Document text
Farmer: [FULL NAME]
Father’s / mother’s name: [NAME]
Village, district, state: [VILLAGE], [DISTRICT], [STATE]
Land: [ACRES] acres, survey / khasra no. [NUMBER] — [OWNER / TENANT / SHARECROPPER]
Crop and season: [CROP], [RABI / KHARIF] [YEAR]
Sowing date: [DATE]
1. Soil Health Card
Nutrient Rating on my card General dose, kg/ha My dose, kg/ha
Nitrogen (N) [LOW / MEDIUM / HIGH] [KG] [KG]
Phosphorus (P₂O₅) [LOW / MEDIUM / HIGH] [KG] [KG]
Potassium (K₂O) [LOW / MEDIUM / HIGH] [KG] [KG]
Card number: [SOIL HEALTH CARD NUMBER] · Date of testing: [DATE]
2. Fertilizer for my land
Fertilizer kg per acre kg for my land Bags Cost
DAP (18-46-0), 50 kg bags [KG] [KG] [BAGS] ₹[AMOUNT]
Urea (46 % N), 45 kg bags [KG] [KG] [BAGS] ₹[AMOUNT]
MOP (60 % K₂O), 50 kg bags [KG] [KG] [BAGS] ₹[AMOUNT]
Total ₹[TOTAL]
Low on the card: +25 % over the general dose; high: −25 %; medium: the general dose.
3. Application for a Kisan Credit Card
To: The Branch Manager, [BANK NAME], [BRANCH]
Date: [DD MONTH YYYY]
Subject: Application for a Kisan Credit Card (KCC) for crop cultivation
Dear Sir / Madam,
I, [FULL NAME], resident of [VILLAGE], apply for a Kisan Credit Card for the cultivation of [CROP] on [ACRES] acres of land, survey / khasra no. [NUMBER], which I cultivate as [OWNER / TENANT / SHARECROPPER].
Amount
Scale of finance for the crop (district), per acre ₹[AMOUNT]
× area, acres [ACRES]
+ 10 % post-harvest and household needs ₹[AMOUNT]
+ 20 % repairs and maintenance of farm assets ₹[AMOUNT]
+ crop insurance premium ₹[AMOUNT]
Limit I request for the first year ₹[AMOUNT]
I declare that I have no other Kisan Credit Card and no outstanding crop loan for the same land. I attach:
[ ] Land record (or tenancy certificate / certificate from the local administration)
[ ] Soil Health Card (copy)
[ ] Proof of identity and address (KYC) as the bank asks
[ ] Declaration of the crops I plan this season
[ ] Consent if the insurance premium is to be paid from the KCC account
I request you to sanction the KCC limit. I will use it for crop cultivation and repay it as per the bank’s terms.
Signature: ____________________
Name: [FULL NAME] · Mobile: [MOBILE] · Bank account: [ACCOUNT NO.]
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