Small Farmers Welfare Fund

Transcription

1 Ministry of Agro Industry and Food Security Small Farmers Welfare Fund Application Form: /18 1. Applicant NIC No: 1.3 Surname: 1.4 Forename: 1.5 Address: Phone No: 1.7 Mobile No: Type of Agricultural Activities: SN Type of Operator Certificate Required Tick accordingly 1 Bio Farming Bio Farming Certificate from Ministry of Agro Industry and Food Security 2 Maurigap Maurigap Certification 3 Intention to indulge in bio farming Letter from Food and Agricultural Research and Extension Institute (FAREI)/Ministry of Agro Industry and Food Security (MOA) certifying the planter s intention to indulge into bio farming

2 2.0 Declaration I am hereby applying for subsidy under the Bio Farming Support Scheme 2017/18 for the above products, fields and acreage. I declare and warrant that the above information provided by me in every respect is true and correct and I have not withheld any information likely to affect the acceptance of this application. I have also been informed that the subsidy that will be provided to me will be calculated on the types of products up to a maximum of five (5) arpents, provided I submit all relevant land tenure documents and other documents e.g Bio certificate from a recognised body, Maurigap certificate from FAREI or letter from the FAREI certifying that I have the intention to/am conducting bio farming. I have also been informed that necessary technical advice should be sought from the Food and Agricultural Research and Extension Institute (FAREI) for the utilization and application of the products on my field/s. I have been made aware that the subsidy is being provided on a first come first serve basis depending on the availability of the product from the supplier and therefore the completion of this application form does not necessarily warrant that the product will be made available to me. I have also been informed that one (1) application of bio fertilizer and seven (7) applications of bio pesticide would be provided as subsidy for a maximum of Rs 1830 per arpent per crop cycle for a maximum of three crop cycles. This Application Form together with the Annexure/s A, B &/or C shall constitute the full set of the said Application Form. 2.1 Signature of Applicant : 2.2 Date: / / 2.3 Registering Officer:. 2.4 Date:../ /. 2.5 Signature of Registration Officer:.. For Small Farmers Welfare Fund Use as per contract: Contract/Lease Agreement Submitted for :. Yes No Verified by:. ( Officer) Bio Farming Certificate from Ministry of Agro Industry and Food Security Signature: Date:. Checked by:. (Technical Officer/Program Welfare Officer) Signature: Maurigap Certification Letter from Food and Agricultural Research and Extension Institute (FAREI)/Ministry of Agro Industry and Food Security (MOA) certifying the planter s intention to indulge into bio farming Date:. SFWF/371/2

3 Application Form: /18/A Annex I Crop Cycle: I 3. Crop ion Plan 3.1 From: To: 3.2 Field Location: 3.3 Number of arpents under cultivation:. (s) / Price Grand 3.4 Applicant: Signature of Applicant : 3.6 Date: / /

4 Application Form: /18/B Annex II Crop Cycle: II 4. Crop ion Plan 4.1 From: To: 4.2 Field Location: 4.3 Number of arpents under cultivation:. (s) / Price Grand 4.4 Applicant: Signature of Applicant : 4.6 Date: / /

5 Application Form: /18/C Annex III Crop Cycle: III 5. Crop ion Plan 5.1 From: To: 5.2 Field Location: 5.3 Number of arpents under cultivation:. (s) / Price Grand 5.4 Applicant: Signature of Applicant : 5.6 Date: / /