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Application Form for Anti Poverty Programme

ANDHRA PRADESH STATE MINORITIES FINANCE CORPORATION
4-1-825/B, II Floor, Laxmi Estate, Abids Hyderabad-1
(To be filled in duplicate)       Date:

APPLICATION FOR ANTI POVERTY PROGRAMME

 

1. Name of the candidate: .........................................................................................

2. Father’s/Husband’s Name: .........................................................................................

3. Age/Date of birth: .........................................................................................

4. Address: ..........................................................................................................................................

5. Ration Card if any give the particulars: ...............................................................................

6. Trade/Business: .........................................................................................

7. Experience: .........................................................................................

8. Business location/spot: .........................................................................................

9. Qualification if any: .........................................................................................

10. Name of the proposal which you want to take up under Anti Poverty Programme

..........................................................................................................................................

10 (a) Amount required: .........................................................................................

11. Whether the above house is owned: .........................................................................................

If not/how long staying in that address: .........................................................................................

12. Whether obtained any loan earlier: .........................................................................................

If so from which bank/organisation: .........................................................................................

Photo

13. Any other information such as

No. of dependents: .........................................................................................

14. Reference’s of two neighbors

1. .........................................................................................

2. .........................................................................................

Place:

 

Signature of the candidate

ECONOMICALLY BACKWARD CERTIFICATE

Date:

This is to certify that

Sri/Smt/Kum………………………………………………………………………

S/o.,D/o or W/o: …………………………………………………………………………………………..

Resident of: ………………………………………………………………………………………………............................................

.Belongs to Economically Backward Class, His/Her Annual Income is below

……………….........................................................................................

Note:

 

Signature