FORM "A"

COMMON APPLICATION FOR FINANCIAL ASSISTANCE IN RESPECT OF
INDUSTRIAL CONCERNS - WHERE ASSISTANCE BY WAY OF EITHER TERM LOAN OR
WORKING CAPITAL IS ABOVE
Rs. TWO LAKHS UPTO Rs. TEN LAKHS*.

(APPLICABLE TO NEW PROJECTS, EXPANSION, DIVERSIFICATION AND
MODERNISATION OF EXISTING PROJECTS. DOES NOT APPLY TO ONLY
RENEWAL OF EXISTING WORKING CAPITAL FACILITIES)

Date:   



1.

Name of the unit and SSI registration No.
(enclose Xerox copy of the certificate

:

 

 

2.

Constitution

:

 

 

3.

Date of establishment

:

 

 

4.

a)  Registered Office

:

Address Tel.No.

 

5.

Whether the office/factory premises are owned.If rented, on lease. Or on hire purchase, furnish details of rental, lease/hire-purchase period, etc.(enclose xerox copies of supporting document)

:

 

 

6.

product (S) manufactured/proposed to be manufactured

:

 

 

7.

If the unit is an ancillary unit, the undertaking to which it is catering and its address

:

 

 

8.

Name of the associate concern (s), if any, and

:

 

 
 
  1. Nature of associate and amount invested

:

 

 
  1. Nature of activity

:

 

 
  1. Items traded/manufactured

:

 

 
  1. Turn-over and profit during preceding Financial year

:

 

 

9.

Brief history of the unit** (giving a brief Account of progress made since inception)

:

 


* This form may also be used for deferred payment guarantees upto Rs.  10 lakhs.

** In case of new units, what prompted the promoter(s) to set up the unit.

 

10.

Name (s) of Proprietor/Partners/Director

:

 

 
  1.  
 
  1.  
 
  1.  
 
  1.  
 
  1.  
 

(Furnish details about the promoters/partners in the proforma at Annexure I)

   
 

11.

Present/proposed banker, their address and Credit facilities, if any, enjoyed from the bank

:

 

 

12.

Credit facilities required

 

No.

Nature

 

Type

Amount (Rs.)

 

1.

Term Loan

     
 

2.

working Capital

(i)

   
 

 

 

(ii)

   
 

 

 

(iii)

   
 

3.

Non-borrowing facilities

 

 

 
       

Total

 

4.

Particulars of the Project

 

 

 
       

Year

       


       

    I        II      III      IV    

 

13.

Capacity (for each product)

 

 

 

 

  1. Licensed

 

 

 

  1. Installed

 

 

 

  1. Operating

 

 

 

14.

Manufacturing process, in brief, giving stage-wise operations/process (indicate, to the extent possible, stage-wise capacity data, yield/conversion data, materials flow etc.,on a separate sheet).

 

 

 

15.

Employment

 

 

 

  1. Strength
    1. Executives (finance and accounting,Production, marketing and general management)
    2. Supervisory
    3. Skilled
    4. semi-skilled
    5. Administrative Staff

    Total


  2. Whether skilled staff has been identified

Present

Proposed

 

16.

Locational advantages of existing and/or proposed premises i.e., absence of civic restrictions, proximity to the source of raw materials and market of theproduct, availability of infrastructure like power,water, labour, transport.

Area/Plinth Value
Area Existing
Area Proposed
Area Existing
Area Proposed

 

17.

Land and Building

  1. Factory Land
  2. Factory Building

Enclosed

    1. Xerox copy of factory building plan duly approved by local authority.
    2. A detailed building cost estimated by an architect and
    3. In case of loans above Rs.5 lakhs, break-up of proposed expenditure on building/workshed.

 

 

 

  1. Whether the existing/proposed land and buildings Will be sufficient for the unit’s present and near Future requirements.

 

 

 

18.

Particulars of machinery and other fixed assets ----existing and/or proposed (proforma invoices to be enclosed) (As per Annexure II).

 

 

 

19.

Necessity for the proposed investment/addition to factory premises/machinery (in case such investment is intended).

 

 

 

20.

Major raw materials/components

 

 

 

  1. Items required

(i) (ii) (iii) (iv)

 

  1. Sources of supply
  2. Conditions of supply* viz., minimum purchase quantity, lead time, seasonality, etc.
  3. Arrangements made for regular supply of Required quantity.

 

 

21.

Utilities

 

 

 

(give comments on requirement, availability/adequacy, qualitative aspects, etc.)

  1. Power
    1. Contracted load
    2. Connected load

    (enclose xerox copy of sanction for power connection).

  2. Water
  3. (enclose xerox copy of sanction for power connection).

  4. Fuel


  5. Others (Specify)

 

 

Economic Feasibility

 

22.

Marketing (separately for each product)

  1. Wherher the product is reserved exclusively for the SSI Sector
  2. Major customers

 

 


*(Enclose copies of proforma invoices in respect of each item)

 

  1. Region/area where the product is/will be sold
  2. Extent of competition; No. of units engaged in similar line in the area
  3. How does the unit meet/propose to meet the competition (comment of comparative advantages enjoyed by the promoters/unit)
    1. In price and quality-how does the unit’s product compare with those of its competitors
    2. Is the unit selling direct to its customers? If so, details like depots/showrooms, sales Force, etc.
    3. If a selling/distribution agency has been appointed, its name, period of contract,commission payable, period by which the bills will be paid by it, etc. (enclose xerox copies of distribution agreement (s), wherever applicable).
  4. Nature and volume of orders/enquiries on hand (xerox copies to be furnished)
  5. If the unit is export oriented, relevant details viz., countries to which exported and actual exports during the last 3 years. (if a marketing study has been done, a copy may be enclosed).

 

 

 

23.

Past performance (in the case of existing units)

  1. Annual turnover during the last 3 years and Monthly turnover for last 12 moths.
  2. Present facilities availed of from bank. If not Availing any facilities, how were the unit’s Needs met in the past.
  3. Details of unit’s borrowings from other Sources 9SFC,SIDC,NSIC,Private Financiers,etc.) including overdues, if any.
  4. Areas in statutory payments, if any.

 

 

 

24.

Target for the future

  1. Furnish projected profitability statement (Annexure - III)
  2. Furnish projected cash flow statement (Annexure - IV)

 

 

 

25.

Working capital required for the anticipated turnover

 

 


 

Cost of production per month (first full year’s production)

:      Rs.



 

Cost and quantity of raw materials per month

:      Rs.

 

Item Stocking/Working

Payment capital

Required period



  1. Raw materials
    -    Indigenous
    -    Imported
  2. Work-in progress
  3. Finished Goods
  4. Receivable/ Sundry Debtors
  5. Expenses

  6. Sub-Total:

    Less:

  7. Credit on purchase
  8. __________ _________ Total : __________ _________

 



Note:

  1. Cost of production includes cost of raw materials plus all expenses.
  2. For items (ii) and (iii) the basis of calculations would be the cost of production.
  3. For iterm (iv) working capital required would be the value of receivables at cost.

 

26.

  1. Investment/Expansion required in fixed assets for the anticipated turnover
  2. Purpose for which term loan is required
  3. By whom were the estimates prepared.
  4. Has provision for possible escalation in prices been made in the estimates.

 

 


27.

Project Cost

 

 

 

Sr.No.

Particulars

Already Incurred

To be Incurred

Total Cost

  1. Land including development
  2. Building and other civil works
  3. Plant and machinery
    1. Imported
    2. Indigenous
  4. a) Essential tools, spares and accessories
    b) Testing Equipment
  5. Miscellaneous fixed assets
  6. Erection/Installation charges
  7. Preliminary and pre-operative expenses (furnish details like legal expenses, salaries, launching expenses, interest on term loan till commissioning of the plant, etc.)
  8. Provision for contingencies
    1. Buildings
    2. Plant and machinery
    3. Other fixed assets
  9. Margin for working capital required
 

______ ______ ______Total: _____ ______ ______

 

28.

  1. Means of Financing
    1. Promoter’s contribution (by way of capital And reserves)
    2. Term loan
    3. Margin money from Department of Industries/SC, ST, BC, and other Corporations
    4. Subsidy __
        ---- Central Government
        ---- State Government
    5. Unsecured loans
    6. Other sources, if any
  2. Source from which promoter’s contribution will be met and unsecured loans obtained
 
 

29.

Start-up period required (adequacy/necessity to be substantiated with implementation schedule)

 
 

30.

Repayment programme

 
 

31.

Security

 

 

  1. Primary (working capital and term loan securities to be indicated separately)
  2. Collateral (full details)
    If there is a guarantor-
    1. Residential address
    2. His borrowings in any capacity from the Bank/other financial institutions
    3. Details of immovable property, if any,owned by him (indicate Land/Building location, dated of acquisition, cost, present value, etc.)
    4. Details of other assets, including movables.(indicate nature of asset, cost, present value etc.)
    5. If in service, name and address of the employer, period of service, salary last drawn, etc.
    6. Details of any similar guarantee, if any,
      Given to other institutions
 



DECLARATION

 I/We certify that all information furnished by me/us is true; that I/We have no borrowing arrangements excepts as indicated in the application, for the unit with any bank; that no legal action has been/is being taken against me/us; that I/We shall furnish all other information that may be required by you in connection with my/our application; that this and any other information available with you pertaining to the borrowing unit, present and future, may also be exchanged by you with any agency you may deem fit, and that you, your representatives, representatives of RBI, DICGC, IDBI or any other Agency as authorised by you, may at any time inspect/verify our assets, books of account etc., in our factory and business premises.

 "I/We further certify that as on date there are no overdues to financial institutions/banks from the undersigned, the other promoters and the company/Companies in which I/the other promoters have interest as a promoter/director/partner/proprietor. I/We further certify that there are no statutory overdues pending against me/the other promoters/the Company or other Companies in which I am/the other promoters are Director/Directors."

Date :

Place: 

Signature

Name and Designation

Name of The concern

 

Enclosure

  1. Xerox copies of audited Balance Sheets with Trading and Profit and Loss Account, preferably audited (in the case of units already established) for the last 3 years.

  2. In the case of limited companies xerox copy of Memorandum and Articles of Association.

  3. Xerox copies of Income Tax, Wealth Tax returns and assessment orders for the last 3 years.

 



ANNEXURE I

DETAILS OF PROMOTERS/PARTNERS
(Please use separate sheets for each promoter/partner)

 

NAME OF UNIT :

  1. Bio-data of

  2. Full Name

  3. Age

  4. Information required for statistical purposes

    1.  Whether the promoter/partner is

      a)

      A member of minority community

      Yes/No

      b)

      A member of Scheduled Castes

      Yes/No

      c)

      A member of Scheduled Tribes

      Yes/No

      d)

      Ex-serviceman

      Yes/No

      e)

      Physically handicapped

      Yes/No


    2.  Sex : Male/Female

  5. Address :                     Office                        Residence            
                                      Telephone No.

  6. Academic Qualification :

  7. Experience     Years     Employer     Designation/Functional Duty     Last Salary drawn

  8. Functional responsibilities in the unit :

  9. Capital/loan contribution in the unit

    1. At the beginning

    2. At present

  10. Reasons for joining/establishing the unit
    (all motivating factors to be furnished).

  11. If associated as proprietor/partner/director/shareholder
    with concerns other than the applicant unit details *like

    1. Name and address of the branch/associates/identical
      Concern

    2. Activity of the concern : ** Functional responsibilities
      In the concern

    3. Capital/loan contribution

    4. Name of the associate concern’s bankers and their addresses

    5. Aggregate credit facilities enjoyed by the concern

    6. Security offered by the concern for its borrowings

    7. Working results of the units for the past three years

  12. Personal assets and liabilities :

    1. Immovable property details like land/buildings,location, date of acquisition, cost, present value,etc.

    2. Other assets.

    3. personal liabilities, if any.

  13. Any other information :

    Place  :                                                       Signature
    Date :

__________________________________________________________________________________________

*  The details in respect of each associated concerns should be furnished separately by way of enclosure.

**   1.  Furnish audited Balance Sheet/Profit and Loss Accounts of these concerns for the last two years and brief write-ups on these concerns including information of the nature of business and size of turnover. Also furnish details of any litigations pending against/from proprietor/partners/directors.

    1. If the promoter is a limited company, furnish a brief write up on the activities and past performance of the company and any other expansion programmes contemplated.

    2. Give particulars of holding company such as names of subsidiary companies, paid-up capital of subsidiary (equity and preference) and percentage holding by the holding company respectively.

  1. product(s) manufactured and installed capacity for each product should also be indicated.



ANNEXURE II*

Details of existing fixed assets

  1. LAND

    1. Location

    2. Area

    3. Whether freehold or leasehold

    4. Purchase price of land; if owned

    5. Rent in case of leased land

    6. Terms of lease

    7. Ground rent payable per year

  2. BULDING

    1. Location

    2. Whether owned or leased

    3. Purchase price of building; if owned

    4. Rent in case of leased/rented premises

    5. Terms of lease


  3. Structure

    Type of Structure (Whether temporary)

    Dimensions

    Area& Sq.mts.

    Actual Cost/Rs.

    Date of Erection


    1. Workshop

    2. Godown

    3. Administrative

    4. Other buildings


  4. COST OF EXISTING M/C Rs.

    In case the assets have been revalued or written up at any time during the existence of company furnish full details of such revaluation together with the reason therefor. Details of existing machinery should be given in Annexure VI A and B.


* To be given in the case of existing units.



ANNEXURE II (Contd.)

PARTICULARS OF BUILDINGS PROPOSED TO BE CONSTRUCTED


S.No.

Description of each Building

Type of Construction

Built-up area

Length mts

Breadth mts.

Average height of each floor mts.

Total Rate of

floor area sq.mts

construction per sq.mts

Estimated cost of each building

Expected date of completion


NOTE:

1.

Please enclose copy of the site plan of the land and blueprints of the buildings duly approved by Corporation/Municipality/Panchayat.

 

2.

In case contract is awarded for construction of building, furnish details thereof such as name of contractor, amount of contract, etc.

 

3.

Other approvals from Inspector of factories, Drug Controller, etc., if any, should be enclosed.

 

4.

Please enclose a plan showing layout of machinery.



ANNEXURE II (Contd.)

Particulars of Machinery


S.No.

Name of Machinery and specification

Second hand / New

Name of manufacturer / fabricator (Place and Country of origin may be given in the case of imported equipment)

Date of acquisition Date of placement of order (actual / expected)

Expected date of delivery

Price* (Invoice price including taxes for indigenous machinery / CIF price for imported machinery)

Estimated expenditure (insurance / freight / instalation / import duty)

Total cost

Performance guarantee,if, any

Remarks


  1. Existing Machinery

    1. Indigenous

    2. Imported

  2. Proposed to acquired

    1. Indigenous

    2. Imported


  1. Quotation/Catalogues/Invoice and other details in respect of each machine to be furnished.

  2. If second hand machinery, valuation report regarding age, performance and value from competent valuers to be submitted.Also, please indicate reasons for going in for second hand machinery and its depreciated value.

  3. * In case of imported machinery

    1. Please indicated mode of payment and foreign currency price of the machinery.

    2. If machinery is to be imported under OGL action taken.

    3. Details of import licence obtained should also be furnished.



ANNEXURE III

Name of the unit

Projections of Performance, Profitability and Repayment
Break-even point : % of installed capacity
Break-even Quantity :Break-even Value : (Rs. In 000’s omitted)


1st      2nd     3rd      4th      5th       6th     7th       8th    

   year    year    year    year    year    year    year    year   


Production during the year (quantity)
% utilisation of installed capacity.

  1. Sales

    1. Sales including all miscellaneous receipts

    2. Less Excise

    3. Net Sales

  2. Cost of Production

    1. Raw materials consumed

    2. Power and fuel

    3. Direct labour and wages

    4. Consumable Stores

    5. Repairs and maintenance.

    6. Other manufacturing expenses

    7. Depreciation/Development
      Rebate/Investment allowances


    8. [Total (cost of production)]      _____________________________________________

    9. ADD Opening stock-in-process and finished goods   a)   ____________________________________

    10. DEDUCT closing stock-in-process and finished goods  b)   ____________________________________
                                                                                          ______________________________________

  3. Cost of Sales :

  4. Gross Profit (A-C)



ANNEXURE III (Contd.)

(in Rupees -000’s omitted)


1st      2nd     3rd      4th      5th       6th     7th       8th    

   year    year    year    year    year    year    year    year   


  1. Interest :

    1. On term loans

    2. On working capital

    3. On other loans, if any.

  2. Selling, General and Administrative Expenses

  3. Profit before taxation (D-(E+F))

  4. Provision for taxes

  5. Net Profit (G - H)

  6. Depreciation added back

  7. Net cash accruals

  8. Repayment obligations

    1. Towards term loan__________________________________________________________

    2. Towards Others__________________________________________________________

                                                   Total Repayment
                                         _________________________________________________________

M. Debt Service Ratio : K : L



ANNEXURE IV

Cash-Flow Statement

(Rupees in lakhs)


Construction period          

OPERATING YEAR                    

1st      2nd     3rd      4th      5th       6th     7th       8th    

   year    year    year    year    year    year    year    year   


  1. Sources of funds

    1. Cash accruals [viz. net Profit before taxation (item G of
      Annexure III) to which shall be added interest (item E of
      Annexure III]

    2. Increase in share capital Equity/Preference

    3. Depreciation

    4. Investment allowances

    5. Increase in long term loans/debentures

    6. Increase in deferred payment facilities

    7. Increase in unsecured loans and deposits

    8. Increase in bank borrowings for working capital

    9. Sales of fixed assets/investments

    10. Others (indicate details)
      Total sources (A)

  2. Disposition of funds :

    1. Preliminary and pre-operative expenses

    2. Increase in capital expenditure

    3. Increase in current assets
      Inventories
      Other

    4. Decrease in long-term loans/debentures

    5. Decrease in unsecured loans/deposits

    6. Decrease in deferred payment facilities

    7. Increase in investments

    8. Interest

    9. Taxation

    10. Dividen-Equity (Amount and Rate)
      Preference (Amount and Rate)

    11. Other expenses (Give details)
      Total Disposition (B)

  3. Opening balance

  4. Net surplus (A-B)

  5. Closing balance




GUIDELINES FOR FILLING UP THE APPLICATION FORM FOR
ASSISTANCE ABOVE Rs.2 LAKHS UPTO Rs.10 LAKHS

Q.2

Indicate whether a proprietary/partnership/private limited/public limited concern or a co-operative society. In case of any proposal to change the constitution indicate both the existing and proposed constitution as also the date for proposed change.

 

Q.7

A copy of agreement with/or letter/order, if any, from the parent u it may be enclosed.

 

Q.15

Explain in detail the plans for recruiting the required personnel.

 

Q.16

While selecting the site for the project, the advantages and disadvantages of the site might have been taken into consideration. Enumerate in detail the advantages and disadvantages which weighed with the unit in selecting the site and also highlight each of the factors which were considered most advantageous for the project. Such as good transport facilities, nearness to market, availability of raw materials, water, power, labour, etc. For instance in explaining the transport facilities that might be available for the project, describe the National and State highways passing nearby specifying the distances from the site of important business centres, nearest railway station, whether the railway line is on the broad-gauge or on metregauge etc.

 

Q.17(a)

Total area and cost therefor including conveyance charges. If the cost is higher than the current market price explain the reasons for such variation. When the land is acquired/proposed to be acquired from a number of owners indicate the area and the cost of each plot.

 
 

It is likely that part of the cost of land is payable in deferred installments. Indicate the amounts paid/payable in different forms such as cash, deferred payments, etc. In case the land is taken on lease basis, give separately the amount of initial premium and the annual lease rent.

 
 

If the land is acquired/proposed to be acquired from any of the promoters/directors of the company or their relatives, give full particulars such as the relationship, area of plot, cost, etc. Also indicate the date of original purchase, price paid and expenditure incurred by the promoter/director etc.

 
 

If the land for the project has been earlier used for agricultural purpose, it may be necessary to obtain the permission of the State Government for converting it into non-agricultural land. Contact the Industries Department of the State Government and obtain the approval of the competant authority and enclose a copy of such approval with the Application.

 

Q.17(b)

It may be explained how the buildings are proposed to be constructed i.e., whether through a contractor or by the unit’s own organisation etc. In case the buildings are to be constructed through contractors, describe the process of selecting the contractor(s) and the reasons for selecting the contractor(s).

 

Q.20

The detailed specification preferably including any industrial standard of raw material required by the unit should be indicated. In the case of raw materials/chemicals which are in short supply, indicate the special arrangements which the company proposes to make for obtaining the indigenous and imported raw materials.

 

Q.21(a)

Furnish particulars of the electrical sub-station from which power would be made available, its distance from plant site, progress in extending the supply line, voltage at which power would be made available and other terms such as how the cost of extending the supply line would be borne etc.

 

Q.21(b)

Explain in detail the proposed arrangements for obtaining the water requirements for the project. In case of tube-wells, give the number of tube-wells proposed to be sunk and their capacities. If water is to be drawn from river etc., give particulars regarding water flow in the river during monsoon and lean season, the length of the pipe line. Also explain whether the water has been analysed and found suitable for use by the unit. If any water treatment is required explain the arrangements envisaged and the capital cost thereof.

 

Q.21(c)

Give information separately regarding the requirements and sources of supply of compressed air, furnace oil, coal, etc.

 

Q.27(vii)

The estimated pre-operative expenses until the company goes into commercial production (according to the schedule of implementation) may be indicated here under the appropriate sub-heads. Interest and commitment charges may be calculated on the basis of the expected drawal of funds depending upon the schedule of construction.

 

Q.27(viii)

The project cost estimates should include a reasonable provision to meet any contingency or unforeseen expenses. This provision is, however, not meant for taking care of the escalation in prices which can be anticipated at the time of estimating the cost of the project. Such escalation may be provided while arriving at the costs of various items such as buildings, machinery and equipment etc.

 
 

Contingency provision is normally made at a minimum of 10% of the cost of non-firm items in the project cost. Costs of items which have already been acquired or for which firm agreements have been entered into may be considered as firm cost items. All other expenses may be treated as non-firm cost items.

 

Q.27(ix)

The bulk of the working capital requirements is normally provided by the commercial banks. But a part of the working capital which is meant for providing the margin for bank borrowings is to be included as part of the project cost.

 



LIST OF ENCLOSURES

  1. SSI registration certificate (1).

  2. Copies of rent/lease documents (5).

  3. Details of promoter (Annexure - I).

  4. Brief description of manufacturing process (14).

  5. Copy of building plan approved by authority (17).

  6. Detailed building cost estimate by an architect (17).

  7. Particulars of machinery and other fixed assets (Annexure II).

  8. Copy of sanction for power connection (21).

  9. Copy of sanction for water connection (21).

  10. Copy of distribution agreements (22).

  11. Copy of order/enquiries (22).

  12. Copy of marketing study, if any (22).

  13. Projected profitability statement (Annexure III).

  14. Projected cash flow statement (Annexure IV).

  15. Copy of Balance Sheet and Trading and Profit and Loss Account.

  16. Copy of Memorandum and Articles of Association.

  17. Copy of Income Tax, Wealth Tax returns and assessment orders for 3 years.

Note - Figures in brackets denote the Sr. No. of the relevant item in the application form "A"