DEPARTMENT OF TOURISM

                                                                                            GOVERNMENT OF KERALA

PARK VIEW, THIRUVANANTHAPURAM- 695 033.

APPLICATION FOR THE SUBSIDY ON ELECRICITY CHARGE FOR

                                                                                                     TOURISM UNITS

                                                                                               (For New Units/Expansion)  

1.  Name and address of the Applicant                       :

 2.   Type of Unit                                                       :

3.    Order No. and date of Classification/ Approval

        from Department of Tourism.                              :

        ( Attach copy of order )                                     

 4.   Date of Commencement of Commercial

       Operation.                                                           :

5.   Date of effect of the Classification/Approval          :

6.   Category of electric connection ( HT/LT )              :

7.   Period for which concessional  tariff is already

       availed from K.S.E.B                                            :

       ( Attach certificate from K.S.E.B)

8.   Period for which subsidy is already claimed

      from Department of Tourism.                                  :

9.   Total period for which subsidy is already

       claimed by the unit in months/year ( 7+8 )              :

10.  Period for which subsidy is now claimed                :

11.  Amount of electricity charges paid during the

       period mentioned in Item 10                                  :

       ( Attach copies  receipt from K.S.E.B )               

12.  Amount of subsidy claimed                                    :

       ( Attach certificate from K.S.E.B on the

          amount to be reimbursed)                                 

            I have read the rules and conditions of the Subsidy on Electricity Charges on Tourism Units and undertake to abide by them.  I also certify that all above facts are true to the best of my knowledge and belief.

                                                                                                                                           Signature of the applicant,

Place :                                                                                                                          For and on behalf of the applicant unit

Date  :