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18
APPLICATION FOR EDUCATED
UNEMPLOYED YOUTH UNDER

"PRIME MINSTER'S ROZGAR YOJANA"
SCHEME 199
1
Name
of the applicant with
of Birth
&
Father/s
Date
Name
2.
Address
3.
Place of Residence during
4.
Qualifications
5.
If
for
Corespondence
unemployed
last
three years
Whether the
belong
furnish
employment
exchange Regn. No. and Date

6.
-9
applicant
toSC/ST/BC
7.
Type
of
industry/Service/Business
prpposed to be started and
activity
of
proposed piece
venture
of
(brief
experience
estaablishment the
project report
in
and
details
the proposed line of

'
activity to
8.
be given)
Present annual income of the Family

duly supported by the Affidavit
9.
10.
Amount
of
Loan required
a)
Machinery & Equipment
b)
Other Fixed Assets
c)
Working Capital, Total
Whether taken loan from any Bank/

Financial institution of State/
Central
Government.
(Details in brief to
11.1
certify that all
furnished by
be furnished)
information
me
is
true
12. Signature of the Applicant
Note Application should be submitted complete

:
in
Duplicate a long with attested copies
in al!
respects
of the following
Documents.
1
Age
certificate
2. Certificate of Qualification
Academic and Technical.
3.
Ration Card or any other proof of Residency for 3 years.
4.
Experience
5.
Passport size photograph to
'
certificate,
if
applicable.
affix to application.
SPECIMEN OF AFFIDAVIT TO BE SUBMITTED

ALONG WITH THE APPLICATION ON RS. 10 NON
JUDICIAL STAMP PAPER DULY ATTESTED BY
OATH COMMISSIONER (NOTARY)
AFFIDAVIT
S/o., D/o.
W/o
resident of
District/State...
do hereby solemnly
1.
That
2.
That
am unemployed.
am not in a position
to
affirm
muster
and declare as under:-
my own
capital for the
project.
3.
That
am
a permanent resident
Since
of
years.
4.
That the family iscome

and parents is Rs
of
my
family which includes
per
spouse
annum from
all
sources such as salary, wages, agricultural, income,

business, rent, interest, pension
5.
That
6.
That
have not defaulted
shall abide
etc.,
repayment of loan from

nationalised bank/ financial institution/Co-op. Bank.
of
7.
in
by the rules framed under the
PMRY for Educated
any
Scheme
Unemployed Youth.
That shall submit the progress report required by the Bank/

Government.
I
DEPONENT
VERIFICATION
Verfied that the
above contents are true and correct to the best of

belief and nothing has been concealed there in.
my knowledge and
Date:
DEPONENT
I
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PJT

FIRST EDITION- 1998

26-?0-6 S\van^v Street.

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a>e>g<5 ^66^)06 OS3a^D65

APPLICATION FOR EDUCATED

UNEMPLOYED YOUTH UNDER

of the applicant with

Place of Residence during

exchange Regn. No. and Date

prpposed to be started and

the proposed line of

Present annual income of the Family

Machinery & Equipment

Other Fixed Assets

Working Capital, Total

Whether taken loan from any Bank/

certify that all

12. Signature of the Applicant

Note Application should be submitted complete

Duplicate a long with attested copies

Academic and Technical.

Ration Card or any other proof of Residency for 3 years.

Passport size photograph to

SPECIMEN OF AFFIDAVIT TO BE SUBMITTED

and declare as under:-

capital for the

That the family iscome

family which includes

sources such as salary, wages, agricultural, income,

have not defaulted

repayment of loan from

by the rules framed under the

PMRY for Educated

That shall submit the progress report required by the Bank/

above contents are true and correct to the best of

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