Basic Information on Proposal for Allotment of Land

Fields marked with (^*) are mandatory

Name of the Company ^*

Contact Person Name ^*

Phone No

Mobile No. ^*

E-mail ID ^*

Fax

Address of Registered office / Head office ^*

Project (Sector) ^*

Brief description of Project

Proposed Investment ^*

Proposed Employment

Direct

Indirect

Area ^*

Industrial Park ^*

Power ^*

Water ^*

Security Code ^*