What is Annexure I ?
>>Annexure I is the actual Application Form for Yuvasree. In this form you need to fill your Employment Registration no - [eg. EB20xxxxxxxxxxxx], Personal Details - [Name, father's Name, Address etc], Bank Details [Bank Branch Name (eg. State Bank of India - Jalpaiguri Branch, Code - 12345) , Bank IFSC (eg. SBIN0012345), Bank MICR (eg. 123456789)], Decleration : Decleration of statement.
Form Sample >>>
ANNEXURE-I
APPLICATION FOR UNEMPLOYMENT ASSISTANCE UNDER THE “YUVA UTSAHA PRAKALPA-2013” SCHEME
1. Name of the Applicant (in Capital letters):
2. Enrolment Number in Employment Bank:
3. Whether Unemployed till date : YES/NO
(Certificate from a Group –A Officer to be attached)
4. Name of the Head of Family (in Capital letters):
5. Postal Address with PIN :
6. Date of Birth:
7. Ration Card/Voter’s Identity Card Number:
(Attested photocopy to be submitted)
8. Bank Account Details (To be opened in any nationalized banks, preferably S.B.I)
i) Name of the Bank branch:
ii) Account Number :
iii) IFSC code :
iv) MICR code :
9. Whether received financial assistance in any Government sponsored Self-Employment scheme in the past : YES/NO.
11. Whether any other member of his/her family has applied for Unemployment Assistance under this scheme : YES/NO
12. Declaration: The information provided by the undersigned here above are true and I shall be liable for the penal action that may be taken up by the Government in case any of these information is proved to be false subsequently. I shall forthwith inform the Employment Bank authority/ the SDO concerned in case I cease to conform to the eligibility criteria of the scheme in the interim period.
(Full Signature of the Applicant)
______________________________________________________________________________
______________________________________________________________________________
For official Use only
The application of Sri/Smt……………………………………….bearing Enrolment No. ...……………for Unemployment Assistance under this scheme has been verified and the same is being sanctioned subject to further verification of his/her eligibility from time to time.
Date:
(Signature with seal)
Sub-Divisional Officer …….........………. /
Joint Director of Employment, Kolkata
Joint Director of Employment, Kolkata