Directorate of Agriculture
Government of Goa
Goa
______________________________________________________________
Application to avail Government assistance under
Coconut/Arecanut/Cashew/Paddy/Support Price
(Please apply separately for each crop)
Serial No. __________ Year 20_ _ - _ _
Zonal Agriculture Office ________
Shri/Smt/Kum……………………
Street …………………………….
Ward ……………Village……….
Post ……………..Taluka………
Name of the Bank/Branch with
A/c No.………………………………..
………………………………………..
Mobile /Tel No……………………….
Date: …………………………………
To,
The Zonal Agriculture Officer,
_________________________
Sub: - Application to avail Government assistance under
Coconut/Arecanut/Cashew/Paddy/Support Price
Sir / Madam,
I state that I am a bonafide……………………………………………….cultivator,
cultivating my property as mentioned under:
1. Location of the field………………………………2. Survey No.……………….
3. Village ………………………………………4. Waddo………………………..
5. Area……………………………….6. Taluka…………………………………..
7. No. of bearing trees (except paddy)…………………………………………….
8. Category....General /Women /SC /ST /SF /MF
(Attach certificate from Competent Authority for ST/ SC farmers)
I wish to avail “Support Price” for Coconut /Arecanut /Cashew nut/ Paddy for the
quantities sold by me during the ……………….. month of ……………..year.
The details are given below:
Sr.
No.
Agency sold Bill No. Date Quantity
(Nos/kg)
Amount
(Rs)
1
2
3
4
5
6
It is kindly requested to provide me the necessary Support Price.
Yours faithfully,
Signature
(Full name in capitals)
The following documents shall be submitted to your office.
1. Cash bill towards sale of produce.
2. Land index if needed.
3. Copy of ration card or EPIC (Electoral Photo Identity Card).
4. Xerox copy of first page of the Bank passbook.
5. Processing fee of Rs. 10/-.