THE ASSAM GAZETTE, EXTRAORDINARY, JANUARY 12, 2023

FORM-IX

[ See rule 8(A)(ii), (vi) and 9(1)(a) ]

FORM OF APPLICATION FOR ISSUE OF REGISTRATION CERTIFICATE TO ESTABLISH/RELOCATE/EXPAND/OPERATE THE SECONDARY WOOD BASED INDUSTRIES (Other than Agarwood Based Industrial Units)

Photo

To,

The Divisional Forest Officer,
{{ $secondaryWbiMaster->division->name }}Division)

Sir,

I/We Shri {{ $secondaryWbiMaster->name }} (in block letters) son of {{ $secondaryWbiMaster->father_name }} inhabitant(s) of {{ $secondaryWbiMaster->permanent_address }} (address to be given in details) under {{ $secondaryWbiMaster->secondaryWbiUnitDetails->district->name }} Police Station, District {{ $secondaryWbiMaster->secondaryWbiUnitDetails->district->name }} By profession , do hereby apply for Grant of Registration Certificate to establish/expand/operate the wood based industries as mentioned below using {{ $secondaryWbiMaster->secondaryWbiMachineMasterDetail->expected_raw_material }} as raw materials.
The particulars of the wood - based industry are given herein below:

1. APPLICANT DETAILS:

  1. Name of the Applicant (Block Capitals)
    (Owener, Partner, Director etc.)
    		2. : {{ $secondaryWbiMaster->name }}
  2. Father's Name
    		3. : {{ $secondaryWbiMaster->father_name }}
  3. Aadhaar Card No. (copy attached)
    		4. : {{ $secondaryWbiMaster->aadhar }}
  4. Pan Card No. (copy attached)
    		5. : {{ $secondaryWbiMaster->pan }}
  5. GST No. (if any)
    		6. : {{ $secondaryWbiMaster->gst }}
  6. Postal Address
    		7. : {{ $secondaryWbiMaster->postal_address }}
  7. Permanent Home Address
    		8. : {{ $secondaryWbiMaster->permanent_address }}
  8. Mobile No.
    		9. : {{ $secondaryWbiMaster->mobile }}
  9. Email ID
    		10. : {{ $secondaryWbiMaster->email }}

2. TYPE AND CATEGORY OF THE PROPOSED UNIT TO BE SET UP: (Tick Mark)

    @if($secondaryWbiMaster->secondaryWbiUnitDetails->processing_manufacturing_unit == 1)
  1. Processing/Manufacturing Unit
    2. @endif @if($secondaryWbiMaster->secondaryWbiUnitDetails->furniture_unit == 1)
  2. Furniture Unit
    3. @endif @if($secondaryWbiMaster->secondaryWbiUnitDetails->commercial_shop == 1)
  3. Commercial Shop
    4. @endif @if($secondaryWbiMaster->secondaryWbiUnitDetails->other == 1)
  4. Others (specify)
  5. Other Remarks {{ $secondaryWbiMaster->secondaryWbiUnitDetails->other_desc }}
    6. @endif

3. DETAILS OF THE PROPOSED UNIT:

  1. Name of the Secondary Wood Based Industry
    		2. : {{ $secondaryWbiMaster->secondaryWbiUnitDetails->unit_name }}
  2. Location / Address
    		3. : {{ $secondaryWbiMaster->secondaryWbiUnitDetails->unit_address }}
  3. GPS co-ordination of the boundary
    		4. : {{ $secondaryWbiMaster->secondaryWbiUnitDetails->gps_coordinates_boundary }}
  4. Forest Range/Division
    		5. : {{ $secondaryWbiMaster->secondaryWbiUnitDetails->division->name }}
  5. District
    		6. : {{ $secondaryWbiMaster->secondaryWbiUnitDetails->district->name }}
  6. Name of the Industrial estate
    		7. : {{ $secondaryWbiMaster->secondaryWbiUnitDetails->name_of_industrial_estate }}
  7. Registration No. of the unit in Commerce &
    Industries Department (if already registered)
    		8. : {{ $secondaryWbiMaster->secondaryWbiUnitDetails && $secondaryWbiMaster->secondaryWbiUnitDetails->registration_no ? $secondaryWbiMaster->secondaryWbiUnitDetails->registration_no : "" }}
  8. Whether the unit is functioning or not
    If yes, since when it was functioning.
    		9. : {{ $secondaryWbiMaster->secondaryWbiUnitDetails && $secondaryWbiMaster->secondaryWbiUnitDetails->unit_functioning ? "YES" : "NO" }}
  9. Name of the new location in case of relocation along with GPS co-ordination.
    		10. : {{ $secondaryWbiMaster->secondaryWbiUnitDetails && $secondaryWbiMaster->secondaryWbiUnitDetails->relocation_name ? $secondaryWbiMaster->secondaryWbiUnitDetails->relocation_name : "" }} - {{ $secondaryWbiMaster->secondaryWbiUnitDetails && $secondaryWbiMaster->secondaryWbiUnitDetails->gps_coordinates ? $secondaryWbiMaster->secondaryWbiUnitDetails->gps_coordinates : "" }}
  10. Reason for relocating the wood based industry
    		11. : {{ $secondaryWbiMaster->secondaryWbiUnitDetails && $secondaryWbiMaster->secondaryWbiUnitDetails->reason_for_relocation ? $secondaryWbiMaster->secondaryWbiUnitDetails->reason_for_relocation : "" }}

4. Nature of ownership (document to be attached) (Tick mark whichever is applicable)-

    {{ $secondaryWbiMaster->Industry_type }}

5. Details of machinery to be installed

SL. No. Type of machines with specification size With or without trolley Size of Specification Horse Power Number Installed capacity in cu.mt. (annual)
1 Horizontal band saw
2 Vertical band saw
3 Circular saw
4 Peeling machine Match stick
5 Making machine Other (specify)
6. Total Capital Value of the unit : {{ $secondaryWbiMaster->secondaryWbiMachineMasterDetail && $secondaryWbiMaster->secondaryWbiMachineMasterDetail->total_capital_value ? $secondaryWbiMaster->secondaryWbiMachineMasterDetail->total_capital_value : "" }}
7. Rated capacity (volume of timber etc.) per year in cu.mt. : {{ $secondaryWbiMaster->secondaryWbiMachineMasterDetail && $secondaryWbiMaster->secondaryWbiMachineMasterDetail->rated_capacity ? $secondaryWbiMaster->secondaryWbiMachineMasterDetail->rated_capacity : "" }}
8. Expected source/sources of raw materials : {{ $secondaryWbiMaster->secondaryWbiMachineMasterDetail && $secondaryWbiMaster->secondaryWbiMachineMasterDetail->expected_raw_material ? $secondaryWbiMaster->secondaryWbiMachineMasterDetail->expected_raw_material : "" }}

9. Employement

  1. Strength of regular employees
    		2. : {{ $secondaryWbiMaster->secondaryWbiMachineMasterDetail && $secondaryWbiMaster->secondaryWbiMachineMasterDetail->employed_man_power ? $secondaryWbiMaster->secondaryWbiMachineMasterDetail->employed_man_power : "" }}
  2. Strength of daily workers
    		3. : {{ $secondaryWbiMaster->secondaryWbiMachineMasterDetail && $secondaryWbiMaster->secondaryWbiMachineMasterDetail->daily_workers ? $secondaryWbiMaster->secondaryWbiMachineMasterDetail->daily_workers : "" }}
10. Whether the applicant is involved in any Criminal/forest/wildlife offence cases : {{ $secondaryWbiMaster->secondaryWbiMachineMasterDetail && $secondaryWbiMaster->secondaryWbiMachineMasterDetail->previous_offence ? $secondaryWbiMaster->secondaryWbiMachineMasterDetail->previous_offence : "" }}
11. Whether the applicant possessing any other Wood Based Industry in the State, if yes, details thereof : {{ $secondaryWbiMaster->secondaryWbiMachineMasterDetail && $secondaryWbiMaster->secondaryWbiMachineMasterDetail->previous_wbi_industry ? $secondaryWbiMaster->secondaryWbiMachineMasterDetail->previous_wbi_industry : "" }}
12. Whether the Registration fee is attached, if so, No. and date of the challan : {{ $secondaryWbiMaster->secondaryWbiMachineMasterDetail && $secondaryWbiMaster->secondaryWbiMachineMasterDetail->license_fee_paid ? "YES" : "NO" }}

Documents to be enclosed (Tick mark whichever is applicable)-

  1. Registration Certificate of the Firm/Soociety/Partnership or Company, as applicable
  2. Registration Certificate of the unit in Industry Department.
  3. No Objection Certificate from Pollution Control Board.
  4. Document showing ownership / allotment of land.
  5. Copy of Receipt of application fee.
  6. Location map of the unit showing the approach road.

I hereby declare that the information provided above is true and that if found false subsequently, my application for Licence may be rejected.

I also undertake the I will abide by the terms and conditions of the Licence and relevant rules, guidelines and instructions issued by the Government, Principal Chief Conservator of Forest and the quthorized officer from time to time and that I will not violate the provisions of the Assam Wood Based Industries (Establishment and Regulations) Rules, 2022.

Place:

Date:

Yours faithfully,

{{ $secondaryWbiMaster->name }}

Signature(s) of the applicant(s).