“all Applicant Coy PART-I von Gap, = Form No. PART I pin copies sited othe Dsus Coe afer commencement ci acti) HHAVE BEEN REPEATED NEED TOBE FILLED ONLY TOTHE EXTENTTHATTHE. CTUALDETAILS ONCOMMENCEMENT VARY FROM THOSE INPARE] -ENEURS MEMORANDUM Ci CAI (ek Te ‘NUMBER (Part I) M MY fi I DATE OF ISSUE DD (eFeTe ee(l< fe log}re | P< Ul, MONTH OF COMMENCEMENT OF fot PRODUCTION/ACTIVITY, 1. NAMEOF APPLICANT kU TsTayo STA) 2. (@) ADDRESSOF COMMUNICATION Kye [ATS TATA Nate [7 ele () TELEPHONE NUMBER (@ FAX NUMBER ti (i) CELL PHONE NUMBER (jv) E-MAIL. ol [alla or PI (v) WEB-SITE (») PERMANENT RESIDENTIAL ADDRESS (MAIN APPLICANT) 4 A (fy Tati Tefeq [Ro Glal[ntolale NTRIG Nvalefelefel PI @ TELEPHONE NUMBER Zz + xy Lo > i) FAX NUMBER Na P (i) CELL PHONE NUMBER GET “(v) E-MAIL Ale S () WEB-SITE 3. NAME OF ENTERPRISE Alay Pye IS+() VILLAGE / TOWN LOCATION OF ENTERPRISE PLOT/KH NOJS.NO. ro = a > Z| io oy a} CODE (i) TEHSIL/TALUKAL MANDAL, CODE ii) DISTRICT (REE | CODE (iv) STATE Meleleal el AL SAT AL AL CODE (¥) PINCODE ALG (vi) AREA (RURAL-1, URBAN-2) CATEGORY OF ENTERPRISE (MICRO-1, SMALL-2, MEDIUM-3) NATURE OF ACTIVITY [Tick Appropriate Box(es)] (MANUFACTURE (i) SERVICE 6(a) RAW MATERIAL REQUIRE, ‘9 @ NAME 2 CODE (ASICC2000*) [ gy Name [&}t [alr [A] ETS! a 3 ry iA rd CODE (ASICC2000*) 7 name [e Jo] ePIAIR 8 CODE (ASICC2000*) a ° 34 N 13] 12 ww name [ALC esp Tt cove (asicc2000*) Fat NATURE OF OPERATION (Perennial-1, Seasonal-2, Casual-3) WHETHER THE UNIT WILL BE ANCILLARY (¥es-1, No-2) M MONTH OF INSTALLATION OF PLANT ale AND MACHINERY WHETHER THE UNIT IS REGISTERED UNDER FACTORY ACT (Under Seotion 2m(i/2m(i)-1, 85)/85(I/85(i-2, not registered-3) ‘TYPE OF ORGANIZATION (PROPRIETARY-1, HINDU UNDIVIDED FAMILY-2, PARTNERSHIP CO-OPERATIVE-4, PRIVATE LIMITED COMPANY-5, PUBLIC LIMITED COMPANY-6, SELF-HELP GROUP-7, OTHERS-8)-3- 12. (a) MAIN MANUFACTURING / SERVICE ACTIVITY, name fyla-ke HT clolm[plolmMe $ CODE (NIC 98*) F151 [218 (b) PRODUCTS TO BE MANUFACTURED/SERVICE TO BE PROVIDED @ name(s TETET I] fet hele lelol miele [NTEIn Fr] 5 CODE (ASICC2000%) aE BR IP19 @ Name@QATs TTT ING, [ele [ee INST DIET] CODE (ASICC2000*) 7h le 13] Gi) NAME/ 2) [tle] felctri[s[ fe fe [ajo I CODE (ASICC2000*) 741° [F [4 @) NaME[T oT ee) [CzT stati [Nis | [Ap fr CODE (ASICC2000*) ad CHE w) name[PP [eT] [ST olelele elt] [Ae I CODE (ASICC2000*) 2191 eT) () Colles for activities and products/services as per classification specified from time to time by the Development Commissioner (Smal Scale Industries), Government of India tobe filed in by the District Industries Centre or the office where the Entrepreneurs’ Memorandum is submitted, (ADD ADDITIONAL SHEET FOR MORE PRODUCTS) 13, (a) INVESTMENT IN FIXED ASSETS [Rupees in lakh] () LAND (OWNED-01/RENTED-02/LEASED-03) ea BIN VALUE* Lt lols] (i BUILDING (OWNED-01/RENTED-02 9 LEASED-03) ao VALUE* O12 (ii) PLANT AND MACHINERY VALUE* ols (in case of manufacturing unit) (iv) EQUIPMENT ‘VALUE* 6} (in case of Servicing Unit) \ () FORFIGN EQUITYIF ANY VALUE* N [*The value in the boxes should be filled in from the right side, ¢g., ifthe value is Rupess-16-fats it should be written as. 1 [0] This will be also apply to all other item (cows) where quantity number, ete, to be given] 14, INSTALLED CAPACITY PER ANNUM ary UNIT Se 216] fyi VALUE (Rs. in Lacs) eloRER 18, POWER LOAD HP. / KW. ol ep 16. (2) @ OTHER SOURCE OF ENERGY/POWER [é] (IE REQUIRED) (NO POWER NEEDED-I,COAL-2,01L-3, LIQUID PETROLIUM GAS-4 ELECTRICITY FROM ORID-5, ELEC- ‘TRICITY FROM GENERATOR-6,NON-CONVENTIONAL ENERGY-7 TRADITIONAL ENERGY/PIREWOOD-8) (i) Ino power required, specify reasons;+4. (6) INDICATE ANNUAL REQUIREMENT SOURCE OF ENERGY QTy UNIT. EN. Bue [elo] [ik 17. EMPLOYMENT Male (Nos.) Female (Nos) (i) MANAGEMENT AND OFFICE STAFF tem (i) SUPERVISORY (ii) WORKERS 18, TOTAL ANNUAL TURNOVER (in Rupecs) (if less than one year of operation, then expected turnover) 19, EXPORT (if any) (in Rupees) SEIEIEE = 20. ENTERPRENEURS’ PROFILE (OF ALL PARTNERS/DIRECTORS OF THE ORGANISATION-USE SEPARATE SHEETS, IF NEEDED) (@) NAME Klilsjujolel mld lui ria @ MALE (M)/ FEMALE (F) P27 Gi) SC(1)/ST(2)/ OBC(3) / OTHERS(4) PHYSICALLY CHALLENGED (5) Zl I (iii) KNOWLEDGE LEVEL (TECHNICAL GRADUATE-1, MANAGEMENT GRADUATE-2, POST GRADUATE-3, OTHER GRADUATE-4, UNDER-GRADUATE-5, ANY OTHER LOWER-6) (iv) EQUITY PARTICIPATION (in Rupees) (ia Percentage of total equity) (v)_ STAKE IN OTHER MANUFACTURING ENTERPRISES (Yes-1, No-2) [ADD ADDITIONAL SHEET, IF NEEDED) 21, DATE OF COMMENCEMENT OF PRODUCTION / ACTIVITY D x 6 MMY YY eK lalelete < D \ parE: (>) 6s \s¢> PLACE: yc. fo) _ [SIGNATURE OF THE INT/AUTHORISED PERSON] »{ IAME OF THE PROPRIETOR: (AGING DIRECTOR (6) Enclose «se. Stifid copy of Power of Atoraey/Board Resolution Society Resolution, wherever applicable, while signing a Parner Managing Director or Authonod Peron, () Enclose a cetified notarized copy of the Partnership Deed/Memorandum of Astosition/Aticles of ‘Association in ease of Medium Enterprises. “Thisisto certify that the information furnished in the memes Sh correct to the best of my knowledge and belief. We have obtained approval {consent / license / permit from the concerned Ministry / Department of Central Govt. / State Govt UT administratiott hs per statutory requirements. DATE: t3\1\0.Y A . Ballo PLACE: WS =<\ 2 [SIGNATURE OF THE APPLICANT/AUTHORISED PERSON} JI«This piansmrdun fe IN wi of prirt 85z ROM ple {I la4-o ett ST-S7— 1992 Gor office useonly) NoDICN/Regn! BS PARE: 27 JAN 2008 ACKNOWLEDGEMENT Ms. LLKEM... adyag FILED MEMORANDUM FORA... re (MANUFACTURING/SERVICE) ENTERPRISE AT THE FY. ADDRESS... s..KH. bho. 6B on RI ndhtraped et... a OFF. ADDRESS... =f... rae PIN... LeteelOG2. FOR THE ITEM / ITEMS INDICATED BELOW AND THE ACTIVITY HAS COMMENSED FROM THE (DATE)O/ /6/ (€6cCAS STATED IN FORMNO._[4¢7% ANDALLOCATED ENTREPRENEUR'S MEMORANDUM NO. AS BELOW: DDMMYYYY DATE OF ISSUE TAIOL I lel¢ ‘NATURE OF ACTIVITY T (MANUFACTURING-1, SERVICE-2) CATEGORY OF ENTERPRISE Zz (MCRO-1, SMALL-2, MEDIUM-3) ENTREPRENEUR’S MEMORANDUM NUMBER 2} 7}}o fo} 9} [|Z] (6|a glo |2|| rarra DETAILS OF ITEMS MANUFACTURED/ SERVICE PROVIDED: Se Ttem of Manufacture/type of ‘Capacity in ease of No. service to be rendered manufacture E nach ne conpoinenti acer dts Sheet metel Component: Dall. Aid: nad M088: auer Lis htine 8 | Loaf sey D. (Add additional sheet if réquired) NOTE : A) Concerned Agency if required shall verify for themselves whether ‘the unit is in regular production on or not. B) The issue ofthis acknowledgement does not bestow any legal right. ‘The Enterprise is required to seek requisite Clearance / Licence / Permit required under statutory obligation stipulated under the laws [Pro© This acknowledgements subject to provision of res Note No. 16 12 July 1998 and Press Note No. 17 dated 27th November 97 regarding the significance, ‘implications and legal status of filing of Entrepreneur's Memorandum, D) This acknowledgement is Subj state and central provision, notification, ‘ules, state location policy, clearance, permissions etc law and is punishable as specified in section 27 of MSMED Act. DATE ee Distinct industries Centre GENRREPNIANAGER DISTRICT INDUSTRIES CENTRE, NAGPUR. PLACE : Nagpur.Office of the General Manager, District Industries Centre, Nagpur 2" Floor, Udyog Bhavan. Civil lines, Nagpur warashtra.gov.in <8) : 2564842 ME : 2505974 NO.DICN/CERTIFICATE/09-10/ 11040 Dated 14 Dec 2009 Certified that change in Part-I Entrepreneurs Memorandum Number Certificate as shown below is hereby registered on the records of Districts Industries Centre, Nagpur. 1. Name of the Unit : Mis. Akay Udyog 2. MN. & Date 27/009/1/2/00202 , Dt 14/01/2009 3.Changes Registered A] Inclusion Addl. Item 2 1. S.P. Machine 2. Dies,Gauges, Jigs & Fixtures 3. Fabrication, Erection & Commissioning Jobs B] Change in Date of 2 02/01/2009 Commencement of Production of add.ltems. C] Change in Name of Partners: _ 1. Shri Kishor Mohta 2. Smt. Sushma Mohta 3. Shri Sumit Mohta D] Change in Investment in Fixed Assets ( Rs. in Lakh ): Old Add. Total i) Land 00.90 00.00 00.90 ii) Building 3 25.17 00.33 25.50 iii) Plant and Machinery S114 53.86 105.00 iv) Other E 01.26 06.26 Total 55.45 ‘This memorandam issued onthe bass of undertaking given by ‘he applicant,” ap CORCER ay ct veyexding } jcPontre existama. and production, Ue 7 “entre,