Application Form For SVAYEM Scheme

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Application Form

SWAMI VIVEKANANDA ASSAM YOUTH EMPOWERMENT SCHEME


A. For Office Use Only
Enterprise Name Application Sl. No.

B. Information about applicant

Residential Experience in
Date of Academic
Name Gender Address with line of activity
birth Qualification
Mobile No. (Years)

(ii) Aadhar/ PAN / Election Photo Identification card / Passport /Driving License No. (any
one out of these)
C .Business Information
Name of the
enterprise
Constitution Ltd. Any Others
Proprietary Partnership Pvt. Ltd.
(Please √) Company (Specify)

State Pin Code


Current Business
Business
Address
Premises Rented Owned
(Please √)
Telephone Mobile
91-
Number Number
E-mail Id
Business Activity Existing
(fill accordingly) Proposed
Date of
Commencement
(DD/MM/YYYY)
Whether Unit is
Registered Yes No
(Please √)
If Registered
(please mention
Registration no.
and the Act
under which
registered)
Registered office
address (if
registered)
Social Category
SC ST OBC Minority Community
(Please √)
If Minority
Community Buddhists Muslims Christians Sikhs Jains other
(Please √)

D. Declaration/Undertaking

I hereby certify that all information furnished by me is true, correct and complete. I am
not a defaulter of any bank.There is no overdue/statutory due owned by me. I shall
furnish all other information that may be required by bank in connection with my
application. The information given by me may also be exchanged with any agency.
Bank or Industry Department representative may at any time, inspect/verify my/ assets,
book of accounts, etc. in our factory, business premises as given above. You may take
appropriate safeguards/action may be taken for recovery of bank dues. I haven’t got
any benefit under PMEGP during last five years.

Date: _______________________ Signature of Applicant

Documents to be attached.

(The list is only indicative and not exhaustive and depending upon the local
requirements at different places addition could be made as per necessity)

1. Proof of identity - Self certified copy of Voter’s ID card / Driving License / PAN
Card /Aadhar Card/Passport.
2. Proof of Identity / Address of the Business Enterprise - Copies of relevant
licenses/registration certificates/other documents pertaining to the ownership,
identity and address of business unit.
3. Project report (for the proposed project) containing details of technical &
economic viability.

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