01. Name of the Principal Investigator/Chief Promoter: Address:

Educational Qualifications: Area of Expertise:

02. Names & Details of other Investigators/Promoters: Add Investigators/Promoters

01. Name of Organisation: 02. Whether Proprietory/Partnership/Pvt. Ltd./Public Ltd. Co.: 03. Contact Person(s): 04. Address of Regd. Office:

06. Company's Bank(s) & Address: 07. Name(s) & Addresses Of Partners/Directors: 08. Last 3 Years Turnover (in lakhs): 09. Gross Profit (in lakhs): 10. Net Profit (in lakhs): 11. Details Of Business

01. Name/Type of the Product to be developed: 02. Description of the Technology: 03. Initial Investment in terms of plant & machinery (in lakhs): 04. What do you propose to do in the incubation facility:

05. Novelty of the Process/Product: 06. Marketability/Need of the Product/Role in Societal Advancement: 07. Summary of the Business Plan and Strength & Weakness Analysis: 08. Licenses & Tie-ups/Technical Know-how/Collaborator/Buy-back or Sales Agreement:

01. Laboratory Space (in sq feet) with Justification: 02. Specialized/Other Equipment that you will Bring: 03. Utilities Required:

04. Equipment of the Facility that you would use: 05. Manpower Proposed to be Employed: 06. Proposed Period of Incubation: