APPLICATION FOR FINANCIAL ASISTANCE FOR ORGANIC MANURE PRODUCTION UNIT

1. Name of the applicant (in block letters) 2. Address (in block letters) 3. Whether belongs to SC/ST 4. Total land possessed by the applicant 5. Whether the applicant is the owner of he land 6. No. of cattles / livestock possessed by the beneficiary 7. Details of organic manure producing unit a) Size of the unit (pit/tank/concrete floor) c) Production capacity per unit/year d) Total production capacity of all the units per year 8. Details of expenditure incurred as fixed and maintenance cost per unit I. Non-Recurring Expenditure a) Digging pit/tank/concrete floor etc. b) Construction of shed c) Any other item (specify) Total : : : : Rs. Rs. Rs. Rs. : : : : : : : : : : : SC / ST / General

b) No. of units established by the applicant :

II.

Recurring Expenditure a) Cost of agriculture waste/coir pith b) Cost of Farm Yard Manure c) Cost of decomposing culture/earth worm d) Cost of Urea e) Labour cost f) Packing/storage g) Maintenance cost of the unit h) Any other item (specify) Total : : : : : : : : : Rs. Rs. Rs. Rs. Rs. Rs. Rs. Rs. Rs.

Declaration of applicant
I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S/o/W/o/D/o . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . hereby declare that the information furnished above is true and correct and I shall abide by the terms and conditions prescribed by the Coconut Development Board for availing myself of the financial assistance. I have incurred Rs. . . . . . . . . .(Rupees . . . . . . . . . . . . . . . . . . . . . . . . . . . . only) as actual expenditure (Recurring and Non-recurring) for establishing the organic manure production unit with a production capacity. . . . . . . . . . . . . tonnes per year. Place: Date: Signature of the applicant