state bank of india bank of india: manufacturing annexure-a - for mse’s upto 25 lakh. (application...
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STATE BANK OF INDIA:
MANUFACTURING
ANNEXURE-A - For MSE’s upto 25 Lakh. (Application form)
ANNEXURE-B - For Others Amount wise (Application form)
TRADE AND SERVICES
ANNEXURE-C - For MSE’s upto 25 Lakh. (Application form)
ANNEXURE-D - General Information (Application form)
NAME AgeAcademic
QualificationRESIDENTIAL
ADDRESSTELEPHONE
(Residence)
Experiencein the line of activity
STATE BANK OF INDIA:ANNEXURE – A
APPLICATION FORM FOR MSEs - Upto Rs 25 Lakh
To be submitted along with documents as per the checklist
(For Office Use)
1 NAME OF THE ENTERPRISE
2 REGD. OFFICE ADDRESS
3 ADDRESS OF FACTORY/ SHOP
4 WHETHER BELONGS TO SC/ST/OBC/MINORITY
Telephone No. (Office)
E MailAddress
Mobile No. PAN Card No.
5 CONSTITUTION Proprietory/ Partnership firm/ Pvt Ltd/ Ltd Company/ Co-op Society
6 DATE OF ESTABLISHMENT
7 NAME OF PROPRIETOR/ PARTNERS/ DIRECTORS OF COMPANY AND THEIR ADDRESSES
Name of AssociateConcern
Address of Associate Concern
PresentlyBanking with
Nature ofAssociation
Extent of Interest as aProp./Partner/Director
or Just Investor in Associate concern
Type of facility
Limit(in lacs)
Outstanding as on …….
Presentlybanking
with
SecurityLodged
Rate ofInterest
RepaymentTerms
Current A/c
Cash Credit
Term Loan
LC/BG
If banking with this Bank, Customer No. be given here
Type of facility
Amount(in lacs)
Purpose for which
reduiredSecurity Offered
Primary Security (Details with approx. value to be mentioned)
Whether CollateralSecurity offered (Please mention yes or no) (If yes, then provide details in Column 12)
Cash Credit YES / NO
Term Loan YES / NO
LC/BG YES / NO
8 ACTIVITY Existing
Proposed(#)# If a different activity other than existing activity is proposed
9 NAMES OF ASSOCIATE CONCERNS AND NATURE OF ASSOCIATION:
10 Relationship pf Proprietor/Partner/Directorwith the officials of the Bank/Director of the Bank
10(a) CREDIT FACILITIES (EXISTING) (Rs. in lacs)
10(b) It is certified that our unit has not availed any loan from any other Bank/ Financial Institution in the past and I am not indebted to any other Bank/ Financial Institution other than those mentioned in 10(a) above.
11 CREDIT FACILITIES (PROPOSED):
In case of term loan requirements, the details of machinery may be given as under:
Past Performance/ Future Estimates (Actual performance for two previous years, estimatesfor current year and projection for next year to be provided for working capital facilities. However for term loan facilities, projections to be provided till the proposed year of repayment of loan):
(Rs in lacs)PAST YEAR-II(Actual)
PAST YEAR-I(Actual)
PRESENT YEAR(Estimates)
NEXT YEAR(Projection)
Net SalesNet ProfitCapital (Net worth in caseof companies)
Statutory Obligation Whethercomplied with (Write Yes/No). If not applicable, then write N.A.
Remarks (Any details inconnection with the relevant obligation to be given)
1. Registration under Shops and Estd Act2. Registration under SSI (Provisional/Final)3. Drug License4. Latest Sales tax return filed5. Latest Income tax return filed6. Any other statutory dues remaining outstanding
Type of machine
Purpose for which
required
Whether imported or indigenous
Name of supplier
Total cost of machine (in case
of imported machine, the
breakup of basic cost, freight,
insurance and customs duty be
given)
Contribution being made by the promoters
Loan required
12. Details of Collateral Security offered, if any, including 3rd party guarantee *(* As per RBI guidelines, banks are not to take collateral security for loans upto Rs. 5 lakhs toMSME units)
13
14 Status regarding Statutory Obligations:
SPACE FOR PHOTO SPACE FOR PHOTO SPACE FOR PHOTO
Signatures of Proprietor/ Partner/ Director whose photo is affixed above
Only one photo of properitor / each Partner / Each working Director is required to be affixed. Each photo will be certified/attested by the Branch Team with name andsignatures on the photograph with Branch stamp. The concerned staff will put his name below the signatures.
15
16 Date: Place:
I/We certify that all information furnished by me/us is true; that I/We have no borrowing arrangements for the unit except as indicated in the application; that there is no overdues/statutory dues against me/us/promoters except as indicated in the application; that no legal action has been/is being taken against me/us/promoters; that I/We shall furnish all other information that may be required by you in connection with my/our application that this may also be exchanged by you with any agency you may deemed fit and you, your representatives, representatives of the Reserve Bank of India or any other agency as authorised by you, may, at any time, inspect/verify my/our assets, books of account etc. in our factory/business premises as given above.
ANNEXURE-B -- For Others Amount wise (Application form)
State Bank of India
Annexure – SSI /1
Small Scale Industries
Application Form
For credit facilities up to Rs. 10 lacs
Note : Item 18 to be filled in by those applying for credit facilities above Rs. 50,000/-
1. Name of the Unit:
Constitution (Please (Proprietary / Partners /
strike out which ever Co-operative Society) is not applicable)
2. Registration No.: (as given by the District Industries Centre /
Directorate of Industries)
3. Business Address:
Residential Address:
4. Background (To be filled up for each individual)
4.1 Name(s) of the Proprietor / Partners
Surname Name Father’s / Husband’s Name Age Sex
4.2 Whether the applicant belongs to Yes / No
Scheduled Caste / Tribe /Minority
Community. If yes, please furnish proof thereof.
4.3 Whether the applicant is Ex- Yes / NO
Serviceman. If yes, please furnish
proof thereof.
4.4 Present annual income of the family
with brief details of the sources
(Indicate farm income & non-farm
income separately)
State Bank of India
5. Size of the applicant’s family Adult ______ Children _____
6. Please furnish ration card No. and
Name of the Issuing Office 7. Size and particulars of land
holdings, if any, in the name of the
applicant of family members
8. Minimum amount required per Rs. ______________
month for family maintenance 9. Cost of the project Fixed Assets RS. ________
Current Assets Rs. ________
Total Rs. ________
10. Brief description of the industrial
activity 10.1 Existing
10.2 Proposed
11.1 Number of persons presently (to be filled in case of existing unit only)
11.2 Number of persons proposed to be
Employed
12. How the activity was financed so far (to be filled in case of existing
unit only)
Source of
Funds (*)
Security Rate of Int. Repayment
per Month
Present
Outstanding
Amount of
Default (if
any)
(*) (Indicate name & address of the sources of funds, e.g. banks / financial institutions / other (specify)
13. Raw materials required (quantity) and sources of supply:
14. Location of the market for the product(s):
15. Financial Projections:
Particulars 1st Year 2
nd Year 3
rd Year
Turnover
Raw Material
Purchases
Other Expenses
Profit
(Indicate the assumptions based on which the above figures have been worked out)
State Bank of India
16. Purpose of the new loan
17. Amount of loan required
18. Means of Financing
18.1 Promoter’s contribution
18.2 Subsidy
18.3 Seed Capital 18.4 Loan (Working Capital / Term Loan)
I / We certify that all information furnished by me /us is true; that I / We have no
borrowing arrangements for the unit with any bank except as indicated in this application;
that there is no overdues / statutory dues against me / us except as indicated in this application; that no legal action has been / is being taken by 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 may also be exchanged by you with any agency you may deem
fit and you, your representatives, representatives of the Reserve Bank of India / National
Bank for Agriculture and Rural Development / Small Industries Development Bank of India or any other agency as authorized by you, may at any time, inspect / verify my / our
assets, books of accounts, etc. in our factory / business premises as given above.
(Affix a photo, in case of thumb impression)
Date Signature / Thumb impression of the Borrower
Place
State Bank of India
Annexure – SSI /2
Small Scale Industries
Application Form
For credit facilities of over Rs. 10 lacs & up to Rs. 50 lacs
1. Name of the Unit: (In block letters)
1.2 Constitution: (Proprietary / Partnership Firm /
(Please strike out whichever is not Private Limited Company /
applicable) Public Limited Company /
Co-operative Society) 1.3 Name of the business house / group :
(if any)
2.1 Registration No. :
(As given by the District Industries
Centre / Directorate of Industries)
2.2 Date of Incorporation /
Commencement of Business:
3 Business Address with Telephone / Telex Number
3.1 Registered Office:
3.2 Administrative Office:
3.3 Factory:
4. Background of the (Please furnish background for
Proprietor / Partners / Directors each person as per the
Appendix I)
5. Brief description of the Industrial activity
5.1 Existing
5.2 Proposed
6. How the Activity was financed so far: (to be filled in case of existing unit only)
Source of Funds (*) Security Rate of
Int.
Repayment
Per month
Present O/s. (in
000s of Rs.)
Amount of
Default (if any)
(*) Indicate sources of funds with name & address, e.g. banks/ financial institutions / others specify)
State Bank of India
7. Past performance for last three years (to be filled by existing unit only)
(in 000s of Rs.)
Particulars 20__ 20__ 20__
Turnover
Net Profit
Retained Profit
Monthly Turnover for last twelve months
Jan Feb Mar Apr May Jun
Jul Aug Sep Oct Nov Dec
8. Arrears in Statutory payments (if any)
a) Income tax
b) Sales tax
c) Provident Fund
d) Employees State Insurance Corporation e) Others (specify)
9. If the unit is an ancillary unit, the undertaking to which it is catering and its
address
10. Name of the associate concern(s), if any
10.1 Nature of association and amount invested
10.2 Nature of activity
10.3 Items traded / manufactured
10.4 Turnover and profit during preceding three years.
State Bank of India
11. Employment Present Proposed
Executives
Supervisory Administrative / Office Staff
Skilled Labour
Unskilled Labour
12. Technical Feasibility ________________
12.1 Name of the product(s), including Bye-products & its (their) use
12.2 Manufacturing Process, in brief (Indicate to the extent possible, stage-wise
capacity data, yield/ conversion data, material flow, etc.
12.3 Capacity: (No . of Units / Quantity in kg. / Volume in litre per annum)
Capacity for each
product
Licensed Installed Operating
Number of working days in a month and Number of shifts in a day:
12. 4 Locational advantages of existing and /or proposed premises and with
reference to i) absence of civic restrictions
ii) proximity to the source of raw materials
iii) market for the product
iv) availability of
a) power b) water
c) labour
d) transport
v) whether clearance has been
obtained from the pollution control authority? 12. 5 Land & Building
Area / Plinth Area (in sq. meters) Value (in 000s of Rs.)
Existing Proposed Existing Proposed
Factory Land
Factory
building
Ancillary
building
Open Storage
Space
State Bank of India
12.6 Type of soil and load bearing capacity (enclose test report)
Enclosures:
a) certified photo copy of sale / lease deed
b) certified photo copy of the Govt. order converting the land into
industrial land, if applicable c) locational map
d) certified photo copy of the site plan of the land and blueprints of the
buildings duly approved by Corporation / Municipality / Panchayat.
12.7 Particulars of Machinery & other assets : As per Appendix II
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 items
(A) (B) ( C) (D)
Quantity
Required
Sources of Supply
Minimum Purchase
Quantity
Lead / Procurement Time
Available throughout the
year
If answer to the above is
no, then no. of months it is
available
(enclose proforma invoices in respect of each item, if available)
13. Utilities
(Give comments on requirement, availability adequacy, qualitative aspects, etc.)
a) Power
Contracted Load
Connected Load
State Bank of India
Future power consumption
(in no. of units) per month
(Enclose certified Xerox copy of sanction for power connection)
b) Water
c) Fuel
d) Others (specify)
14. Economic Feasibility
Marketing (mention separately for each product)
14.1 Whether the product is reserved exclusively for the SSI sector?
14.2 Name of the Major customers
14.3 Region / Area where the product is / will be sold
14.4 Extent of competition & No. of Units engaged in similar line in the area
14.5 How does the unit meet / propose to meet the competition? (comment on the competitive advantages enjoyed by the unit)
14.5.1 In price and quality, how does the unit’s product compare with those of its
competitors?
14.5.2 Is the Unit selling direct to its customers? If so please furnish details like sales
force, showrooms, depots, etc.
14.5.3 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
copies of agreement, wherever such agreement has been entered into)
14.6 Nature and volume of orders / enquiries on hand
(certified Xerox copies to be furnished)
State Bank of India
14.7 If the Unit is export oriented, please furnish exporter code no., if allotted, And relevant details as under in the preceding three years:-
Code No.:
Name of the product exported
Name of the Country where Exported
F.O.B Value in US $
15. Cost of Project
(Please 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
Incurred
To be incurred Total Cost
A Land including
development
B Building & Other Civil
Works
C Plant & Machinery
1) indigenous
2) Imported
D Essential Tools, Spares &
Accessories
E Testing Equipment
F Miscellaneous Fixed
Assets
G Erection / Installation Charges
H Preliminary Expenses
I Pre-Operative Expenses
J Provision for
Contingencies
1. Buildings
2. Plant & Machinery 3. Other Fixed Assets
K Margin for Working
Capital Required
L Total
State Bank of India
16. Means of Financing
(Please furnish details of sources of finance for meeting the cost under the following heads)
(In 000s of Rs.)
Sr.
No.
Particulars Amount
Already Raised
Amount
Proposed to be Raised
Total
A Capital (specify resources contributing capital)
B Reserves
C Term Loans
(give full particulars
D Unsecured Loans and
Deposits
(indicate sources, rate of
interest, repayment period, etc.)
E Deferred Payment Arrangements including
Suppliers Credit
F Subsidy Central Govt.
State Govt.
G Seed Capital
(indicate sources)
H Internal Cash Accruals
I Other Sources (specify)
J Total
16.1 In case internal accruals are taken as source of finance, explain the basis for
estimation of internal accruals by means of a statement.
16.2 Indicate sources from which expenditure already incurred has been financed
16.3 Promoter’s contribution to the project as % of the total cost
(Please furnish list of persons / firms who would be contributing to promoter’s
share of the capital and the respective amounts and their relationships)
State Bank of India
17. Schedule of Implementation
Please indicate the progress made so far in the implementation of the project and furnish the schedule of implementation as follows
Date of Expected date of
commencement completion
a) Acquisition of Land
b) Development of Land c) Civil works for
Factory building
Machinery Foundation
Administrative Building
d) Plant & Machinery Imported
Indigenous
e) Arrangement for power
f) Arrangement for water
g) Erection of equipment h) Commissioning
i) Initial Procurement of Raw
Material
j) Trial Runs
k) Commercial Production
18. Future Projections
(To be given for the next three years)
Please furnish data on projected profitability as per Appendix III
Please furnish data on projected cash flow statement as per
Appendix IV.
Percentage of Cash Sales in Total Sales ____% Period in which payment is received in respect of credit sales
___ days
Average credit available on purchases
____ days
19. Working Capital Required for the Anticipated Turnover:
(Please furnish data as per Appendix VI)
20. Repayment Programmes:
State Bank of India
21. Details of Securities to be offered
21.1 Primary
(Working capital and term loan
securities to be indicated separately)
21.2 Collateral, if any, (give full details)
21.3 Details of guarantor(s)
21.3.1 Name
21.3.2 Residential Address
21.3.3 Occupation
(if in service, name, & address of
his / her employer)
21.3.4 Details of Movable & Immovable
Property (ies) Owned by him / her & Other dependent family members
21.3.5 Details of any similar guarantee, if
Any, given to other institutions
I / We certify that all information furnished by me / us is true; That I / We have no
borrowing arrangements for the Units with any bank except as indicated in the
application; that there is no overdues / statutory dues against me / us / promoters except
State Bank of India
as indicated in the application; that no legal action has been / is being taken against me /
us / promoters; that I / We shall furnish all other information that may be required by you
in connection with my / our 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 / National Bank of Agriculture & Rural Development / Small Industries
Development Bank of India / Deposit Insurance and Credit Guarantee Corporation of any
other agency as authorized by you, may at any time, inspect / verify my / our assets,
books of accounts, etc., in our factory / business premises as given above.
Date __________________
Place Signature of the Borrower
(Name & Designation)
Encl.: Certified Xerox copies of
a) Balance Sheets with Trading and Profit & Loss Account for the last three
years.
b) Memorandum and Articles of Association, Certificate for Commencement
of Business. c) Income Tax, Wealth Tax Returns and assessment orders for the last
Three years, for the unit as well as proprietors / partners / Directors
d) Sales Tax Returns for the last three years.
Forms as per Appendix – SSI-I to Appendix – SSI- VI given hereafter should also be submitted along with the application for advances above Rs. 10 lacs,
State Bank of India
Annexure – SSI /3
Small Scale Industries
Application Form
For Credit Facilities of over Rs. 50 lacs & upto Rs. 5 crores
1.1 Name of the Unit
(In block letters) 1.2 Constitution: (Proprietary / Partnership Firm /
(Please strike out whichever is not Private Limited Company /
applicable) Public Limited Company /
Co-operative Society)
1.3 Name of the business house / group : (if any)
2.1 Registration No. :
(As given by the District Industries
Centre / Directorate of Industries)
2.2 Date of Incorporation /
Commencement of Business:
3 Business Address with Telephone / Telex Number
3.1 Registered Office:
3.2 Administrative Office:
3.3 Factory:
4. Background of the (Please furnish for
Proprietor / Partners / Directors each person as per the
Appendix I)
5. Brief description of the Industrial activity 5.1 Existing
5.2 Proposed
6. How the Activity was financed so far: (to be filled in case of existing unit only)
Source of Funds (*) Security Rate of Int.
Repayment Per month
Present O/s. (in 000s of rs.)
Amount of Default (if any)
(*) Indicate sources of funds with name & address, e.g. banks/ financial institutions /
others specify)
State Bank of India
7. Past Performance
(To be filled by the existing unit only)
(Indicate in 000s of Rs.)
Particulars Last Year Last but One year Last but two years
Turnover
Net Profit
Retained Profit
Monthly Turnover for last twelve months
Jan Feb Mar Apr May Jun
Jul Aug Sep Oct Nov Dec
8. Arrears in Statutory payments (if any)
a) Income tax b) Sales tax
c) Provident Fund
d) Employees State Insurance Corporation
e) Others (specify)
9. If the unit is an ancillary unit, the undertaking to
which it is catering and its address
10. Name of the associate concern(s), if any
10.1 Nature of association and amount invested
10.2 Nature of activity
10.3 Items traded / manufactured
10.4 Turnover and profit during preceding three years.
11. Employment Present Proposed
Executives Supervisory
Administrative / Office Staff
Skilled Labour
Unskilled Labour
State Bank of India
12. Technical Feasibility
12.1 Name of the product(s),
including Bye-products & its
(their) use
12.2 Manufacturing Process, in brief (Indicate to the extent
possible, stage-wise capacity data,
yield/ conversion data, material flow, (etc).
12.3 Capacity: (No . of Units / Quantity in kg. / Volume in litre per annum)
Capacity for each
product
Licensed Installed Operating
Number of working days in a month
and Number of shifts in a day:
12.4 Locational advantages of existing
and /or proposed premises and with
reference to
i) absence of civic restrictions
ii) proximity to the source of raw materials
iii) market for the product
i) availability of a) power
b) water
c) labour
d) transport
v) whether clearance has been obtained from the pollution control authority?
State Bank of India
12.5 Land & Building
Area / Plinth Area (in sq. metres) Value (in 000s of Rs.)
Existing Proposed Existing Proposed
Factory Land
Factory
building
Ancillary
building
Open Storage
Space
12.6 Type of soil and load bearing capacity (enclose test report)
Enclosures:
a) certified photo copy of sale / lease deed
b) certified photo copy of the Govt. order converting the land into
industrial land, if applicable c) locational map
d) certified photo copy of the site plan of the land and blueprints of the
buildings duly approved by Corporation / Municipality / Panchayat.
12.7 Particulars of Machinery & other fixed assets :
As per Appendix II
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.
State Bank of India
12.9 Raw Materials / Components
(Please mention about the imported and indigenous items separately)
Name / Brief description of the items
(A) (B) ( C) (D)
Quantity
Required
Sources of Supply
Minimum Purchase
Quantity
Lead / Procurement Time
Available throughout the year
If answer to the above is
no, then no. of months it is available
(enclose proforma invoices in respect of each item, if available
13. (Give comments on requirement, availability / adequacy, qualitative aspects, etc.)
13.1 Power
Contracted Loan
Connected Load
Future power consumption
(in No. of units) per month
Standby arrangements
(enclose certified Xerox copy of sanction for power connection)
13.2 Water
(Enclosed certified Xerox copy of sanction for water connection)
13.3 Fuel
13.4 Others (specify)
State Bank of India
14. Quality Control
14.1 Details of arrangement made for Quality control. If BIS/FPO/ISO
Specifications are followed, no. of
BIS / FPO/ISO standards and the
Particulars thereof should be
Provided
14.2 Particulars of R & D activity
Proposed
15. Economic Feasibility
Marketing (mention separately for
Each product)
15.1 Whether the product is reserved
exclusively for the SSI sector 15.2 Name of the major customers
15.3 Region / Area where the product
is / will be sold 15.4 Extent of competition and No. of
units engaged in similar line in the
area
15.5 How does the unit
meets / proposes to meet the competition (comment on the
competitive advantages enjoyed
by the unit)
15.5.1 In price and quality, how does the
unit’s product compare with those of its competitors
15.5.2 Is the unit selling direct to its
customers ? If so, please furnish
details like sales force, showrooms,
depots, etc. 15.5.3 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 copies of agreement,
wherever such agreement has been
entered into)
State Bank of India
15.6 Nature and volume of
orders / enquiries on hand
(certified Xerox copies to be furnished)
15.7 If the units is export oriented,
please furnish exporter code no., if
preceding three years.
Code No.:
Name of the Product
Exported
Name of the Country where
Exported
F.O.B Value in US $
16. Cost of Project
(Please 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
Incurred
To be Incurred Total
Cost
A Land including development
B Building & Other Civil Works
C Plant & Machinery
1) Indigenous
2) Imported
D Essential Tools, Spares and
Accessories
E Testing Equipment
F Miscellaneous Fixed Assets
G Erection / Installation Charges
H Preliminary Expenses
I Pre-Operative Expenses
J Provision for Contingencies
1. Buildings
2. Plant & Machinery
3. Other Fixed Assets
K Margin for Working Capital
L Total
State Bank of India
17 Means of Financing
(Please furnish details of sources of finance for meeting the cost under the following heads)
(In 000s of Rs.)
Sr.
No..
Particulars Amount
Already
Raised
Amount
Proposed
to be Raised
Total
A Capital (specify resources contributing capital)
B Reserves
C Term Loans
D Unsecured Loans and Deposits
(indicate sources, rate of interest, repayment
period etc.)
E Deferred payment Arrangements
Including Supplier’s credit
F Subsidy
Central Govt.
State Govt.
G Seed Capital
(indicate sources)
H Internal Cash
Accruals
I Other Sources
(specify)
J Total
16.1 In case internal accruals are taken as
Source of finance, explain the basis
For estimation of internal accruals by
Means of a statement 17.2 Indicate sources from which
expenditure already incurred has
been financed
17.3 Promoter’s contribution to the
project as % of the total cost
(please furnish list of person / firms
who would be contributing to the
promoter’s share of the capital and
the respective amounts and their relationships)
State Bank of India
17 Schedule of Implementation
Please indicate the progress made so far in the implementation of the project and Furnish the scheduled of implementation as follows
Date of
Commencement
Expected Date of
Completion
a) Acquisition of Land
b) Development of Land
c) Civil works for Factory building Machinery
Foundation
Administrative Building
d) Plant & Machinery Imported
Indigenous
e) Arrangement for power
f) Arrangement for water
g) Erection of equipment
h) Commissioning
i) Initial Procurement of Raw Material
j) Trial Runs
k) Commercial Production
19 Future Projection (to be given for the next five years) please furnish data on
19.1 Projected profitability as per Appendix III
19.2 Projected cash flow statement as per Appendix IV
19.3 Projected balance sheet as per Appendix V
19.4 Working capital requirement as per Appendix VI
Percentage of Cash Sales to Total Sales _________%
Period in which payment is received in
Respect of credit sales _______ days
Average credit available on purchases _______ days 20. Financial Assistance required
20.1 Rupee Loan
20.2 Foreign Currency Loan
20.3 Term Loan
20.4 Working Capital (as worked out in Appendix VI)
20.5 Non-Fund Based Limits, i.e. other
Forms of assistance (e.g. L/Cs, Bank
Guarantee, etc.)
21 Repayment Programme
State Bank of India
22 Details of Securities to be Offered
22.1 Primary (working capital and term loan
Securities to be indicated separately) 22.2 Collateral, if any
(full details)
22.3 Details of guarantor(s)
22.3.1 Name
22.3.2 Residential Address 22.3.3 Occupation (if in service, name & address of
his /her employer)
22.3.4 Details of Movable & Immovable
Property(ies) owned by him / her & other
Dependent family members 22.3.5 Details of any similar guarantee, if any, given
to other institutions
23 Whether any Government enquiry,
Proceedings or prosecution has been
Instituted against the unit or its Proprietor / partners / directors for any
Offence ? If so, please give details.
24. Details of pending litigation, if any, against
And by the unit.
25. Please indicate whether the proprietor / any of the partners, promoters / directors have at
any time declared themselves as insolvent If
so, details thereof.
I / We certify that all information furnished by me / us is true; that I / We have no borrowing arrangements of the unit with any bank except as indicated in the application;
that there is no overdues / statutory dues against me / us / promoters except as indicated
in the applications; that no legal action has been / is being taken against me / us /
promoters; that I / We shall furnish all other information that may be required by you in
connection with my / our 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 / National Bank of Agriculture and Rural Development / Small Industries
Development Bank of India / Deposit Insurance & Credit Guarantee Corporation or any
other agency as authorized by you, may, at any time, inspect / verify, my / our assets,
books of accounts, etc., in our factory / business premises as given above.
Signature of the Borrower
(Name & Designation)
Date
Place
State Bank of India
Encl: Certified Xerox Copies of
a) Audited balance Sheets with Trading and Profit & Loss Account, for the
last three years.
b) Memorandum and Articles of Association, Certificate of
Commencement of Business.
c) Income tax, Wealth tax Returns and assessment orders for the last three years, for the unit as well as proprietor / partners / promoters / directors.
d) Sales Tax Returns for the last three years
Forms as per Appendix – SSI-I to Appendix – SSI- VI given hereafter should also be
submitted along with the application
State Bank of India
Annexure-SSI/4
STATE BANK OF INDIA SMALL SCALE INDUSTRIES
Application Form
For Credit Facilities of over Rs.5 crores.
1.1 Name of the Unit
1.2 Constitution Proprietary/Partnership/Private Limited Concern/
Co-operative Society
(Please strike out which are not applicable)
1.3 Name of the business house/group to which the unit belongs
2.1 Registration No. :
(as given by the District Industries Centre, Directorate of Industries)
2.2 Date of incorporation/commencement of business
3. Business Address with Telephone/Telex/Fax No.
3.1 Registered Office
3.2 Administrative Office 3.3 Factory
4. Background of Proprietor/Partners /Promoters/Directors
(Please furnish information for each person as per in Annexure-I)
5. Description of the Industrial Activity 5.1 Existing
5.2 Proposed
6. How the Activity was financed so far (to be filled in case of existing unit only)
Source of
Funds(*)
Security Rate of Unit Repayment
per month
Present
O/s.
Amount of
Default (if any)
(*) Indicate source of funds with name & address e.g. Banks/financial institutions/others (specify)
State Bank of India
7. Arrears in Statutory Payments (if any)
a) Income Tax
b) Sales Tax
c) Provident Fund
d) Employees State Insurance Corporation e) Other (specify)
8. Past Performance for the last three years (in case of existing units)
Particulars 20__ 20__ 20__
Turnover
Net Profit
Retained Profit
9. Monthly Turnover for last twelve months.
JAN FEB MAR APR MAY JUN
JUL AUG SEP OCT NOV DEC
9.1 MANAGEMENT
(Please furnish background of the main promoter other than those furnished in
Annexure-1. write-up on other companies, if any, promoted by him or with which
he is associate together with a copy of the latest balance sheet)
9.2 In case the promoter is a Limited Company, please furnish a write-up on the activities and past performance of the company and any other expansion
programme(s)/diversification contemplated
(a) Memorandum & Article of Association
(b) Audited Balance Sheet and Trading and Profit Loss A/cs for the last three
years of the promoter company.
Copy of the agreement(s), if any, entered into among the promoters.
State Bank of India
9.3 SHAREHOLDING
9.3.1 Please provide a list of shareholders under the heads
a) Promoters
b) Other major groups
c) Foreign collaborations d) NRI shareholders
e) Other institutions
Owing or controlling 5% or more of equity shares, indicating the amount owned
and business relationship, if any, with the company.
9.3.2 In case of preference shareholder, please give a list of ten largest shareholders.
9.3.3 Also furnish number of equity shareholders and preference shareholders
9.4 Employment Present Proposed
Executives
Supervisory
Administrative/Office Staff
Skilled Labour
Other (specify)
9.5 Particulars of existing key technical and executive staff
(Please furnish for existing as well as proposed staff)
Name Designation Qualification Experience Any Special achievement
(Inventions/
Research etc.)
Functional Duties at the
Unit.
10. If the unit is an ancillary unit, the
undertaking to which it is catering and its address
11. Name of the associated concern(s), if any and
11.1 Nature of Association and amount invested
11.2 Nature of Activity
11.3 Items traded/manufactures 11.4 Turnover and profit during preceding three years.
State Bank of India
12. Technical Feasibility (Please enclose the
Feasibility / project report)
12.1 Name of the Products (including by-products)
& its (their) use
12.2 Manufacturing Process, in brief, (indicate
technical process, whether it is a continuous
process, whether this has been tried in the country,
stage-wise capacity data, yield/conversion data,
Material flow etc.) 12.3 Capacity of Units/Quantity in Kg./Volume in Liters)
Capacity of
each product
Licensed Installed Operating
12.4 No. of working days in a month & No. of shifts in a day 12.4.1 In case of any collaboration, please furnish a brief
write-up on the period of collaboration agreement,
the name of the collaborator company, indicating
the activities. Size, turnover, particulars of the
existing plants, other projects in India and abroad set up with same collaboration.
a) Copy of the published brochure highlighting the
activities of the collaborator and balance sheet
for the latest year.
b) Copy of the collaboration agreement c) Fees/royalties payable and the manner in which
payable.
d) Copy of the government approval, if required
for the service of foreign technicians, if any.
12.4.2 If there is no collaboration agreement please furnish full details of arrangement proposed to
be made for obtaining technical advice and
service needed for the implementation of the
project.
State Bank of India
12.4.3 Particulars of the Consultants :
a) Name and address of the consultants
b) Fees payable and the manner in which
payable c) Scope of work assigned to them
d) Brief particulars of consultants including
organizational set-up, bio-data of senior
personnel, names of directors/partners,
particulars of work done in the past and work on hand. Please enclose a copy of
the agreement with the consultants, and in
case of foreign consultant(s) approval of
the Government.
12.4.4 Whether any of the partners/
promoters/directors have any interest in
consultant/collaborator firm. If so, details to
be furnished
12.5 Locational advantages of existing and/or proposed premises with reference to :
i) absence of civic restrictions
ii) proximity to the source of raw materials
iii) market for the product
iv) availability of a) power
b) water
c) labour
d) transport
12.6 LAND & BUILDING
Area/Plinth area
(in sq. metres)
Value (in 000sof Rs.)
Existing Proposed Existing Proposed
Factory Land
Factory Building
Ancillary Building
Open Storage Space
(enclose Test Report)
State Bank of India
12.7 Type of soil and load bearing capacity
Enclosures :
a) Certified zerox copy of sale/lease deed
b) Certified zerox copy of the Govt. Order converting the land into industrial land, if applicable.
c) Locational map
d) Certified zerox copy of the site plan of the land showing contour lines, the
internal road, power receiving station, railway siding, tube-wells, etc. and
blue-prints of the building duly approved by corporation/municipality panchayat.
12.8.1 Please furnish the following particulars of Architects
12.8.1.1 Name and address of the architects/firm
12.8.1.2 Scope of work.
12.8.1.3 Rates quoted and detailed estimate of expenses
12.8.1.4 Fees payable and manner in which payable.
12.8.1.5 Time schedule
12.8.1.6 Penalties
12.8.1.7 Past experience of the architects in the similar work
12.9 PARTICULARS OF MACHINERY & OTHER FIXED ASSETS
As per Annexure –II
12.9.1 If sub-contract of any portion of production is envisaged, the production stages in which the sub-contracting will be done.
Details to indicate the availability of machinery particulars with the sub-
contractors with adequate spare capacity.
12.9.2 Arrangements made for erection and commissioning of the plant.
12.10 Necessity & purpose for the proposed investment/addition to factory
premises/machinery (in case where such investment is intended) for
achievement of the anticipated turnover.
State Bank of India
12.11 RAW MATERIALS & COMPONENTS (Please mention about the imported and indigenous items separately)
(A) (B) (C) (D)
Quantity Required
Sources of Supply
Minimum Purchase
Quantity
Lead/Procurement
Time
Available throughout
the year
If answer to above is
no then no. of months
& period when it is
available
(enclose copies of proforma invoices in respect of each item)
13. UTILITIES (Give comments on requirement, availability/adequacy, qualitative
aspects etc.)
13.1 Power
13.2 Sources of Power and Supply Voltage - Taken from Electricity Board
- Own generation
- Stand-up arrangements
13.1.2 Maximum Demand
13.1.3 Contracted Load 13.1.4 Connected Load
13.1.5 Energy Consumption per year
13.1.6 Power Tariff
13.1.7 Cost of Power per annum at maximum capacity utilization
Please enclose a. Certified zerox copy of sanction for power
b. Certified zerox copy of agreement with electricity board.
c. Certified zerox copy of electrical layout of the plant.
13.2 Water : 13.2.1 Indicate the requirements and suitability of water
13.2.2 Describe the water treatment arrangement
13.2.3 Sources for supply of water arrangement
Proposed and water charges payable
13.3 Steam : 13.3.1 Requirement of steam
13.3.2 Capacity of boiler
13.3.3 Arrangements proposed for steam
State Bank of India
13.4 Compressed Air :
13.4.1 Requirements of compressed air
13.4.2 Arrangements proposed for compressed air 13.5 Fuel :
13.5.1 Requirement of fuel
13.5.2 Arrangements proposed for supply
13.6 Arrangement proposed for carrying raw materials.
14. EFFLUENT Please furnish full details of the value of atmosphere, soil and water pollution
likely to be created by the project and measures proposed for control of pollution.
Indicate whether necessary permission for the disposal of effluent has been
obtained from the concerned authority, if yes, a copy of the certificates should be
furnished.
15. QUALITY CONTROL 15.1 Details of arrangements made for quality control
If BIS/FPO/ISO specifications are followed, no. of
BIS/FPO/ISO standards and particulars thereof should be provided
15.2 Particulars of R&D activity proposed.
16 ECONOMIC FEASIBILITY
Marketing (mention separately for each product)
(Please enclose a Market Survey Report
16.1 Whether the product is reserved exclusively for the SSI Sector? If so, please
furnish Item Code No.
16.2 Names of the Major customers
16.3 Region/Area where the product is/will be sold
16.4 Extent of competition & No. of Units engaged in similar line in the area
16.5 How does units meat/propose to meet the competition
(Comment on the competitive advantages enjoyed by the unit)
16.5.1 In price and quality, how does the unit’s product compare with those of its
competitors
16.5.2 Is the unit selling direct to its customers? If so, please furnish details like sales
force, showrooms, depots etc.
State Bank of India
16.5.3 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
copies of agreement, wherever applicable)
16.6 Nature and volume of orders/enquiries on hand (zerox copies to be furnished)
16.7 If the unit is 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.O.B. Value in US$
17. Cost of Project
(Please furnish estimates of cost of project under the following heads indicate the basis for arriving at the cost of project)
(in 000’s of Rs.)
Sr.No. Particulars Already
Incurred
To be
Incurred
Total cost
A. Landing including
development
B. Building & Other Civil
Works
C. Plant & Machinery
i) Indigenous
ii) Imported
D. Essential Tools, Spares &
Accessories
E. Testing Equipment
F. Miscellaneous Fixed Assets
G. Erection/Installation Charges
H. Preliminary Expenses
I. Pre-operative Expenses
J. Provision for
Contingencies
1. Buildings
2. Plant & Machinery
3. Other Fixed Assets
K. Margin for Working
Capital Required
L. Total
State Bank of India
18. Means of Financing
(Please furnish details of sources of finance for meeting the cost under the following heads)
(in 000s of Rs.)
Sr.
No.
Particulars Amount
Already
Raised
Amount
Proposed to
be Raised
Total
A. Capital
(specify resources contributing capital)
B. Reserves
C. Term Loans (give full
particulars)
D. Unsecured Loans and
Deposits (Indicate sources,
rate of interest repayment
period etc.)
E. Deferred Payment
Arrangements including Suppliers Credit
F. Subsidy
- Central Govt. - State Govt.
G. Seed Capital (indicate sources)
H. Internal Cash Accruals
I. Other sources (specify)
J. Total
19.1 In case internal accruals are taken as sources of finance explain the basis for
estimation of internal accruals by means of a statement.
19.2 Indicate sources from which expenditure already incurred has been financed.
19.3 Promoter’s contribution to the project as % of the total cost.
(Please furnish list of persons/firms who would be contributing to the promoters’
share of the capital and the respective amounts and their relationships).
20. Financial Assistance required :
20.1 Rupee Loan
20.2 Foreign Currency Loan 20.3 Underwriting
20.3.1 Equity Capital
20.3.2 Preference Capital
State Bank of India
20.3.3 Debentures
20.3.4 Guarantee of foreign currency loan/Deferred Credit
20.4 Guarantee for foreign currency loan/Deferred Credit 20.5 Working Capital (Please furnish as per Annexure-VI)
20.6 Other forms of assistance (e.g. LC’s, Guarantees, etc.)
21. Schedule of Implementation :
Please indicate the progress made so far in the implementation of the project and furnish the scheduled of implementation as follows :
Date of Expected
Commencement Date of Completion
a) Acquisition of Land
b) Development of Land
c) Civil Works for
- Factory Building
- Machinery Foundation - Administrative Building
d) Plant & Machinery
- Imported
_ Indigenous
e) Arrangement for power f) Arrangement for water
g) Erection of equipment
h) Commissioning
i) Initial procurement of Raw Material
j) Trial Runs k) Commercial Production.
22. Future Projections
(To be given for the next five years)
Please furnish data on :
22.1 Projected profitability as per Annexure-III
22.2 Projected cash flow statement as per Annexure-IV
22.3 Projected balance sheet as per Annexure-V
22.4 Working Capital requirement as per Annexure –VI 22.5 Percentage of Cash Sales in total Sales - -------%
22.6 Period in which payment is received in respect
of Credit Sales _______days
22.7 Average credit available on purchases _______ days
23. How far does the unit contribute to the establishment of ancillary units in the region.
State Bank of India
24. Please furnish International/CIF/FOB Price of all inputs, which can be imported.
25. Government Consents:
Please indicate whether the various licenses / consents required for the project
have been obtained from the respective authorities.
24.1 Specify any special condition attached to the licenses / consents and the
Undertaking given by the company in connection therewith.
26 Repayment programme:
27 Details of securities to be offered
27.1 Primary
(working capital & term loan securities to be indicated separately)
27.2 Collateral (full details)
27.3 Details of guarantors(s)
27.3.1 Name
27.3.2 Residential address
27.3.3 Occupation (if in service, name & address of his / her employer)
27.3.4 Details of Movable & Immovable Property (ies) owned by him / her & other
Dependent family members
27.3.5 Details of any similar guarantee, if any, given to other institutions.
28 Whether any Government enquiry proceedings of prosecution has been instituted
against the unit or its proprietors / partners / promoters / directors for any
offences? if so, please give details.
29 Details of pending litigation, if any, against and by the concern.
30. Please indicate whether any of the promoters of directors have at any time
declared themselves as insolvent.
State Bank of India
I / We certify that all information furnished by me / us is true; that I / 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 me / us / promoters except as indicated in the application; no legal action has been / is being against me / us / promoters; that I /
We shall furnish all other information that may be required by you in connection with my
/ our 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 / National
Bank of Agriculture and Rural Development / Small Industries Development Bank of India / Deposit Insurance & Credit Guarantee Corporation or any other agency as
authorized by you, may, at any time, inspect / verify, my / our assets, books of accounts,
etc., in our factory / business premises as given above.
Signature of the Borrower (Name & Designation)
Date
Place
Encl: Certified Xerox Copies of
a) Audited balance Sheets with Trading and Profit & Loss Account, for the
last three years.
b) Memorandum and Articles of Association, Certificate of Commencement of Business in case of limited companies..
c) Income tax, Wealth tax Returns and assessment orders for the last three
years, for the unit as well as proprietor / partners / promoters / directors.
d) Sales Tax Returns and assessment order for the last three years
Forms as per Appendix – SSI-I to Appendix – SSI- VI given hereafter should also be
submitted along with the application for advances above Rs. 10 lacs,
TRADE AND SERVICES
ANNEXURE-C - For MSE’s upto 25 Lakh. (Application form)
ANNEXURE-D - General Information (Application form)
NAME AgeAcademic
QualificationRESIDENTIAL
ADDRESSTELEPHONE
(Residence)
Experiencein the line of activity
STATE BANK OF INDIA:ANNEXURE – C
APPLICATION FORM FOR MSEs - Upto Rs 25 Lakh
To be submitted along with documents as per the checklist
(For Office Use)
1 NAME OF THE ENTERPRISE
2 REGD. OFFICE ADDRESS
3 ADDRESS OF FACTORY/ SHOP
4 WHETHER BELONGS TO SC/ST/OBC/MINORITY
Telephone No. (Office)
E MailAddress
Mobile No. PAN Card No.
5 CONSTITUTION Proprietory/ Partnership firm/ Pvt Ltd/ Ltd Company/ Co-op Society
6 DATE OF ESTABLISHMENT
7 NAME OF PROPRIETOR/ PARTNERS/ DIRECTORS OF COMPANY AND THEIR ADDRESSES
Name of AssociateConcern
Address of Associate Concern
PresentlyBanking with
Nature ofAssociation
Extent of Interest as aProp./Partner/Director
or Just Investor in Associate concern
Type of facility
Limit(in lacs)
Outstanding as on …….
Presentlybanking
with
SecurityLodged
Rate ofInterest
RepaymentTerms
Current A/c
Cash Credit
Term Loan
LC/BG
If banking with this Bank, Customer No. be given here
Type of facility
Amount(in lacs)
Purpose for which
reduiredSecurity Offered
Primary Security (Details with approx. value to be mentioned)
Whether CollateralSecurity offered (Please mention yes or no) (If yes, then provide details in Column 12)
Cash Credit YES / NO
Term Loan YES / NO
LC/BG YES / NO
8 ACTIVITY Existing
Proposed(#)# If a different activity other than existing activity is proposed
9 NAMES OF ASSOCIATE CONCERNS AND NATURE OF ASSOCIATION:
10 Relationship pf Proprietor/Partner/Directorwith the officials of the Bank/Director of the Bank
10(a) CREDIT FACILITIES (EXISTING) (Rs. in lacs)
10(b) It is certified that our unit has not availed any loan from any other Bank/ Financial Institution in the past and I am not indebted to any other Bank/ Financial Institution other than those mentioned in 10(a) above.
11 CREDIT FACILITIES (PROPOSED):
In case of term loan requirements, the details of machinery may be given as under:
Past Performance/ Future Estimates (Actual performance for two previous years, estimatesfor current year and projection for next year to be provided for working capital facilities. However for term loan facilities, projections to be provided till the proposed year of repayment of loan):
(Rs in lacs)PAST YEAR-II(Actual)
PAST YEAR-I(Actual)
PRESENT YEAR(Estimates)
NEXT YEAR(Projection)
Net SalesNet ProfitCapital (Net worth in caseof companies)
Statutory Obligation Whethercomplied with (Write Yes/No). If not applicable, then write N.A.
Remarks (Any details inconnection with the relevant obligation to be given)
1. Registration under Shops and Estd Act2. Registration under SSI (Provisional/Final)3. Drug License4. Latest Sales tax return filed5. Latest Income tax return filed6. Any other statutory dues remaining outstanding
Type of machine
Purpose for which
required
Whether imported or indigenous
Name of supplier
Total cost of machine (in case
of imported machine, the
breakup of basic cost, freight,
insurance and customs duty be
given)
Contribution being made by the promoters
Loan required
12. Details of Collateral Security offered, if any, including 3rd party guarantee *(* As per RBI guidelines, banks are not to take collateral security for loans upto Rs. 5 lakhs toMSME units)
13
14 Status regarding Statutory Obligations:
SPACE FOR PHOTO SPACE FOR PHOTO SPACE FOR PHOTO
Signatures of Proprietor/ Partner/ Director whose photo is affixed above
Only one photo of properitor / each Partner / Each working Director is required to be affixed. Each photo will be certified/attested by the Branch Team with name andsignatures on the photograph with Branch stamp. The concerned staff will put his name below the signatures.
15
16 Date: Place:
I/We certify that all information furnished by me/us is true; that I/We have no borrowing arrangements for the unit except as indicated in the application; that there is no overdues/statutory dues against me/us/promoters except as indicated in the application; that no legal action has been/is being taken against me/us/promoters; that I/We shall furnish all other information that may be required by you in connection with my/our application that this may also be exchanged by you with any agency you may deemed fit and you, your representatives, representatives of the Reserve Bank of India or any other agency as authorised by you, may, at any time, inspect/verify my/our assets, books of account etc. in our factory/business premises as given above.
ANNEXURE-D - General Information (Application form)
APPLICATION FORM
A. GENERAL INFORMATION :
1. Name:
2. Address: (furnish details of branches, if any)
3. Constitution:
(Partnership / Proprietorship/Joint Hindu Family/Co-operative Society/ Public Limited Company/Private Limited Company etc.)
4. Date of establishment:
5. Names and addresses of Partners/ Directors etc.:
Name Address
6. Brief details of business experience of persons managing the business:
7. Nature of business:
8. Names of associate concerns and nature of association (i.e. common partner, subsidiary etc.):
Names of associate Concerns Nature of Association Extent of Interest
B. PROPOSAL:
9. Nature of facilities sought: (Please indicate separately the types of facilities required, i.e. whether term loan or working capital advance i.e. cash credit/bill facilities/ clean overdraft etc.)
Sl. No. Type of facility Amount
10. Purpose of the advance: (In case of working capital advance, please state with reasons whether the advance is required (a) for advance payment to suppliers; (b) for carrying higher stocks; (c) for extension of higher credit on sales; (d) to repay sundry creditors for purchases; (e) for repayment of borrowings from other banks/financial institutions; (f) for repayment of other outside borrowings e.g. against hundies etc.; (g) withdrawal of capital; (h) investment elsewhere; (i) any other purpose).
11. (a) Existing arrangements from other banks/financial institutions and others:
(Amount in Rs. )
Name of the Bank or Nature of Position of accounts as Security, rates of
Financial Institution
facility on
_ _ /_ _ /_ _
interest, repayment terms, if any
Limits Outstandings
11. (b) Other borrowings/liabilities:
Source Amount Security Terms of repayment, if any
11. (c) Are you agreeable to deal exclusively with us? If not, please give reasons:
12. Security offered:
(a) Stock, bills etc.
(Please give brief details of stocks; also, what would be the types of bills, whether they would be clean or would be accompanied by documents, i.e., R.Rs., motor truck receipts, etc. If bills cannot be drawn, please indicate reasons therefor).
(b) Mortgage of immovable properties:
(Please indicate brief details of the properties offered, in whose names they stand, nature of mortgage, estimated market value, prior charges, if any).
(c) Life Insurance Policies, Shares, Debentures, etc.:
(Please give details of the security, surrender/market value, etc.)
(d) Guarantee:
(Please indicate brief details about the guarantor, his worth, etc.)
C. FINANCIAL & OPERATIONAL DATA :
13. Performance : (000’s omitted)
Actuals for last year
Estimates for
current year
Projections for
next year Purchase
Sale
Net profit
14. Plans and Prospects: (Please indicate plans for expansion, diversification, etc. if any and prospects for the next year)
15. Position regarding Income-tax Assessment:
(Please indicate the year up to which assessment has been completed. If assessment is in arrears, reasons therefor, amount of arrears of income-tax, if any, and provision made therefor. Please attach copy of latest assessment/return.)
16. Position regarding Sales-tax:
(If there are arrears, these may please be indicated. Please attach copy of latest assessment return).
17. Position regarding Wealth-tax:
(If you are a wealth-tax payer, please attach a copy of the recent declaration and indicate position regarding assessment.)
18. Financial position of the Proprietor/each Partner/ each member of JHF :
(To be furnished in the case of proprietorship concerns partnership firms/joint Hindu family (JHF) concerns respectively.)
(a) Particulars of immovable properties
Name of the individual
Nature of immovable properties
Location Estimated value
(000’s omitted)
Prior charges, if any
(b) Particulars of movable assets
Name of the individual
Brief details of movable assets e.g., share, units, securities, etc.
Market/surrender value (000’s
omitted)
Prior charges, if any
(c) Particulars of borrowings/ liabilities, if any.
Name of the individual
Source Amount in Rs.
Security Terms of repayment, if any
Place.......................
Date........................ Signature of Applicant
NOTE:-
(1) This application form should be accompanied by two copies of the audited balance sheets and profit and loss account which are not more than 12 months old. (In case accounts are not audited, statements of assets and liabilities and supplementary information as per proforma Annexure-D should be furnished). In case of new connection, kindly submit the audited balance sheets and profit and loss accounts (or in the alternative, statements as per proforma Annexure-D) for the last three years.
(2) Please fill in Appendix -A and/or - B, if the application is for a working capital advance and/or term loan.
(3) Please attach two copies of Partnership Deed/Bye-laws / Memorandum and Articles of Association in case of new connection or change in the constitution of partnership firm/ co-operative society / joint-stock company.
APPENDIX-A
(This form is to be completed only when working capital finance is required)
Name of the unit: .....................................................
1. PURCHASES:
(a) General: (Please indicate who are the major suppliers, whether the goods are subject to any quota/ price control/ Government regulation, whether there are any special problems involved in making purchases).
(b) Terms of purchases:
Advance payment, if any, required to be made:
Period and amount of credit available:
(c) Trend of credit received: (000’s omitted)
Actuals for last two years
Estimates for current year
Projection for next year 20_ _ / _
_ 20_ _/_ _
Average credit received Maximum credit received(*)
Minimum credit received(*)
2. SALES:
(a) General: (Please indicate who are the major buyers or nature of class of clientele; whether the goods are subject to any quota/ price control/ Government regulations; after sales service arrangements, where necessary and whether there are any special problems involved in effecting sales.)
(b) Terms of sales:
Percentage of credit sales to total sales:
Terms of Credit:
(Please indicate period of credit, discounts
if any, offered for cash sales or earlier payments for credit sales)
(c) Trend of credit given: (000’s omitted)
Actuals for last two years
Estimates for current year
Projection for next year 20_ _ / _
_ 20_ _/_ _
Average credit given Maximum credit given (*) Minimum credit given (*)
3. STOCKS POSITION: (Please indicate quantity and value both wherever possible.)
(000’s omitted)
Actuals for last two years
Estimates for current year
Projection for next year 20_ _ / _
_ 20_ _/_ _
Average stocks carried Maximum stocks carried (*)
Minimum stocks carried (*)
4. STORAGE: (Please indicate how the goods are stored. whether adequate storage space is available, what portion of goods can be kept under Bank’s lock and key, what portion is required for display and day-to-day operations, period of which stocks can be stored safely and special precautions, if any, required to be taken for storage of stock.)
Place................................
Date................................. Signature of Applicant
(*) Data in regard to maximum and/or minimum should be given where, the average differs substantially from the maximum and/or minimum due to seasonal or other factors.
Appendix B
(This form is to be completed only when a term loan is required)
Name of the Unit:
1. Cost of the Scheme
Cost already met Cost to be met Total Cost Basis of the Cost Estimate
Land
Building
Equipments
(Please indicate nature of equipment)
Others (Please specify)
Total
2. Corresponding Sources of Finance
Cost already met Cost to be met Total cost
Own resources
Borrowing from friends, relatives etc
Borrowing from Bank
Deferred payment
Others (Please specify)
Total
3. Need for the Proposed Capital Expenditure
(Please indicate the background of the scheme viz, why it is taken up and what benefits accrue therefrom)
4. Time Schedule:
(Mention when scheme is to be completed)
5. Mode of Disbursement:
(Whether the loan is required in lump sum or in instalments and if in instalments, please indicate the dates and amounts of withdrawals)
6. i. Profitatbility:
Year 20---/-- 20--/-- 20--/-- 20--/--
Sales
Other income
Total (A)
Expenses
Purchases
Salaries & allowances
Other establishment expenses
Insurance
Rent and taxes
Advertisement and publicity
Stationary
Travelling expenses
Other expenses (Please give details of major items)
Depreciation
Interest
Total (B)
Net Profit (A-B)
Less: Income tax
Net Profit after
tax (C)
Add back depreciation (D)
Total cash accruals (C+D)
Repayment of loan
Note: In case the capital expenditure programme as well as plans for raising funds to meet the expenditure extends over a period of 2 to 3 years, a cash flow forecast statement as in item 6. (ii) given below should be furnished, otherwise statement 6 (i) given above would be sufficient.
6. ii. Cash Flow Forecast: (The statement should cover the entire period of the loan and requires to be completed only if the capital expenditure programme as well as plans for raising funds to meet expenditure extends over a period of 2/3 years or more)
a. Sources of Funds:
Year 20---/-- 20--/-- 20--/-- 20--/--
1. Net Profit after taxes (Item (C) above)
2. Add: back depreciation
3. Total cash accrual: (1+2)
4. Increase in capital
5. Increase in terms loans and deferred payment guarantee
6. Increase in current liabilities
7. Increase in short term bank borrowing
8. Increase in loans and deposits from friends and relatives, subsidiaries, etc.
9. Decrease in fixed assets
10.Decrease in stocks
11.Decrease in book debts
12.Decrease in other current assets
13.Decrease in investments in associate concerns
14.Other (Please specify)
15.Total
(b) Uses of funds
16. Repayment of term loans
17.Repayment of instalments on deferred payments
18. Increase in fixed assets
19.Decrease in current liabilities
20. Increase in book debts
21. Increase in stocks
22. Increase in investments in associate concerns
23.Repayment of deposits/loan
24.Dividends or funds required for personal maintenance
25.Any other (Please specify)
26.Total
27.Surplus (15-26)
7. Repayment Schedule: (Please indicate as to how you intend to repay the loan)
8. Security offered:
(Please give details of the security you propose to give to the bank and details of the existing charges thereon, if any)
9. Working Capital:
(Please indicate here the details of your working capital requirement and the sources from which they be met)
Place
Date Signature of Applicant