FORM – D

ANDAMAN AND NICOBAR ADMINISTRATION

DIRECTORATE OF AGRICULTURE

 

Sub: Application for Pumpset on Cash-cum-Subsidy basis under the Minor Irrigation Scheme – regarding,

1.

Name of the applicant (in Block Letter)

:

2.

Father’s/Husband’s name of the applicant

:

3.

Village and full postal address.

:

 

4.

Approximate annual income from all sources.

:

5.

Agriculture land owned by the farmer (in ha.)

:

6.

Type of pumpset required.

:

i. ˝ HP Electric pumpset.

:

ii. 1 HP electric pumpset.

:

iii.5 HP Diesel pumpset.

:

iv. Any other (please specify)

     (strike out which is not applicable)

:

7.

Type of water sources available

:

i. Pond

:

ii.Well

:

iii.Stream

:

iv.Any other (please specify)

:

8.

Recommendation of Agriculture Demonstrator of area concerned.

:

9.

Recommendation of Agriculture Inspector of the area concerned.

:

10.

Recommendation of Panchayat Pradhan

:

11.

Recommendation of Zilla Parishad.

:

12.

Recommendation of zonal Agriculture Officer.

:

13.

Recommendation of Assistant Engineer (MI), Directorate of Agriculture.

:

14.

Approval of the Director of Agriculture.

:

 

 

 

Place :

Date :

 

 

Signature of the Applicant