1 THE WEST BENGAL SMALL INDUSTRIE DEVELOPMENT CORPORATION LTD. (A Government of West Bengal Company) Shilpa Bhaban, 31,Black Burn Lane, Kolkta-700012 Application Form for Tenancy of Plots / Sheds/Floor Space in the Industrial Estates. 1. Application for tenancy in Industrial Estates should be submitted along with a DD drawn in favour of WBSIDC Ltd. For Rs. 5000/- (in respect of Estate in Group A & B districts) or Rs. 2000/- (in respect of Estate in Group C & D districts) as applicable, towards nonrefundable application processing fee along with the application fees of Rs. 1000/-and Rs.500/- for downloaded forms respectively. 2. Application should be neatly typed/ Handwritten in block letters. 3. All columns should be filled up 4. Application should be submitted in duplicate 5. Application without sufficient information or incomplete in any respect will be summarily rejected. 6. Particulars of Demand Draft: DD No. Bank Amount (Rs.) ---------------------------------------------------------------------------------------------------------------------- CLASSIFICATION OF DISTRICTS: GROUP A- Kolkata Muincipal Corporation GROUP B- North 24 Parganas, South 24 Parganas, Howrah, Hoogly, Burdwan, Nadia, Purba Medinipur GROUP C- Murshidabad, Birbhum, Malda, Jalpaiguri, Darjeeling GROUP D- Purulia, Bankura, Paschim Medinipur, Uttar Dinajpur, Dakshin Dinajpur, Coochbehar --------------------------------------------------------------------------------------------------------------------------------------------------------- For official Use: MR NO Date Serial no. of Application Date of Submission Signature of Receiving Assistant
2 To, The Estate Manager, The W.B. Small Industries Development Corporation Ltd., Silpa Bhawan, 31, Black Bum Lane, 2nd floor, Kolkata -700012. ' Dear Sir, I / We hereby apply for allocation of tenancy of a Plot /Shed/ Floor Space in the following Industrial Estate of West Bengal Small Industries Development Corporation Ltd. I /We furnish here in below particulars of my / our undertaking as per proforma, and documentary evidence, as prescribed. 1. Name of the Industrial Estate... 2. Number of Plots /Sheds/ Floor Spaces required 3. Total area required (in Sft./Katha) Covered Uncovered 4. Whether holding any other Plot /Shed/ Floor Space in this or any other Industrial Estate (Give details)... 5. Tenancy Term (Short Term or Long Term) being applied for.. 6. PERSONAL INFORMATION OF THE APPLICANT i. Name ii. Age iii. Name of Father/ Husband. iv. Address (Present) for communication. v. Address (Permanent) vi. Status of Applicant in the company/ firm applying for Shed/ Plot / Floor Space/Roof Right.. vii. Contact No. /Fax/ Mobile No. and E- mail ID.. viii. Whether the applicant belongs to any of the following (Put a mark): a) SC/ST b) Ex-serviceman c) Physically handicapped
3 7. Name of the Undertaking 8. Office Address with telephone no. 9. Organizational structure of the Company/Firm (Annex Documentary evidence).. 10. Name of Proprietor/Partner(s)/Director(s )/Secretary (for Co-opt. Society)/ Karta (for HUF) etc. 11. Nature of the Project/Scheme. (Copy of the Project Report vetted by DIC is to be submitted at the time of interview).... 12. Date of Validity of Entrepreneur s Memorandum. 13. Line of manufacture as per Entrepreneur s Memorandum 14. Total cost of Project... 15. Total cost of plant & machinery. 16. Total Employment... 17. Electricity (in KW) required. 18. KVA of Transformer, if needed 19. Total requirement of water (For Industrial Production) 20. Expected time to be taken for commissioning of the project.
4 21. Enclosures: a) Copy of Project Report b) Copy of EM c) Clearance Certificate regarding Professional Tax d) Clearance Certificate regarding Service Tax e) Clearance Certificate regarding Income Tax f) Latest Auditor s Report g) Copy of Project Partnership Deed/ Articles & Memorandum of Association and Certificate of incorporation by the Registrar of Companies. h) Copy of SC/ST Certificate, Disability Certificate/Ex-serviceman card etc. i) Attested Copy of Elector s Photo Identity Card/ Proof of residential address like telephone bill/electricity bill/tax receipt from Municipality/ Panchayat j) Copy of Money Receipt towards cost of Application Form. k) Demand Draft for Processing Fee. DECLARATION The information given above is true to the best of my knowledge and I undertake to abide by the general terms and conditions of allotment of tenancy of the West Bengal Small Industries Development Corporation. Date : Signature of the Applicant ( in full ) Name (in full)... Seal of the Company/ Firm/ Proprietor Designation in the Company/Firm...
5 GUIDELINES The industrial entrepreneur should apply for allotment of Industrial Land for their project with a Project Profile or Detailed Project Report (DPR) / Preliminary Project Report which should include the following: Introduction Details of developer / manufacturer Aims and Objectives of Project / Industry Project at a glance Items/ Product mix and Production capacity Market Potential Market Segment: Open market/ Export/ Ancillary Investment Details Land Requirement and justification for land requirement along with a Typical Layout showing the different components like factory / shed / workshop showing typical machines / equipments location and sizes and parking / loading unloading facilities, warehouses, administrative building etc. Power Requirement Water Requirement for next 5 years from the date of first requirement to be indicated (the company has to sign a Take or Pay Agreement for quantity of water indicated) Manpower requirement and employment potential - including managerial, labours - skilled and unskilled Projected / Company balance sheet for 3 (three) years, if any Promoter's Bio-Data