PROFORMA FOR ID CARD

	Photograph

 

1. Name of the Artisan _______________________________________

 

2.  Father/Spouse  Name _____________________________________

 

3*  Category (Gen/SC/ST/OBC/Minority) Date of Birth _____________Sex : Male/Female

	Signature/Thump impression

 

4.  Address ___________________________________________________________

 

5*.  Edu. Qualification (passed)      Nil/Below 10^th / above  

               

6*.  Crafts Practised                       Carpet & other floor coverings/Art Metalware/woodwares/Hand printed TextilesScarves /

          Embroidered & Crochetted goods/Shawls as artware/Zari & Zari goods/Immitation

          jewellery/Cane & Bamboo./ Misc.  

 

7.  Annual Income with the craft practised (in Rs.)           ________________________

 

8*  Income from other sources :                                         Agriculture/other

 

9*.  Family details: [Family consists of artisan, his/ her spouse & dependent minor children only]

  (i)   Member Name____________________________Age :            Sex  : Male/Female

  (ii)  Member Name____________________________Age :            Sex  : Male/Female

  (iii) Member Name____________________________Age :             Sex  : Male/Female

 

10*. Name of the Unit

       Registered :                                                                      Yes/No

       Registration Number :                                                       _________________________             

       Year of Registration  :                                                       _________________________

       Turnover  :                                                                       Below  1 lakh/1-5 lakhs/ above 5 lakhs

       Status of the unit                                                                Working Unit/Non-Working Unit

       Total Artisans  employed :                                                 ______ (Hired ______  /Household member (self employed)_____)     

 

11*. Sources of working capital:                                        

§   Commercial Bank

§   Others Financial Institutions (Minority Finance Corporation/

     SC/ST Fin. Corpn./Backward Class Fin. Corpn./ SIDBI/NABARD/ ICICI) 

§   Self  

12. Annual requirement of working capital  (in Rs.)          ________________________

 

13*. Channels through which products manufactured are sold :

§   Whole Sellers/Retailer/Traders

§   Sales to Central Corporation (CCIC/HHEC)/Sale to State

§   Corporation/ Apex societies/ Others (Urban Haat/ Dilli Haat

§   Sale in National Expo’s /Craft Bazar/ Exhibitions/ National/ State/

§   Distt.Melas)

§   Export   ( Direct) (in Direct)

 

14*.  Bima Yojana                                                                  Yes/No

 

15*.  Whether holding Credit Card                                     Yes/No

        If yes, specify type                                                           ACC ________/SCC_______ /Other ______

 

16*.   Status  :                                                                        National Awardee/ State Awardee/Shilp Guru /NMC/ SMC/  

                                                                                                Any other (please specify)

 

17*. Whether Artisan is also a  member of

        Producer Organization :                                              Yes/No.

        (if yes, please specify)                                                     SHG/Federation or Association of  SHGs/Producer group/

Others (Co-operative Society Producer Company etc.)

          *  (Please tick the appropriate reply)

             (if more than one option is applicable, then all such options are to be ticked)