Government of Tamil Nadu
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Common Application Form

COMMON APPLICATION FORM FOR SINGLE WINDOW CLEARANCE
(Please read instructions before filling up this form)
PROJECT INFORMATION
1. Name
Email
Address of Industrial Project (proposed to be set up)
Telephone (with STD Code)
Fax (with STD Code)
2. Nature of your Oraganization
Proprietary Partnership Private Limited
Public Limited Co-Operative Others
Project Status
New Project Expansion Diversification
2.1 Name and Address of Project Promoters
2.2 Name and Address of the Local Contact Person
3. Line of manufacture
S.No Item of Description Item Code (ITC/NIC) Installed Capacity Unit Capacity
1
2
3
3.1 Names of the Byproducts:
S.No Item of Description Item Code (ITC/NIC) Output based on Annual Capacity of Main Product Unit of Output
1
2
3
3.2 ROC Registration No
4.0 Estimated Project Cost ( Rs. in Million )
Plant and Machinery
Land
Building
Imported (Landed Cost)
Indigenous
Misc. Assets
Contingencies, etc.,
Others (IDC)
Total
4.1 Means of Finance ( Rs. in Million)
Equity from Promoters:
Domestic
Foreign
 
Loans from Financial Institutions
TIDCO's equity if any
Others (Please Specify)
Total
5.0 Registration (please fill the one applicable)
FIPB / RBI Approval No     
IEM No     
EOU Regn. No     
LOI No     
5.1 Amount of Foreign Investment: (in rupees)
      Foreign Equity (%)		  
5.2 Expected date of commencement of construction:  
5.3 Expected date of commencement of commercial production:  
6.0 Employment
Skilled Labour Supervisory Male
Unskilled Labour Management Female
Total (Direct) (Indirect)   
6.1 Maximum number of workers proposed to be employed in the factory on any one day
6.2 Whether factory will be having any process vessels ? If yes, number of such vessels may be indicated:
6.3 Whether the factory is engaged in Dangerous Operations as indicated under rule 95 of Tamil Nadu Factory Rules 1950 ? (please see enclosed handbook) Yes   No