Government of Tamil Nadu

Department of Industries and Commerce

Entrepreneurs Memorandum for setting up Micro, Small or Medium Enterprise

Form No.2015/33/005/11199/SARK
ACKNOWLEDGEMENT PART - I
M/S AADHAAR HAS FILED MEMORANDUM EXPRESSING ITS INTENT TO SET UP A SERVICING ENTERPRISE AT THE
ADDRESS 3-112, SELVASAMUTHIRAM, BLOCK, KEERAIPATTY, TALUK, DHARMAPURI DISTRICT TAMIL NADU PIN
CODE : 636903 FOR THE ITEM/ITEMS INDICATED BELOW AND THE ACTIVITY IS PROPOSED TO COMMENCE FROM
MAY-2022 AS STATED IN FORM NO 2015/33/005/11199/SARK AND ALLOCATED ENTREPRENEURS MEMORANDUM NO
2015/33/005/11199/SARK/E AS BELOW:
Sl.No

TYPE OF SERVICE TO BE RENDERED

CRANK SHAFT GRINDING

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

MM

11

DATE OF ISSUE

05

YYYY
2015

NATURE OF ACTIVITY
(MANUFACTURING-1,SERVICES-2)

SERVICING

CATEGORY OF THE ENTERPRISE

(MICRO-1,SMALL-2,MEDIUM-3)

SMALL

ENTREPRENEURS MEMORANDUM NUMBER

11199

PART I

DATE: 11/05/2015
PLACE: Dharmapuri
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, DHARMAPURI .

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Application Id : 2015/33/005/11199/SARK
Application Date : 11-05-2015
1. Name of the Applicant
2.

: S SIVARAJ

(a) Address of Communication

S/O SUBRAMANI
SELVASAMUTHIRAM VILLAGE KEERAIPATTY PO HARUR TK, DHARMAPURI DT
PIN Code

: 636903

Phone

:-

Phone

:-

Phone

:-

Phone

:-

(b) Permanent Residential Address

S/O SUBRAMANI
SELVASAMUTHIRAM VILLAGE KEERAIPATTY PO HARUR TK, DHARMAPURI DT
PIN Code

: 636903

Phone

:-

Phone

:-

Phone

:-

Phone

:-

3. Name of The Proposed Enterprise (if decided)

: AADHAAR

4. Proposed Location of Enterprise

(i). S .F.No / Door No.
: 3-112
(ii). Street.

: SELVASAMUTHIRAM

(iii). State

: Tamil Nadu

(iv). District

: Dharmapuri

(v). Taluk

(vi). Rural/Urban

: Rural

(viii).Town/Village : KEERAIPATTY
(ix). PIN Code

: 636903

5. Category of Enterprise

: SMALL

6. Nature of Activity

: Service

7. Nature of Operation

: Casual

8. Whether Unit will be an Ancillary Unit

: No

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9. Proposed Schedule of Installation of

: May - 2008

Plant & Machinery

10. Type of Organisation

: Hindu Undivided Family

11. (a) Main Manufacturing/Service Activity

No

Service

ServiceCode

CRANK SHAFT GRINDING

96808

12. Proposed Investment In Fixed Assets (Rs in lakh)

Item
(i).

Land

(ii). Building

Owned/Leased/Rented

Approximate Value

Owned

1000

Owned

1000

(iii). Plant & Machinery Value

(iv). Equipment

15

(v). Foreign Equity,If Any

13. Installed Capacity per annum

:0

14. Power Load (Anticipated)

: H.P : 1.50 K.W : -

15. (a). Other Source of Energy

Item

Quantity

Electricity From Grid

2 KWh

Electricity From Generator

2 KWh

(b) Reason if no power required

16. Expected Employment

(i).

Management & Office Staff

(ii). Supervisory

(iii). Workers

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17. Expected Schedule Of Commencement of

Production/Activity

: May- 2022

18. Entrepreneurs Profile

(a). Name
: S SIVARAJ S/O SUBRAMANI
(b). Gender

: Male (M)

(c). Community : OBC (3)

(d). Knowledge Level : Under Graduate

(e). Equity Participation : 1000

(f). Equity % : 10

(g). Stake in other Manufacturing Enterprises : No

(h). Physically Challenged: No
Date :
Place :
[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, SIDCO
IE, SALEM MAIN ROAD, DHARMAPURI-636701.
(b) Send a certificate/notarized copy of the Partnership Deed/Memorandum of association/Articles of Association to General Manager, District
Industries Centre, Dharmapuri .
(c) In case, self certified copy of the generated application is not received by the General Manager, District Industries Centre, Dharmapuri 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 :2015/33/005/11199/SARK is true and
correct to the best of my knowledge and belief.
Date :
Place :
[SIGNATURE OF THE APPLICANT / AUTHORISED PERSON]

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