SGD Setting Up of New Factory

Tea Development & Promotion Scheme
Component: Small Growers Development

Sub Component: Setting up of New Tea Factory –
Micro/Mini/Big factories
APPLICATION FORM
Sl Particulars
No.
1 Name of the Small Tea Garden/
SHG in Block Letters
1A Name of Owner/ Secretary/
President of the SHG
1B Identification card number issued
by Tea Board for individual
applicant for micro/ Mini Tea
Factory
1C Registration certificate from
register of societies in case of
SHGs applied for Mini Factory
1D Details of Grower members of
SHGs along with command area
and copies of Identification card
issued by Tea Board
2 Mailing address with PIN Code
2A E-Mail ID
2B Telephone & Mobile Number
3 Name & address of the proposed
manufacturing Unit
3A Registration no. Under Tea
Marketing Control Order.2003
(for new factories by self help
group a copy or proof of the
application to the Licensing
authority of the Board to be
enclosed)
3B Details of the Ownership of the
land where tea factory proposed
to be set up
4 Status of the applicant Small Tea Growers/ SHG of STGs
4A Type of factory( Strike out Micro tea Factory / Mini / Big Tea Factory
whichever is not applicable)
4B Type of tea to be produced ( Black ( CTC/Orthodox)/ Green/

Strike out whichever is not White/Oolong/Speciality tea such as hand rolled
applicable) tea/Organic
4C Annual capacity of Production in
Kgs
4D Plinth area( in Sq Ft)
5 Plantation Details
5A Area under Tea in Ha.
5B Quantity of Green leaf produced Yr1 Yr2 Yr3
in last three years in KGs
5C Name of the planting materials
( Name of Seeds and Clone)
5D Average maximum leaf harvested

in a day during peak season
6 List of Machinery applied for No Area (in sqft) Amount(Rs.)
Total
For civil work*
Activity Plinth area in Value (Total in Name and

sqft RS) address of
the
registered
govt
contractor
Total
Grand Total
*Please attach plan and
estimate duly attested by
Civil Engineer for civil work

6B Amount of Subsidy applied for
40% of total amount
7 State the source of mobilization of Financial institutes/own (Please tick mark

fund for which subsidy has been source of funding)
applied for.
8 Any other additional information
the application wish to inform
9 Aadhar number of applicant

10 Bank A/c Details. A. Bank Name
B. IFSC code No.
C. Branch Name
D. Bank Account No.
11 Please state if any of the applied
items are proposed to be
imported under the Export
Promotion Capital Goods Import
(EPCG) scheme Please submit a
declaration .
12 In case any SHG / Cooperative of SHGs set up organic Tea factory, then
following details of organic certification may be furnished.
(i) The name and complete
address of the Organization to
whom applied for with date
(ii) Expected time of obtaining

certification
(iii) Training details with cost
(a) Financial involvement for

certification
(b) Cost for training
(c) Cost for auditing by the

certifying agency
(d) Total expenditure incurred

for acquiring certificate
DECLARATION
I/We hereby declare that the above mentioned particulars are true to the best of my/our
knowledge and also declare that I/We will strictly abide by the terms and conditions laid
down in the Scheme.
Signature -------------------------------- -
Name ----------------------------------------
Designation --------------------------------
Full Address ------------------------------
Documents to be submitted along with the application:
1. Duly filled in application in the prescribed format and signed by the

authorized signatory with seal & date.
2. Photocopy of the certificate regarding Registration of the garden with Tea
Board. Land document (title deeds) or possession certificate issued by
land revenue department in support of ownership of Tea Garden. Copy of
the Identification card issued by Tea Board(if available).
3. Registration certificate from register of societies in case of SHGs applied for Mini
Factory.
4. A Detail list of Grower members of SHGs along with command area and copies of
Identification card issued by Tea Board
5. A copy of the letter addressed to the Controller of Licensing requesting for TMCO
registration.
6. A declaration by the applicant that the applied items are not covered
under the EPCG (Export Promotion Capital Goods) Import scheme.
7. A declaration by the applicant SHG that they will comply with the plant
protect code (PPC) guidelines
8. in case of individual applicant, a declaration obtained from the Boards
Development Officer that the applicant is following the PPC guidelines.
9. Original current quotation of the supplier for the applied items
10. Site/ layout plan for the factory, machineries, Details Project report
including source of funding, marketing plan etc.
11. A certificate in the SHGs letter head that all the applicant members of the
SHGs will be following the safety standards in the factory. They shall also
certify that they are complying with the provisions of the relevant labour
laws and there will be no outstanding dues exceeding Rs. 10000/- on
account of workers’ wages or any other statutory dues.
LETTER OF UNDRTAKING
(On Non Judicial Stamp Paper of Rs. 20/- or appropriate value)
(For setting up of New Tea Factory-Micro/Mini/Big factories)
To,
Tea Board
Sub : Small Growers Development - for setting up of New Tea Factory-

Micro/Mini/Big factories
A/C. in respect of -----------------------TF
Dear Sir,
In continuation of Tea Board having sanctioned a subsidy of Rs.

(Rupees only) for setting up of New Tea
Factory-Micro/Mini/Big factories and as detailed hereunder in first schedule in favour
of Tea Factory, we do hereby agree to maintain
the machinery in good condition already procured and installed in our factory in the
manner envisaged under the scheme and on the terms and conditions hereinafter
mentioned.
1. To observe, fulfill, and perform all the terms and conditions laid down in
the TD&PS Component, Small Growers Development for setting up of
New Tea Factory-Micro/Mini/Big factories.
2. Not to sell and/or transfer the tea garden/factory and the machinery
purchased under the scheme without prior written consent of the Tea
Board.
3. I/We agree to sign such documents/papers all undertaking as may be
required by Tea Board from time to time.
4. I/We also hereby undertake to pay the green leaf price to the supplier of
green leaf to our factory in accordance with the price sharing formula
notified by the District level green leaf price Monitoring Committee.
5. I/We hereby undertake to submit the monthly return in regard to tea
manufactured and price realized during each month and also the yearly
statement of the scheme.
6. In the event of breach of any of the aforesaid undertaking or the terms and
conditions under the factory up-gradation scheme, Tea Board at its option
will be entitled to call for immediately all amount paid as subsidy with
interest thereon at the rate of 12% per annum and we undertake to pay the
same within 10 days from the date of demand as per the payment made
by the Tea Board for the items of machinery procured and civil work
undertaken by us under TD&PS Component, Small Growers Development
- for setting up of New Tea Factory-Micro/Mini/Big factories.
(Details of machinery to be procured with accessories and civil work, if any)
Description of the machinery Name of the supplier
Signature of Authorized Signatory
Seal of the Factory/estate & Date.

SGD Setting Up of New Factory

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Tea Development & Promotion Scheme

Component: Small Growers Development

4B Type of tea to be produced ( Black ( CTC/Orthodox)/ Green/

5D Average maximum leaf harvested

6 List of Machinery applied for No Area (in sqft) Amount(Rs.)

Activity Plinth area in Value (Total in Name and

*Please attach plan and

estimate duly attested by

Civil Engineer for civil work

7 State the source of mobilization of Financial institutes/own (Please tick mark

9 Aadhar number of applicant

(ii) Expected time of obtaining

(iii) Training details with cost

(a) Financial involvement for

(b) Cost for training

(c) Cost for auditing by the

(d) Total expenditure incurred

Full Address ------------------------------

Documents to be submitted along with the application:

1. Duly filled in application in the prescribed format and signed by the

Sub : Small Growers Development - for setting up of New Tea Factory-

A/C. in respect of -----------------------TF

In continuation of Tea Board having sanctioned a subsidy of Rs.

(Details of machinery to be procured with accessories and civil work, if any)

Description of the machinery Name of the supplier

Signature of Authorized Signatory

Seal of the Factory/estate & Date.

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