Government of Tamil Nadu

Department of Industries and Commerce

Entrepreneurs Memorandum for setting up Micro, Small or Medium Enterprise

Form No.2010/33/001/05375/DDNV
ACKNOWLEDGEMENT PART - I
M/S D.NATARAJAN HAS FILED MEMORANDUM EXPRESSING ITS INTENT TO SET UP A MANUFACTURING ENTERPRISE
AT THE ADDRESS 159, SRI BHARATHI NAGAR 2ND STREET ,R.K.PET BLOCK, VELLANORE, AVADI, TIRUVALLUR
TALUK, THIRUVALLUR DISTRICT TAMIL NADU PIN CODE : 600062 FOR THE ITEM/ITEMS INDICATED BELOW AND THE
ACTIVITY IS PROPOSED TO COMMENCE FROM AUG-2011 AS STATED IN FORM NO 2010/33/001/05375/DDNV AND
ALLOCATED ENTREPRENEURS MEMORANDUM NO 2010/33/001/05375/DDNV/E AS BELOW:

Sl.No ITEMS OF MANUFACTURE CAPACITY IN CASE OF MANUFACTURE

1 AGARBATTIES 1000 Numbers

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 YYYY

17 11 2010
DATE OF ISSUE

NATURE OF ACTIVITY 1 MANUFACTURING

(MANUFACTURING-1,SERVICES-2)

CATEGORY OF THE ENTERPRISE

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

3 3 0 0 1 1 1 05375 E PART I
ENTREPRENEURS MEMORANDUM NUMBER

DATE: 17/11/2010
PLACE: Thiruvallur

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, THIRUVALLUR .

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 Application Id : 2010/33/001/05375/DDNV
Application Date : 17-11-2010
1. Name of the Applicant : D.NATARAJAN

2.
(a) Address of Communication

NO. 159 2ND STREET,

SRI BHARATHI NAGAR, VELLANORE, AVADI, THIRUVALLUR DISTRICT, CHENNAI.
PIN Code : 600062
Phone : 09789806609
Mobile : 9092984640
FAX Number :-
EMail : murugan.enter@yahoo.com
WEB Site :-

(b) Permanent Residential Address

NO. 159 2ND STREET,

SRI BHARATHI NAGAR, VELLANORE, AVADI, THIRUVALLUR DISTRICT, CHENNAI
PIN Code : 600062
Phone : 09092984640
Mobile : 9092984640
FAX Number :-
EMail : murugan.enter@yahoo.com
WEB Site :-

3. Name of The Proposed Enterprise (if decided) : D.NATARAJAN

4. Proposed Location of Enterprise

(i). S .F.No / Door No.

: 159

(ii). Street. : SRI BHARATHI NAGAR 2ND STREET

(iii). State : Tamil Nadu

(iv). District : Thiruvallur
(v). Taluk : Tiruvallur
(vi). Rural/Urban : Rural
(vii). Block : R.K.Pet
(viii).Town/Village : VELLANORE, AVADI
(ix). PIN Code : 600062

5. Category of Enterprise : MICRO

6. Nature of Activity : Manufacturing

7. Nature of Operation : Perennial

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8. Whether Unit will be an Ancillary Unit : No

9. Proposed Schedule of Installation of : April - 2011

Plant & Machinery
10. Type of Organisation : Proprietary
11. (a) Main Manufacturing/Service Activity
No Product/ProductCode Item Code Approximate Value
1 AGARBATTIES / 36227 24247 1000 No.

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

Item Owned/Leased/Rented Approximate Value

(i). Land Owned 10

(ii). Building Owned 4
(iii). Plant & Machinery Value 1
(iv). Equipment -
(v). Foreign Equity,If Any -

13. Installed Capacity per annum : 10000 Numbers

14. Power Load (Anticipated) : H.P : - K.W : 1000.00

15. (a). Other Source of Energy

Item Quantity
(b) Reason if no power required THIS IS A HAND MAKE PRODUCT FOR WHICH ANY SOURCE OFEN

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16. Expected Employment

(i). Management & Office Staff 1

(ii). Supervisory 1
(iii). Workers 5
17. Expected Schedule Of Commencement of
Production/Activity : August- 2011

18. Entrepreneurs Profile

(a). Name : D.NATARAJAN
(b). Gender : Male (M) (c). Community : OBC (3)
(d). Knowledge Level : Under Graduate
(e). Equity Participation : 13500 (f). Equity % : 25
(g). Stake in other Manufacturing Enterprises : No
(h). Physically Challenged: Yes
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,1-D,1ST
CROSS C.V.NAIDU ROAD,MANAVALANAGAR,THIRUVALLUR-602002.
(b) Send a certificate/notarized copy of the Partnership Deed/Memorandum of association/Articles of Association to General Manager, District
Industries Centre, Thiruvallur .
(c) In case, self certified copy of the generated application is not received by the General Manager, District Industries Centre, Thiruvallur 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 :2010/33/001/05375/DDNV is true and
correct to the best of my knowledge and belief.

Date :
Place :

[SIGNATURE OF THE APPLICANT / AUTHORISED PERSON]

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