9/6/2017 Farmer

Application Form

Scheme Name - Chhatrapati Shivaji Maharaj Shetkari Sanman Yojana

Application ID : 20170902202901314L0004500014 Created On : 2017-09-02 20:29:01.0

Applicant Details

User Id User Name Relation Type Relation With Taluka Grampanchayat Scheme1 Scheme2 Scheme3 Scheme4

pundalikarghode Pundalik Atmaram Arghode self pundalikarghode Narkhed BELONA

ashokarghode Ashok Pundalik Arghode children pundalikarghode Narkhed BELONA

Bank Details

User Id District Bank Name Branch Name Loan A/C no Saving A/C no

pundalikarghode Nagpur Nagpur DCC Bank Belona / Belona 31 9081

Declaration Form

B] Government declaration dated 28th June , 2017 in given paragraph (III) sub section (i) To (viii) Out of subsections (i) to (Viii) is not holding as eligible.

1. Maharashtra State Ex/Current Minster /State Minister, State Ex/Current Member of Parliament /Rajya Sabha Member, State Ex/Current Vidhan Sabha/Vidhan Parishad Member

2. Zilla Parishad Member, Mahanagar Palika Members

3. Kendra and State Government Officials/Employees, Semi Government Official/Employees and Kendra or State Government aided Officials/Employees.

4. Farmers who pays Income Tax basis on sources other than agriculture.

5. Pensioner whose Monthly pension is more than 15000/- ( Excluding Ex Sainik).

6. Agriculture Revenue Baazaar Samiti, Co-operative Sugar Industry, Co-operative Cloth Manufacturer, Nagarik Co-operative Institute, Zilla Intermediate Co-operative Banks and Co-operative Milk
Union Officer and Office-bearer (President and Vice President) and President of Labour Co-operative Institute.

7. Citizen whose Income is more than approx. 3 Lakhs.

8. Personals registered under Sales Tax or Service Tax having Annual income more than 10 lakhs in Financial year in 2016-2017.

For this Scheme, Eligiblity Criteria for Loan waiver/Incentive other Benefits are as follows. Please select the applicable corresponding Checkbox.

1) Scheme for Loan waiver of Rs. 1.50 lakhs, where entire Family Overdue (interest + principle) < Rs. 1.50 lakhs.

2) Scheme for Loan waiver of Rs. 1.50 lakhs, where entire Family Overdue (interest + principle) > Rs. 1.50 lakhs. Hence eligible for the waiver, accepting to settle the overdue amount excess to
1.50 lakhs on individual basis prior to receiving Any waiver amount.

3) Scheme for incentive of 15000/- to 25000/- on regular re-payment of fresh loans taken during 2015-16 & 2016-17

4) Scheme for incentive of 25000/- on regular re-payment of restructure loans of 2015-16

Kiosk Id : narkhed_18152

Declaration

I / We hereby declare that all the information provided by me / us in section (a)(b)(c) is true to my / our knowledge. I / We understand that, if in future any information
provided by me is / us found to be false / incorrect by the Government Of Maharashtra then, I am / We are liable to return Loan Wavier Amount / Encouragement Amount
received along with Interest / Fine. Also, I / We will be responsible if any legal action taken against me / us. I / we are aware that the information provided in the
Application regarding Loan wavier / Encouragement Scheme will be Government Of Maharashtra directive.

NOTE:
1) If you registered using Non-Aadhaar on our portal, Please enroled yourself for Aadhaar and update your Aadhaar number in your profile.
2) If your bank account number is not linked with Aadhaar, Please linked it with Aadhaar.

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