GOVERNMENT OF GOA
DIRECTORATE OF ANIMAL HUSBANDRY & VETERINARY SERVICES
PASHU SAMVARDHAN BHAWAN PATTO-PANAJI-GOA
(APPLICATION FOR ESTABLISHMENT OF A MODERN DAIRY UNIT CONSISTING OF
MINIMUM TEN MILCH ANIMALS)
1. Name of the Applicant in Block Letters: -
2. Father’s /Husband’s name:-
3. Permanent Address:
a) Ration Card No: -------------------------------------------------
b) House No: -------------------------------------------------
c) Ward / Locality -------------------------------------------------
d) Village / Town: -------------------------------------------------
e) Taluka -------------------------------------------------
f) District -------------------------------------------------
g) Telephone No. -------------------------------------------------
4. Whether employed / unemployed.
Profession and occupation if any
5. Date of Birth / Age
6. Educational / Qualification.
7. Whether by own finance or Bank
loan Name & Address of the Bank.
8. N.O.C. from Village Panchayat/
Municipality whether enclosed
9. Whether the applicant or any member
of his / her family has taken subsidy
earlier for such a unit and under
1 to 10 Milch Animal Scheme. If so
give details.
10. Whether owning any cattle shed
if so give specification/details.
11. Whether for establishment of New
Dairy Project or for Expansion of
existing dairy unit, for purchase
of Equipments for existing dairy unit
and renovation of existing cattle
shed, give details.
12. Form I & XIV to be attached and
N.O.C.from the landowner if
applicant’s name does not figure
on I & XIV Form.
13. Whether willing to executive a
bond as per Scheme pattern and
milch animals(Minimum 10) from
neighbouring State Markets.
14. Whether to complete the Project
within six months period from the
date of approval letter.
15. Survey Site Plan/Plan of the Cattle
Shed to be attached and Address
of the site project.
16. Project report giving the details
such as your requirement/prospects
and Economics of the project
is to be attached.
17. Whether supply of Milk will be
done to the Dairy Co-operative
Society and whether willing to
insure his milch Animals
immediately after purchase.
18. Whether a member of the
Dairy Co-operative Society.
If so, name & address of
the Society. If not whether willing
to become member.
19. Whether the project will be
continued for a minimum
period of 10 years in working
condition.
20. Number and breed of Milch
animals to be purchased and
from where.
21. Whether applicant already
owning C.B.Cows, local
cows she buffaloes, & other
Dairy Animals. If so, mention
their Numbers and year of
purchase. State if any existing
machinery with the applicant.
I, hereby declare that the above information given by me is true to the best of my knowledge and belief. I also assure you that I shall utilized fully the subsidy and loan sanctioned to me, for creating the intended asset, to enable me to carry on my profession /trade, failing which I shall be liable to refund the subsidy and the loan.
Certificate and remarks to be given by the Area Veterinary Officer/Assistant Director with stamp and date by incorporating.
a) The information given above by the farmer is correct.
b) The records of Ear Tagging/ Identification of the existing
Animals is done and are maintained in the Office.
c) Conducted the site inspection of the proposed area and following observations are noticed (if any)
d) After inspection, the proposal found to be healthy, feasible and farmer has not ample land and capacity to establish the Dairy Unit by this own finance/financing Institute.
e) The project report submitted by the farmer is verified and countersigned.
Signature of the Veterinary Officer
Assistant Director with date and
Office stamp.