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APPLICATION TO AVAIL SUBSIDY FOR SHADENET BY FARMERS

1. Name of the beneficiary 2. Fathers/Husbands Name 3. Address of the beneficiary in full 4. Location of the Garden a) Village b) Mandal c) District 5. Survey No. 6. Category of farmer SC/ST/BC/OC SF/MF/BF : : No. of Plants Age 7. Total extent owned by the farmer with existing crops 8. Horticulture crops proposed for Shadenet Crop Area (Hec.) : : : : : : : :

9. Whether any Bank loan is proposed to be taken. If so name and address of the bank 10. Any other information.

: :

Place: Date: SIGNATURE OF BENEFICIARY

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