Online Consent Management System
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  1. Industry Details
  2. Occupier Details
Industry Name:
(max 50 characters)
Industry Type:*
Industry Status: *
(select current status)
Commissioning Month/Year:
Industry OR HCE Registration/ License No.:                    (registration.Date )             (reg.address max 40 char )
Capital Investment of Plant & Machinery:*
(in Lakhs)
Total Investment(Fixed Assets + Current Assets - Current Liabilities):
(in Lakhs)
Industry Address:*
Plot No./Khesra NO./ Revenue SurveyNo:
 (enter plot number)
Name of Mauza:  (enter Mauza Name)
Khata no.:  (enter khata number)
Place:  (enter village/city of industry locality)
Post Office:  (enter Post Office Name)
District:*  (select district)
Block / Tehsil:*
 (enter industry Block)
Pin :  (enter PIN of industry address)
Phone Number: (STD Code - Number)
Fax No. With Code : (STD Code - Number)
E-Mail Address : e.g.
Shifts in Industry :
Whether industry premises declared as prohibited Area:
Working Seasons per year :
From To
Expected Date of Production :*
No. of workers attending factory per day :*
No. of persons residing in premises:*
Whether Cess Paying : NO YES
Occupier Name:* (maximum 50 chars)
Designation: : (designation of occupant)
Address :* (address, max 100 chars)
Village/City: (village/city of address)
(write district)
Post Office:
Pin:* (PIN of occupant address)
Phone No. With Code: (STD Code - Number)
Fax No. With Code : (STD Code - Number)
Mobile No:* (occupant mobile no)
E-Mail Address:*
Status of Applicant:
Name, Address and Telephone of the Chairman/Managing Director/Managing Partner/Owner/Board of Director List (Full Time or Part Time) Other Kinds or Office Bearers are to be Furnished with their Period of Tenures in the Respective Office * :
Period Of Tenures:-25/01/2005 To 21/06/2009
Hint Question:*
(select question)
Your Answer:* (answer of hint question)
Click to generate Password:* Click here to generate password
Generated Password:* This is one time password
Document, if any:
(.pdf,.jpg,.jpeg,.gif max of 2MB in size)
Do you want to send login Credential in mail? yes no (Click Yes to email registration details)
  Fields marked * are mandatory