TIN/GST/VAT/Service

Tax Registration No.

Aadhar No.

Employment/shop given to family members in NTPC* Yes No

What experience in the relevant field? Certificate Head/Ward By Member/Sarpanch/Ward Council Has been issued. Yes No

Years of experience

Investable available with the applicant Amount (Rs.)*

Contact No.

Mobile No

Whether involved in any criminal case? Yes No

Whether convicted or listed in any legal dispute?
Yes No

Attach Document
1. Experience Certificate verified by local bodies (Ward Member, Head of the Gram Panchayat, Ward Council).
2. Proof of PAN, TIN, GST, or Service Tax (self-attested copy).
3. “Aacharan Praman Patra” issued by the respective authority.
4. Proof of Investment Capacity (Bank Statement or FD Certificate).

Acceptance of Terms
Yes No

Verified Application Form

Payment of Application Fee
Yes No

Confirmation of Fee Submission

Official Acknowledgment

I, the undersigned, agree to abide by the rules and conditions as outlined in the annexure. I declare that the information provided above is true to the best of my knowledge. I also understand that any false information may lead to the rejection of my application and/or legal actions."