I/We ____________________son/daughter/wife/widow of ____________resident of _____________________________ do hereby solemnly affirm and declare as under:-
1. that I/We have submitted an application dated __________ for permanent registration of the unit as small scale/ancillary/tiny/export oriented unit/Small Scale Service and Business enterprise.
2. that I/We am/are proprietor(s)/partner(s)/Managing Director of the unit whose name and address is given below:-



3. that all particulars furnished in the application form are factual and correct.
4. that the location of the unit does not violate any locational restrictions for the time being in force and that I/we have obtained the necessary locational clearances from the competent authority.
5. that I/we have obtained all the statutory clearances/No Objection Certificates/permission required to carry out the manufacture/activity under the prevalent laws, regulations and rules in force.
6. that I/We have also obtained the necessary registration/licence, wherever required, under the relevant laws, rules or orders, for the time being in force, for carrying out the said industrial activity.
7. that the unit does not require an industrial licence because:

a) the unit employs less than 50/100 workers with/without use of power.

b) the items proposed to be manufactured are reserved for exclusive production in the small scale industries sector.

c) the unit does not manufacture any item which is included in Schedule-II of Notification No. S. O 477 (E) dated 25.7.1991 and is not reserved for exclusive manufacture in the SSI sector as included in Schedule-III of the above notification.

8. That the original value of investment in plant and machinery installed at the unit is within the limits prescribed for tiny/SSI/SSSBE/ancillary/export oriented unit as per existing provisions.
9. That the units not owned or controlled or a subsidiary or any other industrial undertaking in terms of the Notification No. S.O. 2 (E) dated. 1.1.93.
10. That I/We undertake to inform the registering authority within 30 days of the crossing of the investment limits in plant and machinery and submit the registration certificate for cancellation of registration or deletion of relevant endorsements as ancillary/EOU/tiny enterprise/Small Scale Service and Business Enterprise.
11. That I/We understand that if at a future date the said unit does not satisfy any of the conditions laid down in the notification No. S.O.232 (E) dt. 2.4.91, or does not comply with any of the conditions or restrictions for the time being in force, or includes manufacture items that require an industrial licence, then is such an eventuality, I/We shall be liable and required to surrender our registration as a SSI unit.
12. That I/We undertake to inform the Directorate of Industries/Registering authority immediately in case a situation arises as mentioned at para 11 above.
13. That I/We undertake to inform and to keep informed the Directorate of Industries/Registering Authority on all parameters and changes, if any, as required from time to time.

14. That I/We undertake to refund to the Central or State Government any or all financial incentives or benefits given under various schemes of assistance for small scale industries alongwith 18% interest, as may be demanded by the appropriate authority of Central/State Govt, in case it is found that the information or particulars submitted to obtain registration were wrong and fraudulent.
15. That I/We fully understand that we have to comply with the above conditions failing which we are liable for action by the Registering authority for cancellation of the Registration as well as under other relevant provisions of the laws and rules in force.


Verified that the contents of the affidavit are true to the best of my knowledge and belief.





(*Note) Strike out whichever is not applicable.