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package of incentives and concessions under karnataka ...

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I, (full name)...................................................... S/o…………………………………… Managing Director /Director / Proprietor/ Partner <strong>of</strong> M/s............................................……......................................................................................................................................................................……… (Complete address), do hereby solemnly affirm <strong>and</strong> declare that the particulars statedabove in the application are true <strong>and</strong> correct to the best <strong>of</strong> my knowledge, information <strong>and</strong> belief.In case any <strong>of</strong> the Statement / Information furnished in the application or documents are found tobe wrong or incorrect or misleading, I do hereby bind myself <strong>and</strong> my / our unit to pay to theGovernment on dem<strong>and</strong> the full amount received as reimbursement in respect <strong>of</strong> the abovementioned activity, within 7 (Seven) days <strong>of</strong> dem<strong>and</strong> being made to me in writing.Place:Date:Signature <strong>and</strong> Seal(Proprietor/Mg. Partner/Chief Executive)NOTE: Your application for Incentive will be processed only after you complete all the Requirements.For Office UseApplication No:Remarks:121

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