SMALL INDUSTRIES DEVELOPMENT BANK OF INDIA Application form for assistance to existing units (for exposure upto Rs. 200 lakh)
I Applicant details Name of the applicant Address for correspondence Constitution of the applicant Status of the applicant (Small / Medium / Service) 5 SSI Registration. No./ SIA Ack.No. 6 Date of Incorporation 7 Date of Commencement of Operations 8 No. of years of experience in similar line of business 9 Past Association with SIDBI (with Existing / New No. of yrs.) 10 Details of restructuring / OTS, etc., if any 11 Details of any external rating obtained (If yes, copy to be enclosed) 1 2 3 4 Registered Office Full Address Rented / Owned /Leased Person(s) Contact Tel No. Fax No. E mail address Factory / Service Establishment (existing) Factory / Service Establishment (proposed)
Name, Address & Tel.No. of the auditor Reg.No. and date of regn. Auditor of the applicant since when
If recently changed, details of previous auditor also to be furnished
Details of Products / Services (Existing and Proposed)
@ Attested photocopies should be attached for all promoters/guarantors.Present.
IV.Valid till. Lakh) Passport No.) . Owned / Rented. Place of PAN Card No. No .. 200 lakh)
Sl.Tel no. Owned / Rented./ mobile no. . enclose copy of certificate III Promoters/Directors Bio-data of all the promoters/directors of the unit (Separate sheets for each promoter/director is required to be furnished) Promoter/Director Name Father's / husband's name Age Qualification Relationship with Chief Promoter Full Residential Address( incl .
Financial Position of applicant unit/ associate concern(s) Past Financial position of the Applicant unit to be given as per Annexure I.
Installed capacity p.Permanent. Date and Place of Whether first generation entrepreneur Experience in similar line of
activity Experience in other line of activity Functional responsibility in the unit
Shareholding in the unit .Existing . . furnish details as above of any other shareholder having more than 5% financial stake in the unit.
Present capacity utilisation
End use of product
Export orientati on Yes/ No
Any quality certification obtained ? If yes.Application form for Loans (for exposures upto Rs.
Pl. residing since Net worth (Rs.a. Original should be shown to SIDBI Officer at the time of submission of this application for the purpose of verification. Brief particulars of all the Associate/Group concerns may be furnished as per Annexure II and brief financials here under :
. Please also submit 2 photographs of all promoters/directors/guarantors alongwith their signature duly certified by a Bank or Gazetted Officer.
value & type of charges created
Fund based Basedkfjdffkld -Term Loan
Outstanding as on ___
-Working Non Fund capital Are there any defaults? Yes/No. 200 lakh)
Networth Y1 Associate concern I Associate concern II . SIDBI a Name of the Bank(s) / FI(s). if any Asset Classification Furnish the above details for all the existing Banks / FIs. Y2 Y3 Y1
Net Sales Y2 Y3
Existing Facilities with Banks /FIs incl.
VI. give details Details of expected incremental qualitative / quantitative benefits Schedule of Implementation and Expected month/year of implementation No..1. 1
Project Details Purpose for which assistance now required : Purpose Indicate whether it is for Expansion /diversification / modernisation /technology upgradation and details thereof If new products envisaged.year before Y2
V. lakh) facility (bankwise)
Rate of interest (% p.Last FY. of employees .Application form for Loans (for exposures upto Rs. Details.)
Nature of Security . lakh) Net profit Y1 Y2 Y3
Y1 .(s) c Dealing since (each Bank / FI)
Facilities enjoyed : Nature of Amount (Rs. no. b Dealing person and contact tel.a.year before Y1. copies of latest sanction letters of other banks/FIs may be attached. Also.existing
2 3 4 5
. Branch. 6.. Y3 . Y2 .
Location. No. basis of cost estimation.
.etc. No 1 Details Land and site development Civil Works Plant & Machinery (incl. Lakh) Total
* Basis of Internal accrual to be indicated. Cost of Project S. type.2.) # Attached attested photocopies of applicable documents. & Pre-operative expenses /Others
Details of Land (Area.3. 1 2 3 4 Details Additional (share) capital Internal accruals* Interest free Unsecured Loans Term Loan proposed from SIDBI Raised (as on________) (Rs.Application form for Loans (for exposures upto Rs. 6. Lakh) Total Amount
* Details of Plant & machinery and Misc. amount and arrangements proposed may be indicated. fixed Contingency provision. if any ** Prel.construction cost. Assessment of Working Capital to be furnished at Annexure V.4 Whether additional Working Capital required for the unit. Means of Finance S. If yes. 6. 200 lakh)
No. installation) * -Indigenous -Imported assets Misc. and Pre operative Expenses Margin money for working capital Others TOTAL Incurred (as on ________) (Rs.additional 6. fixed assets at Annexure IV & IVA ** Furnish the basis of contigencies provision / Prel. floor. No. Acquisition cost & date) # Details of civil construction (Area. Freehold / lease hold / unexpired lease. Please also attach of
Chartered Accountant cerfitied recent net worth statement of all promoters/directors/guarantors as per SIDBI’s format. of employees . owned by.
1 2 3 Item Technology used Any Technical collaboration? If yes. status thereof. direct sales. retail network. sources and distance) Power
Connected Load Utilised load Requirement of power for Additional machines Back-up arrangement (DG)
Other critical inputs if any
6. Marketing & Selling Arrangements Applicants remarks
Items Main Markets (Locations) Names of five major customers accounting for bulk sales during last FY (Indicate clearly if the unit is relying on a single buyer).7
the Board. Please attach a copy of
6.5 6. No.9 6.Application form for Loans (for exposures upto Rs. details of main technical professionals Details employed
latest No Objection Certificate /consent letter obtained from Pollution Control
6. if any Locational advantages Indicate competitors Any USP or specific market strength Whether product has multiple applications Distribution channels ( e.10
Projected profitability : Statement to be enclosed as per Annexure VI. Technology S. New target customers.8
Raw material / Labour/ Utilities
Raw material (Details.g. arrangement. Pollution control measures. etc.6
Statutory Approvals required for the project. 200 lakh)
Types of effluents generated. distribution network )
product/ service differentiation. none
of our promoters/partners/proprietor/directors/managers/employees/guarantors and/or any of their relative(s) is/are Director(s) in SIDBI or any of the Scheduled Banks/FIs and/or related to any Senior Officer(s) of SIDBI. If polluting. I/we have no borrowing arrangements for the unit with any bank/FI except as indicated in the application. there are no overdues/statutory dues/government enquiry/proceedings/prosecution against the unit/associate/group concerns/promoters/directors/partners/proprietor except as indicated in the application. I/We
confirm that none of our units/associates/group concerns/promoters/directors /partners/ proprietor has / have defaulted to any bank/FI. Details of Collateral security offered and value (basis).
. pollution control measures taken Whether the project is entitled for any govt. if any.Application form for Loans (for exposures upto Rs. [copies of title deed(s) and valuation report(s) of a recent date should be attached] List of guarantors for the proposed loan Enclose documents as indicated in the check list at Annexure VII. Orders on hand (enclose copies)
e. Category as per pollution control dept. infrastructure facilities. technical expertise. tax exemptions.12 Brief Highlights of the applicant / project (such as market standing. etc. d.11
Items Please indicate the various licenses / consents for the project / unit already obtained from the respective authorities Please indicate licenses / consents for the project / unit that are yet to be obtained.) DECLARATION I/We hereby certify that : a. if any. c. Details thereof Repayment period (in months) sought including repayment holiday requested. all information furnished by me/ us above and appendix/annexures/statements and other papers enclosed are true. 6. in the
b. subsidy. no legal action has been/is being taken against the unit/associate/group concerns/promoters/directors/partners/proprietor.
f. Firm Tie up. 200 lakh)
Marketing team details.
I/We shall furnish all other information that may be required by SIDBI in connection with my/our application for financial assistance. I/We have no objection to SIDBI furnishing the information submitted by me/us to any agency as you may deem fit in connection with consideration of my/our application for financial assistance.Application form for Loans (for exposures upto Rs.
Encl : As above Place : Date : Signature Name & Designation (Rubber Stamp)
. I/We have no objection to SIDBI/its representatives making necessary enquiries/verifications while considering my/our application for financial assistance.
Brief Past Financials of the Applicant
Particulrs Net Sales or Income Profit after Tax (PAT) Gross Cash Accruals Net Profit Margin(NPM) Working Capital (Current Assets .Current Liabilities) Networth Secured Debt
Y1 . Y3 . Y2 .Application form for Loans (for exposures upto Rs.year before Y2
.year before Y1.Last FY.
.(s) 4 Dealing since 5 Sanctioned limit(s) & Outstanding amt. 200 lakh)
Details of Associate /Group Concerns
Name & address of the concern Constitution Existing since Product(s) Share holding of the main promoter(s) of applicant unit (Names of the promoter directors may be attached) Total paid-up share capital Please attach audited financial statements of each of the Associate/Group concern for the last 3 years.
Rate of Interest
Fund based Limit -Term Loan -Working capital Non Fund Based 6 Details of security offered and value 7 Asset Classification 8 Details of restructuring /OTS.Application form for Loans (for exposures upto Rs. if any.
Annexure III Credit Track record of the Associate Concerns
1 Name 2 Name & Address of existing Banker (s) 3 Dealing person and contact tel. no.
and postal address Lead time for deliver y of machin ery Invoice price (for indigenou s machiner y) / CIF price (for imported ) (Rs. after sale service etc. lakh)
Purpose/ use of MFA
. Also enclose Chartered Engineer's certificate regarding residual value and life in respect of second hand machinery.
Furnish competitive quotations. contact person. indicate the need / reasons for acquiring such machinery. catalogues / invoice for each machinery proposed to be acquired In case of second hand /fabricated machinery.No. 200 lakh)
Annexure IV Particulars of machinery proposed for the project
Name of machiner y. (model / specificat ion) Name of manufactur er. lakh) Purpose /use of machine Basis of selectio n of supplier Remark s reg. Assets / equipment Proposed
S. e-mail address telephone no.
Annexure IV A Details of Misc.Application form for Loans (for exposures upto Rs. Name of item
Name and Address of the Supplier
lakh) Current Year Estimates Next year Projections
4 5 6
.Application form for Loans (for exposures upto Rs. 200 lakh)
Annexure V Assessment of Working Capital
ASSESSMENT OF WORKING CAPITAL REQUIREMENTS AS PER NAYAK COMMITTEE (TURNOVER METHOD) Sl. No 1 2 3 Particulars Gross Projected Sales Working Capital Requirement (@ 25 % of Gross Projected Sales) Minimum stipulated Margin Money for Working Capital (@ 5 % of Gross Projected Sales) Actual/ projected net working capital (liquid surplus) Net Working Capital (3 or 4 whichever is higher) Permissible Bank Borrowing (2 .5) (Rs.
.Application form for Loans (for exposures upto Rs........................ Interest and taxes (PBDIT) (2 ........7) Tax Profit after Tax [PAT] (8 .... 4.. 3........5 ..................................... .........6 ................................N o.......................
Annexure VI A Profitability projections for the Unit / Company as a whole*
S.............4 ........................................... ......1) Interest on Term Loan Interest on Working Capital Interest on unsecured loans Depreciation Profit before Tax [PBT](3 ... .. 1 Item Net Income from operations Net Income from other sources Total Income 2 Raw materials Power and fuel Wages and salaries Selling expenses Other expenses Total Cost 3 4 5 6 7 8 9 10 11 12 13 14 Profit before depreciation....................................... 2.......................................9) Dividends/ Withdrawals Gross Cash Accruals ( 10 11 + 7) Repayments of all term liabilities (Principal) Debt Service Coverage Ratio [DSCR] ((10+7+4)/ Actuals for previous Y1 Y2 ............................ 200 lakh)
Annexure VI Assumptions underlying the Profitability Projections 1...... .....
Average DSCR (Total of 10+7+4 for projected period/(Total of 13+4 for projected period)
* Please give projections for the entire tenure of SIDBI loan.Application form for Loans (for exposures upto Rs. ** Furnish the basis of Net Income from operations & Net income from other sources
Details of similar guarantee. 1 SSI Regn. Documents No. fixed assets proposed to be acquired under the scheme 10 Duly signed CA certified latest net worth statements of promoters/directors & guarantors in SIDBI format. / SIA Ack No. Father's/Husband's name. In case of guarantors please furnish. given to other institutions 11 2 sets of photographs along with signatures of all promoters/directors/guarant ors duly certified by a Bank or Gazetted Officer. residential address. 200 lakh)
Annexure VII CHECK LIST of documents to be submitted along with the application
S.Application form for Loans (for exposures upto Rs. or CA certificate certifying SSI/MSI status copies of 2 Certified Memorandum & Articles of association / Partnership Deed 3 Audited financial results for the last three years of Applicant unit 4 Copies of lease deed / sale deed of primary land 5 Copies of latest sanction letters from commercial banks / FIs which have sanctioned assistance to the unit 6 NOC from pollution control board/consent letter. Age. Name. Y/N Reasons for Non-submission
. if applicable Returns/Assessment 7 IT orders/Sales tax returns of the Applicant Unit/ promoters/directors for 2 years 8 List of existing plant and machinery 9 Competitive quotations for machines and Misc. if any.
13 Copy of title deed of collateral security and valuation report as of a recent date
. 200 lakh)
12 Audited financial results for
last three years for each associate concerns.Application form for Loans (for exposures upto Rs. if applicable.