FORM – C

ANDAMAN AND NICOBAR ADMINISTRATION

DIRECTORATE OF AGRICULTURE

Sub: Application for pumpset on loan-cum-subsidy under Minor Irrigation Scheme – regarding

1.

Name of the applicant (in Block Letter)

2.

Father’s/Husband’s name of the applicant

3.

Village & full postal address

  

 

4.

Approximate annual postal address

5.

Agriculture land owned by the farmer (in ha.)

6.

Type of pumpset required.

i.

˝ HP Electric pumpset.

ii.

1 HP Electric pumpset.

iii.

5 HP Diesel pumpset.

7.

Any other (please specify)

(strike out which is not applicable)

i.

Pond

ii.

Well

iii.

Stream

iv.

Any other (please specify)

(strike out which is not applicable)

I do hereby declare that the following documents will be kept ready for submission to the concerned bank as and required for sanction of loan.

8. a.

Licence/sale deed/gift deed.

b.

Khatuni slip (patta)

c.

Revenue map.

d.

Valuation certificate of land.

e.

Non-encumbrance certificate of the land.

f.

No dues certificate from the Agriculture Department and near by bank.

g.

Two solvency certificate of the sureties to the satisfaction of the bank.

h.

A passport size photograph.

Place :

Date :

Signature of the Applicant

9.

Recommendation of Agriculture Demonstrator of area concerned.

10.

Recommendation of Agriculture Inspector of the area concerned.

11.

Recommendation of zonal Agriculture Officer.

12.

Recommendation of Assistant Engineer (MI), Directorate of Agriculture.

13.

Approval of the Director of Agriculture.