MSME
Application Information Form
AWARD 2015, HARYANA
Classication for the companies will be as per the Government of India’s denition which is based on the investment in the plant and machinery for manufacturing and in the equipment for enterprises providing or rendering the services.
·¤ ÂçÙØæð´ ·¤æ ß»èü·¤ÚU æ ÖæÚUÌ âÚU·¤æÚU ·¤è ÂçÚUÖæáæ ·ð¤ ¥ÙéâæÚU ç·¤Øæ ÁæØð»æ, Áæð ç·¤ ©U ÂæÎÙ æð æ ×ð´ Üæ ÅU °ß¢ ×àæèÙÚUè ×ð´ ·é¤Ü çÙßðàæ ÌÍæ âðßæ æð æ ×ð´ ©U·¤ÚU ææð´ ×ð´ ç·¤Øð »Øð ·é¤Ü çÙßðàæ ÂÚU ¥æ ææçÚUÌ ãñÐ 1. Is your company registered with Ministry of Micro, Small & Medium Enterprises, Government of India? ( Øæ ¥æ·¤è ·¤ ÂÙè âé ×, Ü æê °ß¢ × Ø× ©Ulæð» ×¢ ææÜØ, ÖæÚUÌ âÚU·¤æÚU mUæÚUæ ÚUçÁSÅUÇüU ãñU?)
YES(ãUæ¢)
NO(ÙãUè´)
If yes, which category do you fail under? (ØçÎ ãUæ¡, Ìæð ¥æ 緤âæ æð æè ×ð´ ¥æÌð ãñ´¢?) Micro (âé ×)
Small (Ü æé )
Medium (× Ø× )
SSI Registration/EM Part-2 No. (°â.°â.¥æ§ü. ÚUçÁSÅðUþàæÙ / §ü.°×. ÂæÅüU-2 Ù ÕÚU) _____________________________________________ Date(çÎÙ梷¤) _______________ Note: The SSI Registration/EM number is compulsory for the registered MSMEs (ÚUçÁSÅUÇüU °×.°â.°×.§ü. ·ð¤ çÜ° °â.°â.¥æ§ü. ÚUçÁSÅðUþàæÙ/§ü.°×. Ù ÕÚU ÂýÎæÙ ·¤ÚUÙæ ¥çÙßæØü ãñU) 2. Company Information (·¤ ÂÙè ·¤æ çßßÚU æ ) Name of the Company (·¤ ÂÙè ·¤æ Ùæ×)
Year of Establishment (SÍæÂÙæ ßáü)
Registered Address (¢Áè·ë¤Ì ÂÌæ)
Telephone (ȤæðÙ Ù ÕÚU)
FAX (Èñ¤ â)
Website (ßðÕâæ§ÅU)
Email (§ü-×ðÜ)
Ownership Pattern (Sßæç× ß ·¤æ Âý·¤æÚU) Proprietary (Sßæ×è)
Partnership (âæÛæðÎæÚUè)
Are you a 100% EOU? ( Øæ ¥æ 100 ÂýçÌàæÌ §ü.¥æð.Øê. ãUñ?) Total Number of employee (including contract labour) (·¤×ü¿æçÚUØæð´ Male (ÂéM¤á)
Private Limited (Âýæ§ßðÅU çÜç×ÅðUÇU)
Public Limited (Âç Ü·¤ çÜç×ÅðUÇU)
Yes
No
·¤è ·é¤Ü ⢠Øæ (·¤æò ÅUþð ÅU ÜðÕÚU âçãUÌ))
Female (×çãUÜæ)
Proprietors / Partners / Promoters (àæèáü ÂýÕ¢ æÙ) 1. _____________________________________________________ Designation (ÂÎ): __________________________________ Age (¥æØé): ________ 2. _____________________________________________________ Designation (ÂÎ): __________________________________ Age (¥æØé): ________ 3. Operational Details Please select ONE INDUSTRY from the following 13 sectors, you would like to be nominated under for the awards: Food & Agro Products (¹æl÷Ø Auto Components (¥æòÅUæð
°ß¢ ·ë¤çá ©U ÂæÎ)
·¤ ÂæðÙð´Å÷Uâ)
Metal and Metal Products (ÜæðãUæ Paper & Packaging (ÂðÂÚU
Apparel, Fashion Garment & Accessories (ÂçÚU
°ß¢ ÜæðãUæ ©U ÂæÎ)
°ß¢ Âñ·ð¤çÁ¢»)
Textile (including readymade garments) (ÅñU
IT & ITES (except Hardware) (¥æ§üÅUè-¥æ§üÅUè§ü°â
(ãUæÇüUßðØÚU ·ð¤ ¥çÌçÚUQ¤))
ææÙ, Èñ¤àæÙ ÂçÚU ææÙ °ß¢ âãUæØ·¤ °âðâÚUèÊæ)
Scientic, Measuring & Laboratory Instruments (ßñ Handicrafts and Wooden Furniture (ãñU
ææçÙ·¤, ×æÂÙð °ß¢ ÂýØæð»àææÜæ ·ð¤ ©U·¤ÚU æ)
ÇUè·ý¤æ Å÷U⠰ߢ Ü·¤ÇUè ȤÙèü¿ÚU)
âÅUæ§Ëâ (ÚÔUçÇU×ðÇU ßS ææð´ âçãUÌ))
Engineering Goods (including machinery Electrical & Electronic Goods & Components (§¢ÁèçÙØçÚ¢U» âæ×æÙ (×àæèÙÚUè, §Üðç
ÅþU·¤Ü, §Üð ÅþUæðçÙ â ©U ÂæÎ ß ©U·¤ÚU ææð´ âçãUÌ)) Page 1 / 4