Form of application for a licence under section 24 of the Madhya Pradesh Vinirdishta Bhrashta Acharan Nivaran Adhiniyam, 1982

To The Collector, District ........... Place .......... Dated .......... 1. I/We request that a licence be granted to me/us under the Madhya Pradesh Vinirdishta Bhrashta Acharan Nivaran Adhiniyam, 1982. 2. A sum of Rs. 500 being the fees in respect of this application has been deposited. 3. The required particulars are given below:- (i) Name of the applicant with complete present address and permanent address; (ii) Is the applicant a private individual/private company/public company/firm or association (iii) In case applicant is - (a) an individual, his nationality; (b) a private company, the nationality of all members of the company alongwith place of registration; (c) a public company, the nationality of directors, the percentage of share capital held by Indian nationals, alongwith place of incorporation; (d) a firm or association, the nationality of all the partners of the firm or of the association; (e) a society; details thereof; (iv) profession or nature of business of applicant; (v) Details of immovable and movable property owned by the applicant; (vi) Whether he has developed any land before the date of this application. If yes, give details thereof; (vii) Whether applicant, has financial resources to establish colony (State sufficient particulars); (viii) Whether applicant has ever been convicted for any offence? If yes, give details; (ix) Income tax permanent account number (copy of the statement for the last year for which account has been filed should be enclosed); (x) Nature of joint interest, if any; (xi) If the applicant intends to supervise the works, his previous experience should be explained. If he intends to appoint a manager the name of the manager, his qualifications, nature and extent of his previous experience should be specified and his consent letter should be attached. I/We do hereby declare that the particulars furnished above are correct and am/are ready to furnish any other details as may be required by you. Yours faithfully, Signature and designation of the applicant Dated ...... day of 19 ...