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The form records applicant and enterprise details including address in Odisha (Bhubaneswar), communication information, enterprise type and nature of activity, registered office particulars, organization ownership, and owner share details. It also captures project cost and financing, proposed commencement dates, employment table by category, and the primary activity as repairing, servicing, and maintenance of hardware items, with validity acknowledgement notes and legal disclaimer.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/ein-application-form-entrepreneure-memorandum-number-part-i/305433/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/ein-application-form-entrepreneure-memorandum-number-part-i/305433.png","ImageObject",442,249,{"name":88,"@type":89},"wps_ap_test_251126_0180","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-14","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",8,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What is the purpose of this EIN application form?","Question",{"text":109,"@type":110},"It documents and acknowledges a self-declaration memorandum submitted with intent to set up a service enterprise under the entrepreneur identification system.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What primary activity is listed for the enterprise?",{"text":114,"@type":110},"The primary activity is repairing, servicing, and maintenance of hardware items.",{"name":116,"@type":107,"acceptedAnswer":117},"What legal disclaimer is included with the acknowledgement?",{"text":118,"@type":110},"The acknowledgement does not bestow any legal right, and the enterprise must obtain required clearances, licenses, or permits under applicable laws.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},305433,1790484648,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":76,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":9},8796095027276,"https://avatar.qwps.com/avatar/d3BzX2FwX3Rlc3RfMjUxMTI2XzAxODA=","EIN APPLICATION FORM  \n1. (i) ENTREPRENEURE MEMORANDUM NUMBER(PART I)  \n(ii) Date of Issue  \n(iii) Validity  \n2. Designation Proprietor  \n3. Name of Applicant SAROJ KUMAR ROUT  \nPLOT NO-17/579/19/4115,OLD PLOT NO-17/579/19/4115,OLD  \nSTATION BAZAR,P.O- STATION BAZAR,P.O-  \n4. (i) Address of Communication (i) Permanent Residential Address  \nBUDDHESWARI BUDDHESWARI  \nCOLONY,BHUBANESWAR COLONY,BHUBANESWAR  \n(ii) PIN Code 751006 (ii) PIN Code 751006  \n(iii) Telephone Number (iii) Telephone Number  \n(iv) Fax Number (iv) Fax Number  \n(v) Cellphone Number 9438579880 (v) Cellphone Number 9438579880  \n(vi) E-Mail [saroj.rout@rediffmail.com](saroj.rout@rediffmail.com) (vi) E-Mail [saroj.rout@rediffmail.com](saroj.rout@rediffmail.com)  \n(vii) WebSite (vii) WebSite  \n5. Name of Enterprise SANJUKTA INFOTECH  \n6. Type of Enterprise SMALL  \n7. Activity Nature SERVICE  \n8. Enterprise Address  \n(i) State ODISHA (ii) RIC/DIC BHUBANESWAR  \n(iii) District KHORDHA (iv) Block BHUBANESWAR MC  \nMANCHESWAR INDUSTRIAL  \n(v) Address (vi) Area URBAN ESTATE,BHUBANESWAR  \n(vii) PIN Code 751010 (viii) Mobile 9438579880  \n(ix) Telephone No (x) Fax Number  \n(xi) Email [saroj.rout@rediffmail.com](saroj.rout@rediffmail.com) (xii) Website  \n9. Registered Office Address  \n(i) State ODISHA (ii) District KHORDHA  \n(iii) Address MANCHESWAR INDUSTRIAL ESTATE,BHUBANESWAR  \n(iv) PIN Code 751010 (v) Mobile 9438579880  \n(vi) Telephone No (vii) Fax Number  \n(viii) Email [saroj.rout@rediffmail.com](saroj.rout@rediffmail.com) (ix) Website  \n10. Type of Organisation PROPRIETARY  \n11. Owner Details  \n\n| SlNo | Owner Name | Gender | Category | Date of Birth | %age of Share | Technical Qualification |\n| --- | --- | --- | --- | --- | --- | --- |\n| 1 | SAROJ KUMAR ROUT | M | GE | 01-07-1983 | 100 | PG DIPLOMA IN COMPUTER HARDWARE AND NETWORKING |\n\n12. Project Cost & Finance  \n(i) Fixed Capital 3431000.00  \n(iii) Self Finance 1098000.00  \n13. Investment  \n14. Proposed Date of commencement of Production  \n15. Employment  \n(ii) Working Capital  \n(iv) Borrowed Finance 1618000.00 12-12-2017  \n67000.00 2400000.00  \n\n| Employment Type | General | SC | ST | Other | TOTAL |\n| --- | --- | --- | --- | --- | --- |\n\n\n|  |  | Male | Female | Male | Female | Male | Female | Male | Female |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| Technical\u003Cbr>(Supervisory+Skilled) |  | 6 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 7 |\n| Non-Technical (Supervisory+Skilled) |  | 2 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2 |\n| Local Employee | 9 |  | PH Person |  | 0 |  | Total Women |  | 1 |  |\n\n16. Main Category of Product  \n17. (i) Power Requirement  \n18. Date of Commencement of Service  \n19. Item of Service with Capacity  \nYES  \nREPAIRING AND SERVICING AND MA  \n(ii) Annual  \nRequirement(KW) 12-12-2017  \n8  \n\n| SlNo | Name of Service | Quantity | Unit | Value (Rs. ) |\n| --- | --- | --- | --- | --- |\n| 1 | REPAIRING AND SERVICING AND MAINTENANCE OF HARDWARE ITEMS | 15000.00 | No | 5880000.00 |\n\nPlace : BHUBANESWAR Signature  \nOFFICE OF THE GENERAL MANAGER  \nDISTRICT INDUSTRIES CENTRE, BHUBANESWAR, ODISHA  \nEntrepreneur Identification Number  \n1. M/s. SANJUKTA INFOTECH Proprietor SAROJ KUMAR ROUT has filed the Self Declaration Memorandum with an intent to set up a Service Enterprise is acknowledged by the RIC / DIC BHUBANESWAR as given below:  \n2. PRIMARY ACTIVITY 1. REPAIRING AND SERVICING AND MAINTENANCE OF HARDWARE ITEMS  \n3. ENTREPRENEUR IDENTIFICATION NUMBER : 0 1 7 2 2 0 0 3 2 1 First three boxes are for RIC/DIC code, fourth and fifth boxes are for category of enterprise (fourth box for indicating manufacturing or service and fifth box for indicating micro or small or medium) and last five boxes indicating serial number.  \n4. Date of Acknowledgement  \n5. Valid up to (3 years)  \n\n| 1 | 7 | - | 0 | 4 | - | 2 | 0 | 1 | 7 |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n\nD  \nD  \n-  \nM  \nM  \n-  \nY  \nY  \nY  \nY  \n\n| 1 | 5 | - | 0 | 4 | - | 2 | 0 | 2 | 0 |\n| --- | --- | --- | --- | --- | --- ","cbCaiso2EnCrgfHW","https://ap.wps.com/l/cbCaiso2EnCrgfHW","pdf",20480,"English","# EIN APPLICATION FORM\n## ENTREPRENEURE MEMORANDUM NUMBER (PART I)\n## Applicant and Enterprise Details\n## Owner Details and Enterprise Type\n## Project Cost and Finance\n## Employment Details\n## Primary Activity and Service Items\n## Acknowledgement Information","[{\"question\":\"What is the purpose of this EIN application form?\",\"answer\":\"It documents and acknowledges a self-declaration memorandum submitted with intent to set up a service enterprise under the entrepreneur identification system.\"},{\"question\":\"What primary activity is listed for the enterprise?\",\"answer\":\"The primary activity is repairing, servicing, and maintenance of hardware items.\"},{\"question\":\"What legal disclaimer is included with the acknowledgement?\",\"answer\":\"The acknowledgement does not bestow any legal right, and the enterprise must obtain required clearances, licenses, or permits under applicable laws.\"}]","EIN APPLICATION FORM - ENTREPRENEURE MEMORANDUM NUMBER - PART I | PDF",1789824863]