Applicant ID: KVUP237027-11838371

Office Name: KVIC-BULANDSHAHR-UP Agency: KVIC

1. Aadhaar Number 818045822941 2. Legal Individual
3. Applicant Name SMT. AMEENA KHATUN
4. Gender : FEMALE 5. Date of Birth : 01-Jan-1991 Age 32
6. Social Category : General 7. Special Not Applicable

8. Qualification : 8th Pass 9. PAN No. : NGYPK7790G

W/O. MO ISLAM, DOULATPUR KALAN, PO. KHAS

Address :
UNCHAGAON

10. District: BULANDSHAHR Pin Code: 202398

State: Uttar Pradesh E-mail ID:

Mobile No.1: 7895245294 Mobile No.2:

Address of Proposed Unit: W/O. MO ISLAM, DOULATPUR KALAN, PO. KHAS

BULANDSHAHR
11.
District: BULANDSHAHR Pin Code: 202398

State: Uttar Pradesh Unit Location : Rural

12. Type of Activity : Manufacturing SERVICE AND TEXTILE

Tailoring and preparation of Readymade Garments

13. Name of Activity :
UMDER GARMENTS

14. Whether EDP Training No 15. Institution

16. Preferred Agency: KVIC

Capital 600000 Total:

17. Loan Required 1000000
working Capital: 400000

PUNJAB NATIONAL BANK

1st Financing Bank Name and DAULATPUR KALAN

18.
Address VPO DAULATPUR KALAN DISTT BULANDSHAHR UP 202398

BULANDSHAHR IFS Code: PUNB0112500

19. Alternative Bank IFS Code:

I, AMEENA KHATUN Certify and declare that all the information provided above is true and correct. Any information
that may be required to be verified, shall be provided to the concerned authority.It is also certified that me or my
spouse has not taken any subsidy underPMEGP Scheme or any similar Scheme of the State / Central Government.

Online Submission Date:8/12/23 3:37 PM Signature of Applicant

Report Print Date: 2023.August.12 AD 03:46 PM Page 1 of 1