Government of Tamil Nadu Department of Industries and Commerce

Entrepreneurs Memorandum for setting up Micro, Small or Medium Enterprise

Form No.2011/33/012/31795/PPNP ACKNOWLEDGEMENT PART - I

M/S P.JAYARAMACHANDRAN HAS FILED MEMORANDUM EXPRESSING ITS INTENT TO SET UP A MANUFACTURING ENTERPRISE AT THE ADDRESS 226/3, MEENKARAI ROAD,ZAMIN UTHUKULI ,POLLACHI(SOUTH) BLOCK, POLLACHI, POLLLACHI TALUK, COIMBATORE DISTRICT TAMIL NADU PIN CODE : 642004 FOR THE ITEM/ITEMS INDICATED BELOW AND THE ACTIVITY IS PROPOSED TO COMMENCE FROM OCT-2011 AS STATED IN FORM NO 2011/33/012/31795/PPNP AND ALLOCATED ENTREPRENEURS MEMORANDUM NO 2011/33/012/31795/PPNP/E AS BELOW:
Sl.No 1 ITEMS OF MANUFACTURE WELDING (ARC) CAPACITY IN CASE OF MANUFACTURE 3 KWh

NOTE: THE ISSUE OF THIS ACKNOWLEDGEMENT DOES NOT BESTOW ANY LEGAL RIGHT. THE ENTERPRISE IS REQUIRED TO SEEK REQUISITE CLEARANCE / LICENCE / PERMIT REQUIRED UNDER STATUTORY OBLIGATIONS STIPULATED UNDER THE LAWS OF CENTRAL GOVERNMENT / STATE GOVERNMENT / UT ADMINISTRATION / COURT ORDERS .

DD DATE OF ISSUE NATURE OF ACTIVITY (MANUFACTURING-1,SERVICES-2) CATEGORY OF THE ENTERPRISE (MICRO-1,SMALL-2,MEDIUM-3) ENTREPRENEURS MEMORANDUM NUMBER 10

MM 09

YYYY 2011

MANUFACTURING

1 3

MICRO 3 0 1 2 1 1 31795 E

PART I

DATE: 10/09/2011 PLACE: Coimbatore SIGNATURE (S.A.P.Vairamani) Additional Director of Industries & Commerce (DIC) Note : (1) The concerned Financial Institutions/Agencies who provide Loan/Clearance/Assistance, shall verify this Entrepreneur Memorandum Form Part I in the website http://www.msmeonline.tn.gov.in, to ascertain the genuineness / validity / cancellation using the above EM PART I Number (2) The concerned Financial Institution/Agencies who provide Loan/Clearance/Assistance, shall ascertain the eligibility of subsidies and incentives given by the Government, from the General Manager, District Industries Centre, COIMBATORE .

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Application Id : 2011/33/012/31795/PPNP Application Date : 10-09-2011

1. Name of the Applicant 2. (a) Address of Communication 157,SRIRAM ILLAM MEENKARAI ROAD,NANJEGOUNDEN PUDUR,, AKILANDAPURAM(PO),POLLACHI PIN Code Phone Mobile FAX Number EMail WEB Site : 642004 : 04259253441 : 9965430333 :::: P.JAYARAMACHANDRAN

(b) Permanent Residential Address 157,SRIRAM ILLAM MEENKARAI ROAD,NANJEGOUNDEN PUDUR,, AKILANDAPURAM(PO),POLLACHI PIN Code Phone Mobile FAX Number EMail WEB Site : 642004 : 04259253441 : 9965430333 :::: P.JAYARAMACHANDRAN

3. Name of The Proposed Enterprise (if decided) 4. Proposed Location of Enterprise (i). S .F.No / Door No. : 226/3 (ii). Street. (iii). State (iv). District (v). Taluk (vi). Rural/Urban (vii). Block

: MEENKARAI ROAD,ZAMIN UTHUKULI : Tamil Nadu : Coimbatore : Polllachi : Rural : Pollachi(South)

(viii).Town/Village : POLLACHI (ix). PIN Code : 642004 : MICRO : Manufacturing : Perennial

5. Category of Enterprise 6. Nature of Activity 7. Nature of Operation

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8. Whether Unit will be an Ancillary Unit 9. Proposed Schedule of Installation of Plant & Machinery 10. Type of Organisation 11. (a) Main Manufacturing/Service Activity No 1 Product/ProductCode WELDING (ARC) / 96855

: No : September - 2011

: Proprietary Item Code 28920 Approximate Value 3 KWh

12. Proposed Investment In Fixed Assets (Rs in lakh) Item (i). Land Owned/Leased/Rented Owned Owned Approximate Value 3 1 1 : 1 KWh : H.P : 5.00 K.W : -

(ii). Building (iii). Plant & Machinery Value (iv). Equipment (v). Foreign Equity,If Any 13. Installed Capacity per annum 14. Power Load (Anticipated) 15. (a). Other Source of Energy Item (b) Reason if no power required

Quantity -

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16. Expected Employment (i). Management & Office Staff 1 1 : October- 2011

(ii). Supervisory (iii). Workers 17. Expected Schedule Of Commencement of Production/Activity 18. Entrepreneurs Profile (a). Name : P.JAYARAMACHANDRAN (b). Gender : Male (M) (c). Community : OBC (3) (f). Equity % : 100 (d). Knowledge Level : Post Graduate (e). Equity Participation : 100 (h). Physically Challenged: No
Date : Place :

(g). Stake in other Manufacturing Enterprises : No

[SIGNATURE OF THE APPLICANT / AUTHORISED PERSON] NAME OF THE PROPRIETOR/PARTNER/MANAGING DIRECTOR

(a) Send a self-certified copy of this application along with a self-certified copy of Power of Attorney/Board Resolution/Society Resolution wherever applicable, while signing as Partner/Managing Director or Authorised Person to GENERAL MANAGER , DISTRICT INDUSTRIES CENTRE, 2 RAJA STREET, COIMBATORE - 614 001. (b) Send a certificate/notarized copy of the Partnership Deed/Memorandum of association/Articles of Association to General Manager, District Industries Centre, Coimbatore . (c) In case, self certified copy of the generated application is not received by the General Manager, District Industries Centre, Coimbatore within one month from the date of generation of the application, the acknowledgement issued for EM(PART I)will be cancelled and displayed in the website. (d) In respect of those who furnish wrong information and do manipulations in the online Application Form, penal action will be taken by the Department and simultaneously the acknowledgement issued for online EM PART I will be automatically cancelled and displayed in the website.

Undertaking This is to certify that the information furnished in the Memorandum in FORM No :2011/33/012/31795/PPNP is true and correct to the best of my knowledge and belief. Date : Place : [SIGNATURE OF THE APPLICANT / AUTHORISED PERSON]

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