A&NI KVIB

ANNEXURE – V

FORMAT FOR SPONSORING THE BENEFICIARY FOR UNDERGOING EDP TRAINING

a) Name & Address of the beneficiary :

b) Name of the Activity :

c) Location of the Unit :

d) Whether the beneficiary belongs to :

SC/ST/OBC/Minority/Ex-Servicemen/
PHC/Women OR General
e) Name of Financing Bank with add :

f) Total cost of the Project : C.E. : _______________ W.C. _______________

g) Amount sanctioned with date :

h) If the beneficiary is from any : a) Name ___________________

Institution, Trust, Co-op. Society,
Name & Designation of the b) Designation ___________________
Representative

I hereby sponsor Shri/Smt./Kum. ______________________________________, S/o/W/o/D/o

_____________________________ for undergoing EDP Training at your Training Institute.

Place :
Date :
Signature of the Branch Manager
(With Seal)
To,

The Director of Industries &

Member Secretary, A&NI Khadi & V.I. Board,
Udyog Prisar, Middle Point,
Port Blair – 744101. A&N Islands
(Certificate to be issued by Training Centre)

Shri/Smt./Kum. ___________________________________, S/o/W/o/D/o ___________________

____________ sponsored by [Name & Address of the Bank] _____________________________________
_________ has undergone ______ days EDP Training from _________________ to _________________.
Kindly send the recoupment of the expenditure of Rs. _______________ at the earliest.

Place :
Date :
Signature of the Principal /
In-charge of the Training Centre
To,
The Director of Industries & Member Secretary,
A&NI Khadi & V.I.Board,
Udyog Prisar, Middle Point,
Port Blair – 744101, A&N Islands.

Copy to : The Branch Manager (Financing Branch),_____________________________

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 A&NI KVIB
………………………………………………………………………..[Name & Address of the Bank]

Ref. No. Dated, the 2009.

To
……………………………………………………..,
……………………………………………………..,
……………………………………………………..,
[Nodal Bank]
Sub: Submission of Application form-cum-Receipt for claiming Govt. Subsidy for the
project financed in favour of Shri / Smti / Kum. ……………………………………………
Under PMEGP scheme of KVIC-reg.
Sir
Please find enclosed herewith an “Application form-cum-Receipt for claiming Govt. Subsidy”
duly filled in all respects for the project financed in favour of Shri / Smti. / Kum. …………………………….
.………………………………, S/o / W/o / D/o ………………………………..………………. R/o ……………………………
…………………………. under PMEGP scheme of KVIC.

The details of the project are as under :-

Activity :
Project Cost : Rs…………………………………
Own Contribution : Rs…………………………………
Bank Financed released so far : Rs…………………………………
Margin Money : Rs…………………………………
Undergone EDP training
Period :
Training Institute :

In this connection I am also enclosing herewith the following documents for your ready
reference :
1. Attested copy of Category Certificate for Special Category
2. Copy of Sanction Order
3. Certified copy of Ledger extracts
4. Attested copy of EDP training Certificate
The Govt. subsidy amount of Rs. ………………….. may kindly be released at an early date.
Yours faithfully

Encl : As above.
Br. Manager
With Seal
Copy to :-
1. The Director of Industries & Member Secretary, Udyog Parisar, Middle Point,
Port Blair - 744101
2. The Lead District Manager, Lead Bank Office, SBI, Port Blair for information.
3. The Director [PMEGP], Khadi & Village Industries Commission, Gramodaya, 3, Irla Road, Ville
Parle [West], Mumbai-56 for information.
4. The State Director, Khadi & Village Industries Commission, 6 th & 7th Floor, 33, Chittaranjan
Avenue, Kolkatta-12 for information.

Br. Manager
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 A&NI KVIB
Please Tick () One of No.1 and any one of Number 2
1 Male Female 2 Gen SC ST OBC Minority Ex-Serviceman PH HBA
…………..……………………………………… Bank
H.O./C.O ………………………………………………..

(Application Form cum Receipt for claiming "Govt. Subsidy" from the A&N Islands Khadi
& Village Industries Board by beneficiary and Bank -
(TO BE FILLED IN BLOCK LETTERS OR TYPED)
From Full Postal Address of the Branch
The Branch Manager,
…………………..………….Branch Vill./Town .………..……..……………………
………………………………..Tehsil Road .....…………....…………………………
……………………………...District P.O.……….……....…… Pin………...…….…
...……………………….State / UT District .………….………………………..…….
…………………………………….Pin State / UT ……………………………………….
Ref. No…………………………….. Date ………………………………………
To
The Director of Industries & Member Secretary,
A&N Islands Khadi & Village Industires Board,
Udyog Parisar, Middle Point, Port Blair.
(THROUGH THE FINANCING BANK's NODAL BRANCH)
Sub : Payment of "Govt. Subsidy" against the Bank Finance sanctioned under Prime
Minister’s Employment Generation Programme of KVIC - regarding.
Sir,
I / We, Shri / Smti. / Kum. …………………………………………………………..……………… son/ wife /
daughter of .....................………………………………………….……… Secretary / Chairman / President /
Managing Trustee / Proprietor of ……………………………………….………… hereby inform that a Village
Industry project [Name of the activity …………………………………………………………………………………………]
has been sanctioned in my / our favour under the captioned Scheme by …………………
………………………………..…… (Name of the Financing Bank Branch .………………………………… Tehsil………
……….……….. District ……………………....……State/UT ………………………..……………… as detailed below:-
Details of Project cost Amount Means of finance Amount
A) Capital Expenditure
i) Work shed Rs. Own Contribution Rs.
ii) Machinery / Equipment Rs. Term Loan for Fixed Capital Rs.
B) Working Capital Rs. Cash Credit for working Rs.
Capital
Total Rs. Total Rs.
Note : 1. Cost of land should not be included in the Capital Expenditure under the project cost.
2. Total Cost of the project should not exceed Rs.25.00 lakh for manufacturing and Rs.10.00 lakh for
Service Sector.

I / We, therefore request you to please advise the Bank to disburse an amount of
Rs.………………………… (Rupees……………………………………………………………………………………………. only)
being the Govt. subsidy sanctioned by the A&N Island Khadi & V.I. Board, Port Blair. The detail of my
/ our project is as under:
2.1 a) Full Name of the beneficiary / Society / :
Institution / Trust
b) Father’s Name (In case of Individual) :

Signature of the Beneficiary…………………………. Contd.…

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 c) Date of Birth of individual :
d) Full Address (with Pin Code) :

e) Legal Status / Constitution (Partnership firm :

not eligible)
f) Registration No. and date, if any :
2.2 Location of the Unit (Village, Taluka, Dist. and :
State with Pin Code)

2.3 Village Industry Activity (Please specify) :

2.4 a) General Category : YES/NO
or
b) Whether the beneficiary belongs to SC / ST/ :
Minority / OBC/Ex-Servicemen / PHC /
Women / HBA. (Please specify)
2.5 Per Capita Fixed Investment (C. E. divided by full : Rs.
time employment equal to Rs. 1,00,000 in plain
areas & Rs. 1,50,000 in hilly areas)
2.6 Employment envisaged (Full time) :
2.7 Particulars of deposit of Own Contribution :
a) Nature of Deposit : SB/CD
b) Account No. :
c) Date of deposit :
d) Amount deposited : Rs.
2.8 Bank's Sanction Letter No. (Copy of sanction :
order to be enclosed)
a) Date of Sanction :
b) Amount sanctioned : Rs.
2.9 Date and amount of first disbursement (Certified :
copy of ledger extracts to be enclosed)
2.10 Whether the sanction is covered under Credit :
Guarantee Fund Scheme for Micro, Small
Industries of CGTMSE
3. I / We hereby agree to abide by the terms and conditions and instructions issued by the
Khadi & V. I. Commission in this behalf from time to time and those to be issued in future
with regard to PMEGP. I/We also agree to furnish quarterly progress report on
production, sales, employment, wages paid etc. to the Bank which in turn will send
the information on quarterly basis to the Khadi & V.I. Commission/Board for record and
further information.
4. I / We hereby declare that the Govt. Subsidy has not been claimed either by me or by any
other person of my family for the same or any other Project in the past and “one family one
subsidy” norm has been followed. Further, the Bank credit has not been/will not be utilized to
adjust or square off any previous loan / advance taken by me / us in the past.

Signature of the Beneficiary…………………………. Contd.…

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5. Certified that the unit financed by ………………………………..………………..………(Name of
Financing Bank) ………….………………………….….......(Name of the Branch) in my / our favour
under ……………………………………………………….……...……….. (activity/industry) is a new Village
Industry unit and not an existing unit.
6.(*) It is also certified that the unit located at the address mentioned in the Govt. Subsidy is in my
name only and I am the sole proprietor of this unit. It is also declared that, it is not a
Partnership Firm/Private Company, etc.
7. Certified that I / We have already undergone necessary EDP Training of………...Days / weeks
/ Months during the year ………………… conducted by …………………………………………………………
……………………………………………………………………..(Name & Address of the training institute).
OR
8. Certified that I / we shall display following sign-board at the main entrance of my / our
project site:-
…………………………………………………………..…..(unit name)
Financed by …………………………………………………... (Bank)
under PMEGP Scheme of KVIC.
9. I / We are ready to bear the amount of Guarantee fee and Annual Service fee in respect of
Credit Guarantee Fund Scheme for Micro, Small Industries operated by CGTMSE, if the Bank
in its discretion decides to recover the same.
10. I / We, hereby undertake to refund proportionate amount of Govt. subsidy calculated on
working capital loan/cash credit facility, if the said WC Loan / CC facility is not adequately
utilized as per stipulated norms of KVIC. The average utilization of working capital during the
first year of operation of the unit should not be less than 75% of the sanctioned limit and the
limit should touch at least one peak level utilization of 100% within two years' period before
the Govt. Subsidy amount is adjusted with the loan amount.
11. It is hereby declared that all facts furnished above by me/us in the Govt. Subsidy
claim are correct and if any information is found to be false or leads to misguiding
the authorities with ulterior motive of availing Govt. Subsidy, I /We should be
subjected to any punishment as deemed fit in the eyes of law.
12. The Advance Stamp Receipt of Govt. Subsidy amount is also attached.

Yours faithfully,

Place:
Date:
Name & Signature of the Beneficiary
SEAL

COUNTERSIGNED

BRANCH MANAGER
(Seal of the Bank Branch)

Signature of the Beneficiary…………………………. Contd.…

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 RECEIPT
Received Rs. ………………………..… (Rupees……………………………………………………………
……………….…………………………………..only) from the Chief Executive Officer, Khadi and Village
Industries Commission Mumbai-56, towards the payment of "Govt. Subsidy” in respect of project
for……………………………………………………………………….….……………… sanctioned for Rs.
………………....……… by…………………….………………… Bank at ……………………………….. Branch.

(Revenue Stamp)
(Signature of the Applicant)
Note:- In case of a Co. operative Society/Institution, Seal has to be affixed.
(For the use of the Bank/Branch)
1. In consideration of the project of the above beneficiary / Institution, our Bank / Branch has
sanctioned a loan of Rs. ………………..……….……… after proper appraisal of the project at this end.
As against a loan of Rs. ……………………...….. (C.E. Rs……….……..…….. W.C. Rs.…………………..…)
the Bank has released first installment / full lump sum amount of loan of Rs. ……………..…...… on
…………..…..…… The Bank shall arrange to deposit the amount of Govt. Subsidy in Term Deposit
in the name of the beneficiary for 3 years from the date of release of first installment of the loan.
It is confirmed that no interest will be paid on the amount of TDR by the Bank and no
interest will be charged on the corresponding amount of the loan for a period of 3
years. The Bank is aware, that if the advance goes "bad" before 3 years, Govt. Subsidy will be
adjusted to liquidate loan liability of the beneficiary with interest. Recovery, if any, effected later
will be remitted to the Commission.
2. Certified that the unit sanctioned by our Bank Branch in favour of Shri /Smti. / Kum. / M/s
.…………………………………………………………………………….…... is a new unit and not an existing unit.
The instant Govt. Subsidy claim is in conformity with the guidelines and instructions issued by
RBI, KVIC and our Bank. The instant project has not been sanctioned for utilization / adjustment
partly or wholly, of any debt deemed bad or doubtful of recovery or to adjust / liquidate any past
loan / advance.
3. Certified copy of the Sanction order of the Bank and certified ledger extracts of the
borrower’s Term loan A/c and Cash credit account is / are enclosed.
4. Shri / Smti. / Kum. …………………………………………………………… Son/wife/daughter of ………………..
………………………..has been undergone EDP training and a copy of the certificate is enclosed .
5. Certified that the unit sanctioned by our Bank Branch in favour of Shri / Smti. / Kum.
………......................................................……………… and Govt. Subsidy amount released to the
unit will be proportionately recovered and remitted to KVIC if the unit does not adequately utilize
the WC / CC facility as per KVIC norms i.e. the average utilization of WC during the first year of
operation of the unit should not be less than 75% of the sanctioned limit and the limit should
touch atleast one peak level utilization of 100% within 3 years' period before the Govt. subsidy
amount is adjusted with the loan amount.
Place:
Date :
(Signature & Designation of the Bank
Official with Seal of the Bank)
Signature Code / P.A. No……………..
Encl. :
1. Attested copy of Category Certificate for Special Category
2. Copy of Sanction Order
3. Certified copy of Ledger extracts
4. Attested copy of EDP training Certificate

Signature of the Beneficiary………………………….

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