Application Form: MBMA Assistance for Food/Agro Processing Units across Meghalaya

Filled By:*


Nature of Entity*

Registered / Unregistered *


Name*

Gender *

Age *

Registration No. *

Date of Registration:



District:*

Select Urban/Rural
Rural Urban

Select Municipal Board/Town Committee

Block:

Village/Town:

Locality:

Postal Address:*

Name of Key Person (except for sole-propreitorship)

E-mail ID

Mobile Number: *

Activity Undertaken: *

Processing
Packaging
Sorting/Grading
Other,specify
What is your Product :*
Product Sub Product
Where all do you sell your products? *
Within the Village
Within the Block
Within the District
Within Meghalaya
Within India
Outside India

What was the total sales in financial year 2019-20? (in Rupees) *


What kind of support do you require? *

Support for sourcing packaging materials
Support for sourcing machine
Support for quality assesment
Storage
Support for certifications/registration(FSSAI, Organic, GI, etc.)
Others

Specify descriptively what is the support required?*


Please attach copy of FSSAI Certificate or any other registration certificate of your product, if available

Document type allowed (pdf, jpg, jpeg and png only) and max size 500KB



Have you taken any bank loan?*


Name of the Bank:

Principal Amount:

Year of Borrowing:

What purpose was it for?: