FORM 4

[see Clause 9(B )(i)]

Application for Interest and/or Wage/ Employment Subsidy ( In case of

Modernization/ Expansion/ Diversification of Existing Units)

(Under Rajasthan Investment Promotion Scheme 2003)

 

From

M/s____________________________________

_______________________________________

_______________________________________

 

To :Commissioner Industries

Rajasthan/

General Manager,

District Industries Centre,

…………………

 

Sub :    Regarding Interest and/or Wage/ Employment Subsidy  in case of      modernization/ expansion/ diversification.

 

I…………………… (Name of the applicant) S/o…………………. aged………… hereby apply for grant of Interst Subsidy on term loan availed and /or Wage/ Employment Subsidy, and submit as under"

 

1.                  Name and complete address of the proposed venture:

2.                  Registration Number (if any) under :

a.       Rajasthan Sales Tax Act, 1994

b.      Central Sales Tax Act, 1956:

c.       Any other Act(s):

3.                  Name of the Goods dealt with/ Service rendered:

4.                  (a)  Name of the term loan sanctioning financial Institution/ Bank, along with the amount :

 

Name

Date of Sanction

Amount

(i)

(i)

(i)

(ii)

(ii)

(ii)

(iii)

(iii)

(iii)

 

(b)  The project of the unit has been financed by own resources/accruals as certified by ……………….. (name the Chartered Accountant who has certified the Project Report)

 

5.                  Details of investments :

 

(a)  Existing

 

(b)   Owing to :

 

Modernization :

 

Expansions :

 

Diversification :

 

6.                  Number of employees :

 

a.       Existing :

b.      Owing to :

Modernization :

 

Expansions :

 

Diversification :

 

7.                  The cost of the project as approved by the above financial institution/banks:

8.                  New employment generated or likely to be generated :

9.                  It is requested to kindly grant 5% (6% in case of SC/ST) of the interest subsidy, and 25%/30% of the employment/ wage subsidy under this Scheme (30% where no term loan has been taken).

 

I hereby declare that I have fully understood the provisions of Rajasthan Investment Promotion Scheme, 2003 and agree to comply with the same. In case of availing excess benefits or non compliance with the provisions of this Scheme, I undertake to repay whole of the amount actually availed under the scheme and shall also be liable to pay interest at the rate of 18% per annum on such amount.

 

List of documents attached :

 

(i)

project Report duly verified

Yes/No

(ii)

Copy of sanction of loan from Financial institution/Bank in cases where term loan has been availed

Yes/No

(iii)

Copy of the NOC/Consent/License if Statutory required for the nature of the project

Yes/No

(iv)

Certificate of Chartered Accountant in case of financed by owned resources/accruals

Yes/No

(v)

Cast certificate in support of additional interest subsidy of 1% to SC/ST investor(s)

Yes/No

 

 

Dated………….                                                                      Signature of Applicant

                                                                                                            Status

                                                                                                Name of venture

 

VERIFICATION

 

I……………. hereby certify that the particulars stated above are true and correct and nothing has been concealed

 

 

Signature of application with status