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    © All Rights Reserved
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    10 views23 pages

    Sample Application Form of MLI - Upto 2 Crore

    Uploaded by

    Yugant Sonawane

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 23
    oS Matauri ten PNB-1016/2013 Micro, Small and Medium Enterprises Application Form for Credit Facilities of over Rs. 1 Crore & Upto Rs.2 Crore for Manufacturing Sector 71 | Name of the Unit (In block letters) 12 | Constitution |¥ | Proprietary | Partnership | Pvt Ltd. | Ltd. Company ‘Co-op society ‘ey Os 7.3 [Name of the Business house/ group (if any) 2.1 | Registration No. {as given by the District Industies Centre / Directorate of Industries) 2.2 | Dato of Incorporation / Commencement of Business 2.3] State ily where joan Distict is required Branch where loan is required 2.4 | Whether applicant belongs + |f@SCISTIOBCIMinoity ~ {¥ | sc | st | ogc | minority | General Community etc. 3. Business Address with Tolophone No. 31_| Registered Office 3.2 | Administrative Office 33 | Factory Address 3.4, Telephone Nos. Mobile No. PAN No, Email 1D 4. Ni ‘of the Propri Pai Prom¢ (Please furnish Information for each porson as per the Annexure ee EE ee eer OO eee eee eee OO 5. Brief Description of the Industrial Activity 51 | Existing 5.2 | Proposed 6. How the Activity was financed so far: (to be filled up in case of existing unit only) Repayment | Present O/s | Amount ‘Source of Funds (*) Security Rate of | permonth | (in 000s of | of Int Rs.) | Default (any) (*) (indicate sources of funds with name & address, e. . banks! financial institutions/others (specify) 7. Past Performance: (To be filed up in case of existing unit only) Indicate in 000s of Rs.) Parlours Tast Year ast but one Wear Tast bul Two years: Tumover Net Profit Retained Profit Monthly Turnover of last twelve months Month “Amt, 8, Arrears In Statutory Payments (if any) Particulars ‘Amount Since when (period) Tncome Tax | VAT Tax Provident Fund Employees State {tnsurance Corporation ‘Others (specify) a 9, | Ifthe Unit is an ancillary unit, the undertaking/Parent Company to which it Is catering and Its address 10. Details of the associate/aliod concern(s), if any (Attach soparate sheet, If required), 10.1. Name of association and amount invested: 10.2 Nature of activity 10.3 Items taded/ manufactured: 104 Tumover and profit during preceding three years: 44. Employment Present Proposed Executives ‘Supervisory Administrativey Office Staff Skilled Labour ‘Unskilled Labour 12, TECHNICAL FEASIBILITY 12.1 Name of the Product(s), including bye-products & its (their) use: Jia Atanufacturing Procoss, in brief. (Indicate to the extent possibie, stage-wise capacity data, yield /conversion data, material flow, etc.) 12.3 Capacity (No. of Units Quantity in Kg. / Volume in iter per annum) Capacity for each product Licensed Thatalled ‘Operating No. of working days in a month —— & No. of shifts in a day. 12.4. Locational advantages of existing and/or proposed premises with reference to I) Absence of civic restrictions. li) Proximity to the source of raw materials, iil) Market for the product, Availability of iv) a) Power by Water ©) Labour a) Transport ¥) whether clearence has been obtained from the Pollution control authority: 12.5 LAND & BUILDING: ‘AreaiPlinth Area {in 99. meters) Value (in. 0005 of Rs.) Exising [Proposed Existing Proposed Factory Land Factory Building Andilary Building ‘Open Storage Space 12.6 Type of soil and load bearing capacity (enclose test report) Enclose: a) cerified Xerox copy of sale [Tease deed 'b) Certified Xerox copy of the Govt. order conve ‘applicable ©) Location map 4) Cerlfied Xerox copy ofthe site plan of the land and blueprints of the buildings duly approved by ‘corporalion / municipality / panchayat. 19 the land into Industrial land, if 12.7 PARTICULARS OF MACHINERY AND OTHER FIXED ASSETS (As per Annexure Il) 12.8 _ Necessity & purpose for the proposed investment / addition to factory premises/machinery (in case where such investment is intended) for achievement of the anticipated turnover, 12.9, RAW MATERIALS / COMPONENTS (Please mention about the imported and indigenous items separately) ‘Name/ Brief Description of the tems: (A) (8) (cy (D) Name of raw material ‘Quantity Required ‘Sources of supply Minimum Purchase Guantily Lead? Procurement Time ‘Available throughout the year answer to the above iso, then no. of months & period when itis available (Enclose copies proforma invoice in respect of each Hem, iravailable) 13, UTILITIES {Give comments on requirement. avallabllityladequacy, qualitative aspects, 13.1 Power: Contracted Load Connected Load Future power consumplion (in no, of units) per month Stand-by Arrangements (Enclose certified Xerox copy of sanction for power connection) 13.2. Water (Enclose certified Xerox copy of sanction for water connection) 13.3. Fuel 13.4 Others (specify) 44, QUALITY CONTROL 444 etait of arrangements made for ually conto, ( BIS/FPOISO specications are flowed no. of BISIFPOMSO Standards end the particulars thereof should be provided. 14,2. Parliculars of R&D activity proposed 45. ECONOMIC FEASIBILITY (Merketing (mention separately for each product) 45.1 Whether the product is reserved exclusively for SSI sector: Perec eee reece ae 15.2 Name of Major customers: 15.3 Region /Area where the product is/ll be sold: 45.4 Extent of competition & No. of Units engaged in similar line in the area: 45.5 How does the units mee¥/proposes to mest tho competition {Comment on the competitive advantages enjoyed by the unit) 41554 In price, and quality, how does the units Product compare with those of is ‘competitors. 15.52 _Is the unit selling direct to its customers? If 50, please fumish dotails like sales force, showrooms, depots elc. 18.5.3 Ifa selling/distribution agency had been appointed, its name, Period of contract, omission payable, period by which the bill will be paid by itetc {Enclose copies of agreement, wherever such agreement has been entered into) 15.6 Nature and volume of orders/ enquiries on hand ( certified Xerox copies to be furnished ) 15.7 _ Ifthe Unitis export oriented, please furnish exporter code no, if allotted, and relevant details ‘as per the following details in the preceding three years:- Code No. ‘Name of the Product Exported | Name of the Country where Exported | F.0B. value in US$ 16 Costof Protect (Ploase furnish estimates of cost of project under the following heads. Indicate the basis for arriving at the cost of project) (In 000s of Rs.) Sr. No Particulars ‘Already Tobe Total cost incurred Incurred %_ | Cand including development B_ | Building & other Civil Works © | Plant & Machinery 4) Indigenous 2) Imported D__| Essential Tools, Spares and Accessories E _| Testing Equipment F | Miscellaneous Fixed Assets G__ | Erection/instaiiation Charges [Preliminary Expenses T | Pre-operative Expenses J [Provision for Contingencies 7)Bulldings 2)Plant & Machinery 3)0ther Fixed Assets K | Margin for Working Capital Required /L] Total of sources of finance for meeting the cost under the following heads) (in 000s of Rs.) Stn. Particulars Anount Aready | Amount Proposed [~ Total Ee a Raised to bo Ralsed | Capital (6pecify resources contributing capital) B [Reserves | Ferm Loans: (give full particulars) D | Unsecured Loans, and deposits — {indicate sources, rate of interest, repayment period etc.) E— | Doferred Payment Arrangements Including Supplier's Credit F | Subsidy Central Govt. State Govt. | Seed capital (indicate sources) 1 internal cash Accruals T | Other Sources (specify) J [Total 474 incase intomal accruals are taken as source of finance explain the basis for estimation of intemal accruals by means of statement, 172. Tneiealo sources from which expenditure already Tnourred has been financed 40 47.3 Promoters contribution tothe project as ofthe foal {Please furnish list of personstinms who would os ‘contributing to the promoter’s share of the etal and the respective amounts ard their elationshiPs) 18. Schedule of Implementation: Sched Fale the progress made 20 far inthe implementation of ne project and furnish the Schedule of implementation as follows: Dale of Saavenanen¢oeecame a) | Acquisition of Land ip) | Development of Land ©) | Civil works for Factory Building ‘Machinery Foundation ‘Administrative Building @) | Plant & Machinery Imported Indigenous @) | Arrangement for power 1) [ Arrangement for water 4) | Erection of equipment hh) | Commissioning 1) | ntl Procurement of Raw Material | Trial Runs 1) | Commercial Production 19 — Euture Projections, (To be given for the next three years) Please furnish data on 49.1. Projected profitability as per Annexure I 49.2 Projected cash flow statement as per Annexure IV 49.3 Projected Balance Sheet as per Annexure V 49.4 Working Capital Requirement Annexure VI " 49,8 Percentage of Cash Sales in Total Sales % Period in which payment is recelvad in respect of credit sales days ‘Average credit available on purchases days 20 Financial Assistance Required: 30.1 | Rupes Loan 202 | Foreign Currency Loan 203 | Term Loan 30.4 | Working Capital (as worked out in Annexure VI) 205 | Non-Fund Based Limits, of assistance {E.g. L/Cs, Bank Guarantees, etc.) ‘Other Forms 24. Repayment Programme: 22 Details of Securities to be offered: 22.4 Primary (Working capital and torm loan secures to be indicated separately) 22.2 Collateral, ifany (full details) 22.3 Detalls of guarantor(s) (Attach separate sheet, if required) 22.3.1 Name 22.3.2 PAN No. [ee 22.8.3 Aadhar Card No. 22.3.4 Residential Address 22.3.6 Telephone/Mobile No, 22.36 Email 1D LC 7 22.3.7 Occupation (tin service, name & address of his/her employer) 12 22.38 Details of Movable & Immovable Property (ies) Owned by hinvher & other dependent family members 22.3.9 Details of any similar guarantee, if any, given to other institutions: 23. Whether any Government enquiry, proceedings or prosecution has beon instituted against the unit or its proprietoripartners/directors for any offence? If so, please give details. 24. Details of pending litigation, if any, against and by the unit. 26. Please indicate whether the proprietor/any of the partners/ promoters! directors have at any time declared themselves as insolvent. If so, give details thereof. {We certify that all information furnished by me/us it true; that !We have no borrowing arrangements for the unit with any Bank except as indicated in the application that there is no overdues/statutory ‘dues against melus/promoter except as indicated in the application ; that Ve shall furnish all other information that may be required by you in connection with my four application that this may also be exchanged by you with any agency you may deem fit and you, your representatives, representatives of the Reserve Bank of India or any other agency as authorized by you, may, at any time, inspectverity my/our assets, books of accounts, etc., in our factory/business premises as given above. Date: Place: ‘Signature of the Borrower(s)/Applicant(s) Encl: Original/Certified Xerox Coples of indicative documents as per the check list. 13 Annexure ~ Details of Proprietor/Partners/Managing ParineriPromoters/Directors/Managing | SPACE FOR THE Director PHOTO (Please indicate inter-relationship. if any, among the partnorsidirectors/promoters) (Please use separate sheet for each person) Signature- | Name - T | FullName 2 [Name of the Father/Husband ~ 3 [Age a | Sex | Whether belongs to Scheduled Castes / Scheduled Tribes / Yes No Minority Community. | Are You an Ex-service man Yes No 7 [WWPreor | [Pasenort | Voter Monty Card PAN Card Driving Licence ‘Radhaar Card Identity Card ‘Job Card |_| ID Proof No. i [ &. _ | Address Proof Eieciridly Bil | Telephone Bill Bank Account Statement of any other bank \ [Teter from Telfer from recognized public authority | Ration card reputed employer | verifying the address of the customer to the satisfaction of the bank ‘Address Proof No/Details He tH J — [Address Office: {| Telephone NoJMobile No. @ | Emaiio 70 | Permanent Residence | [Academic Qualification T1_| Experience: Years Employer Designation Last Salary Drawn 14 72_ | Functional Responsibiliies in the unit 73._ | CapitaliLoan Contribution in the unit ‘ithe Beginning ‘At present 14 _ | Reasons for joining/ establishing the unit (Please mention about the motivating factors ) 15, If associated as proprietor/partneridirector! shareholder with concoms other than the applicant unit, please furnish foliowing details separately for each conoem by way of enclosure 16.1 | Name and address of the branch/associatessidentical concern 162 | Aciwily of the concem 763 | Functional responsibiity in that ‘concern 754 | CapitaLoan Contibition 755 | Name of the assodate concen's Banker and their address 156 | Aggregate credil faciliies enjoyed bythe concer 15:7 | Security offered by the concem forts borrowing 168 | Working resuits of the unit for the past three years 76. Personal Assols and Liabillies : 16.1 Immovable property details ike landibuildings, Location, date of acquisition, cost, present value etc. 16.2 Other Assets 16.3 Personal Llabiities, irany, (including guarantees/acceptances given) 17. 15 Place: Date: Land of Existing Signature Annexure! Location ‘Area Whether Freehold or Leasehold Purchase Price of Land if owned Rentin case of Leased land ‘Terms of Lease Ground Rent payable per year B. Bullding 7 Location Whether Owned or Leased Purchase price of Building if owmed Ront in case of Leased/Rented Premises Terms of Lease Sructure Type of Structure {indicate “Pit Permanent) Dimensions ‘rea (in Sq. m) ‘Fetwal Cost (in Rs.) Dale of Erection 1) Workshop 2) Godown 3) Administrative 4) Other Buildings, In case the assets have been revalued or written up at any time during the existence of unit, furnish Full details of such revaluation together with the reason therefore. 16 Ings Pro nstructed Type | Bultup Area (in meters) | Tolal_ | Rale of [Estimated] Expected Serial | Desoription of | _ of Floor in | Construction | Cost of | Date of No. | Each Bulding | Const sq.m. | per each | Completion ruc ‘°° TCengih | Breadth | Average bes tidasel astuaud Height Note: 1. in case contract is awarded for construction of building, fumish details thereof such as name of Contractor, amount of contract, ete. 2. Other approvals from inspector of factories, drug Controllers, otc, if any, should be enclosed 3. Please enclose a plan showing layout of machinery. Particulars of Machinery , | Name of Machinery | Second | Name of Daie of | Expected | Invoice Eslimated —] Total No. | and Specification | Hand/ | Manufacturer? | Acquisition’ | Date of | price ‘expenses ola | Cost New | Fabricator Date of | Delivery | including | OF insurance (place of Placement Taxes for | freight County and | of order Indigenous | Installation, Origin, if (ectual’ Machinery! | Import Imported) cexpocted) CIF Duty For Imported Machinery T_| Existing Machinery “indigenous [—[4aimported Z| Proposed tobe acquired 2indigenous Zaimported ‘Quotation / Catalogues / Invoice and olher deta in respect of each machine to be furnished. 2. If seoond had machinery, valuation report regarding age, performance and value from competent valuor to be submitted. Also please indicate reasons for going In for second hand machinery and its dopreciated valuo, 3. Incase of imporled machinery, please indicate mode of payment and price of the machinery in foreign currency. 7 4. Incase the assets have been revalued or writen up at any time during the existence of unt, furnish ful

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