FORM AKINFRA
KERALA INDUSTRIAL INFRASTRUCTURE DEVELOPMENT CORPORATION
(A STATUTORY BODY OF GOVERNMENT OF KERALA)
TRIVANDRUM
KINFRA HOUSE
TC No. 31 / 2312Phone: 91 – 471 - 2726585
Sasthamangalam Fax: 91 – 471 –2724773
Trivandrum – 695 010E-mail:
Keralawebsite:
APPLICATION FOR REGISTRATION
“FORM A”
Park Name:
A. DETAILS OF THE APPLICANT
01.a.Name of the Chief Promoter:
b.Address:
c.PIN code:
d.Phone No.:
e.e-mail:
f.Mobile No (***):
g.Bank Details(***):
1. Name of Bank:
2.Account No.:
3. Bank Code:
4. IFSC Code of Bank:
02.a.Names and address of the other Promoters (if any) and % of share capital
- :
- :
- :
- :
B.DETAILS OF EXISTING ORGANISATION (if any)
01. Name of Organization:
02.Address of the Organization:
03.Phone No.:
04.Name of the Product(s) manufactured:
C.BRIEF DETAILS OF THE PROPOSED PROJECT
01.Name of the Product(s):
(with details)
02. (***) Raw material used
03. (***) Finished Products
04.Category of Industry as per Pollution
Control Board standards (Please Tick):
05.(***) Production flow chart submitted :
06.Proposed Investment (in lakhs)
a.Built-up space: Rs.
(in case opting for land)
b.Plant and Machinery: Rs.
c.Auxiliary Services: Rs.
07.Area required
a.Land in cents:
b.Built-up space in sq.ft.:
08. Name of the Industrial parkwhere land to
be allotted:
9.Utilities required (***)
a.Amount of Power (in KW):
b.Quantity of Waterin Litre per day :
10. Whether the applicant had own
Warehousing facility :
(if Yes, Please provide details separately )
11.Manpower to be employed:
12.Installed capacity of Plant:
13.Proposed form of implementing agency(Please tick)
- Proprietary
- Partnership
- L.L.P
- Private Limited Company
- Public Limited Company
(Submit details)
14.Proposed date for commencement
of commercial production:
15.Preferred mode of payment:
(Please tick)
- R.T G S payment:
(StateBank of India, ALTHARA Branch, Trivandrum
Account No. 3176 3060 697 IFS Code SBIN0007203)
- Demand Draft:
Signature
Designation
Seal
Place:
Date:
(***) Mandatory
Annexure to FORM A
D. ADDITIONAL DETAILS TO THE PROPOSED PROJECT
01.Name of the Product(s):
(with details)
02. Raw material used
- …………………..
- …………………
03. Finished Products
- ………………………
- ………………………
04. Whether the applicant has own warehouse facility :
(if Yes, Please provide details separately )
05. Category of Industry as per Pollution Control Board standards
(Please Tick)
06. Production flow chart submitted :
Signature
Designation
Seal
Place:
Date:
TERMS AND CONDITIONS OF
APPLICATION FOR REGISTRATION (FORM A)
- This is an “Application for Registration” only.
- The “Application for Registration” duly filled in may be sent to the Managing director, Kerala, Industrial Infrastructure Development Corporation, KINFRA House, TC 31 / 2312, Sasthamangalam, Trivandrum – 10.
- The submission of “Application for Registration” shall not be construed as any commitment or obligation on the part of the Corporation that any plot shall be allotted to the applicant.
- Your application for registration shall be accompanied with a registration fee of Rs. 5,000/- (Rupees Five thousand only), plus service tax by way of Demand Draft drawn in favour of Managing Director, Kerala Industrial Infrastructure Development Corporation, payable at Trivandrum.
- Detailedprofile of the proposed project is to be submitted along with the Application for Registration.
- The Registration fee Rs. 5,000/- is refundable if firm allotment is not made.
- The selection of allottees among the registered applicants will be made by a Committee duly constituted for this purpose.
I / We agree to the above terms and conditions of the Application for Registration.
Place:
Date:
Signature
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