The Official Website of Jammu & Kashmir Government, India

APLICATION FORM PROVISIONAL REGISTRTATION AS
SMALL SCALE INDUSTRIES
(To be filled in Duplicate)

INSTRUCTIONS

Write/type in block (in capital letters)

Fill up whichever is applicable
Use English alphabets/Arabic numbers while filling up blocks (to help computerisation),leave one blank after each word
While filling the form, use the following procedure

Name of the unit

ii. Pin Code

iii. Date

iv. Quantity

v. Amount (Rs in thousand)

vi) Fill up appropriate code in the blocks wherever applicable
Example 1 Yes-1 No.2,No.3

If NA fill up

Example 2 Category : SSI 1, Ane 2, Tiny 3, SSAE 4, EOU-S
If Tiny fill up 3

5. Block/boxes marked ( ) are to be filled by office.

Applicant should sign all copies

Abbreviations used:

SSI: Small Scale Industries,
ANC. Ancillary Industrial undertaking,
SBE: Small Scale Service and Business enterprise
Tiny: Tiny enterprise,
EOU: Export Oriented and
NA: Not applicable.

FORM

Name of the unit/Applicant

Address for communication.

Tele: Pin Code.

Category of unit

SSI-I

TINY 4 ANC-2,
EOU 5 SSSBE 3

Location:

Place/Town

Tehsil/Taluk

District

State

Type of organisation:

Proprietary I,Partnership 2, Pvt Company 3, Cooperative 4.

Nature of activity.
Manufacturing /Assembling(01)
Processing(02)
Job Work (04)
Repairing/Servicing(08)

For any combination of activities add the respective code to get the required code.

Main items of manufacture/activities

(i) Name

Code

(ii) Name

Code

(iii) Name :

Code

(iv) Name:

Code:

(v) Name

Code

Investment in Fixed assets (Rs in ‘000)

(i) Land

(ii)Building

(iii)Plant and Machinery

(iv) Other fixed assets

Total

9. Investment in Plant and Machinery
(original value Rs in ‘000)

Note: Should exclude items whose value is not taken into account while computing the investment.
Please enclose project profile in case value of investment in Plant and Machinery exceeds Rs 40 lacs.

10 Power Load H.P.

(1 H.P. =0.795 K.W) K.W.

Employment

Managerial and Office staff Supervisory and workers

Date of commencement of production
(estimated)

Date
Signature of Applicant (Authorised Person)

Name of proprietor/partner/Managing Director.

FOR OFFICE USE ONLY

NIC Code

Application No.```````