Specimen Application Form for Letter of Intent / Registration for IT parks

DIRECTORATE OF INDUSTRIES

INFORMATION TECHNOLOGY BRANCH

Application for Letter of Intent for proposed Private IT Park/Registration of Existing IT Park/Conversion of Letter of Intent to Registration of Private IT Park. (To be submitted along with application fee of Rs.1000/- by way of RBI Chalan. Copy of the challan should be enclosed along with application)
  1. Name of applicant Company etc. with full address.

(2) Whether Pvt. Ltd./Public Ltd. Company/Partnership Firm /Cooperative Society/Trust

(Please enclose registration certificate)

(3) Name of IT Park

  1. Location (i) Survey Nos./Plot Nos.

(ii) Village/Town/City

(iii) Taluka/Dist.

(iv) Total Area

(v) Area under ownership

(vi) Area under Lease

Please enclose copies of conveyance /title deed/7/12 Extract/Property Card/Lease deed etc.

(5) Whether N.A. Permission is issued by Collector concerned for Information Technology Park

(6) Whether located in permissible Zone /Regional Plan/Development Plan (Enclose Zone Confirmation Certificate from Municipal Corporation/Municipal Council/Town Planning Department/ Other concerned local authority)

(7) Whether ULC Exemption U/S 20 of ULC Act is obtained from D.I. (Please enclose copy) (where applicable).

(8) Whether issued Letter Of Intent/ Registration as Private IT Park earlier by Directorate of Industries.(if so, please enclose copy)

(9) Whether NOC under Industrial Location Policy was issued by Directorate of Industries in the past. If so, please mention No. & Date.

(10) Details of Built up area to be constructed/constructed in the following format duly certified by Chartered Architect.

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Total area

Built up area for IT units

Open Plot area for IT units

Built up area for support services

Open Plot area for support services

Parking

space area.
           

(11) Whether Plan is approved by MMC/Collector concerned/CIDCO/ TMC/KMC/Other local Authority.

(12) Whether Intimation of disapproval (IOD)/CC/Occupation Certificate issued by the authorities mentioned at Sr.No.11.

(13) Details of Connectivity in MBPS/KBPS provided/proposed to be provided.

(14) Details of power feeder line/substation provided/proposed to be provided.

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(16) Declaration:-

I hereby declare that all the information in support of the above information/ particulars given by me in the above form are true and correct to the best of my knowledge and belief. I, further undertake to use and ensure the use of the premises (including land and built up area) of the Information Technology Park exclusively for Information Technology units and support services and infrastructure.

 

Place: Name & Signature of applicant.

Date: