eTracking Applicnt ID: KVTN16176914-1524043

Office Name: KVIC-PERAMBALUR-TN Agency: KVIC

1. Aadhaar Number : 484247863332 2. Legal Type : Individual

3. Applicant Name SHRI RAJAJIMUTHUSAMY

4. Gender : MALE 5. Date of Birth : 17-Apr-1991 Age 25 Yrs.

6. Social Category : Other Backward Caste 7. Special Category : Not Applicable

8. Qualification : Graduate 9. PAN No. :

2,18 MELATHERU,PILIMISAI,ADHANURSOUTH,PERAMBALUR
Address for Communication:
PERAMBALUR

10. District: PERAMBALUR Pin Code: 621713

State: Tamil Nadu E-mail ID: kzee36912@gmail.com

Mobile No.1: 8940902432 Mobile No.2: 8940902432

2,18 MELATHERU,PILIMISAI,ADHANURSOUTH,PERAMBALUR
Address of Proposed Unit:
PERAMBALUR
11.
District: PERAMBALUR Pin Code: 621713

State: Tamil Nadu Unit Location : Rural

12. Type of Activity : Service SERVICE AND TEXTILE

Servicing of Electric wining and Electronics appliances and equipments

13. Name of Activity :
CELLPHONE SERVICE CENTRE

14. Whether EDP Training Undergone : No 15. Institution Name

16. Preferred Agency: KVIC

Capital Expenditure: 374000

17. Loan Required Total: 500000
working Capital: 126000

CANARA BANK

1st Financing Bank Name and PERAMBALUR

18.
Address Mvk Complex, Thuraiyur Road, Perambalur- 621212

PERAMBALUR IFS Code: CNRB0001214

19. Alternative Bank IFS Code: CNRB0004519

I, RAJAJIMUTHUSAMY Certify and declare that all the information provided above is true and correct. Any information that
may be required to be verify, shall be provided to the concerned authority.

Online Submission Date:9/19/16 8:09 AM Signature of Applicant

Report Print Date: 2016.September.19 AD 08:18 AM Page 1 of 1