DIRECTORATE OF AGRICULTURE, GUJARAT STATE, GANDHINAGAR  

( Developed by : Information Technology Center, AAU, Anand.)

Application form for Enrollment of private Hybrid/Research variety (Part-A)  

1 Name of Company: *
2 COMPANY ADDRESS : * COMPANY ADDRESS
PERMANENT 		GUJARAT ADDRESS
(If company from out state)		 RESEARCH FARM ADDRESS
Plot No./ Street/ Survey No.
Village/City
Taluka/Lane
District/Area
PINCODE
3 Contact Details: * Name of Person: Mobile Number : Email ID:
Password :
4 Name & address of Responsible Person for Company : *
(As per seed license)		 Responsible Person :
Upload Address proof (As per Aadhar card)
(Max 2048 kb) 		(Pdf, Jpeg, Jpg, Png)
5 Seed Sale’s license Details : * License No.:
Valid up to :
Issuing authority: Upload Licence Copy :(Pdf, Jpeg, Jpg, Png)
6 Research Farm Detail : Area (in ha.) :
DSIR No. Yes/No, If Yes, upload Document :
(Upload Valid DSIR Certificate) (Pdf, Jpeg, Jpg, Png)
Own Farm land or Lease?

Please upload document
(7/12 & 8-A / Lease agreement) 		Own Farm On Lease

(Pdf, Jpeg, Jpg, Png)
7 Breeder’s Degree Certificate
(Must be M.Sc. Agri in Plant Breeding & Genetics)
 (Pdf, Jpeg, Jpg, Png)

Signature of Authorized Person:
Stamp:
(Jpeg, Jpg, Png)

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