site development. b. Buildings. c. Plant & Machinery. d. Misc. Fixed Assets. e. Preliminary & Pre-Operative expenses. f. Margin money for working capital. g. Contingencies.
15.	Means of Finance (Rs. in lacs) a. Own funds. b. Loans.
16.	Copy of SSI Registration/ License /Copy of Memorandum & Articles of Association/Copy of Registration of Society/Trust/Copy of Partnership Deed.
17.	Process Flow Chart.
18	Details of effluents if any and treatment process thereof.