Annexure 1

Bio-data of the Promoters / Guarantors

(Pl affix recent

passport size
colour
photograph and
sign across it)
a. Name
b. Fathers/ Husbands Name
c. Date of Birth
d. Sex (Male/Female/Third Gender)
e. Relationship with chief promoter
f.

Whether belongs to Scheduled Castes /

Scheduled Tribes / Minority community
g. Are you Ex-Servicemen

Yes / No
Yes / No

h. Residential Address- Temporary

i.

Residential Address- Permanent

j.

PAN No

k. Mobile No
l.

Telephone No Office

m. Telephone No Residence
n. Academic qualifications
o. Professional qualifications
p. Experience
q. Functional responsibilities in the unit
r.

Reasons for joining / establishing the

unit (please mention about motivating
factors)
s. Family details - Spouse & children
(age,
educational
background
&
present occupation)
t. Details
of
Past
Experience
of
Entrepreneurship
u. Major Skills / Area of Expertise

Signature
Name

v. Financial/ capital contribution in all the

existing enterprises/ businesses in
which involved as promoter/ director/
partner/ proprietor etc (face value
only)
w. Functional
responsibility
in
applicant enterprise
x. Functional
responsibility
in
proposed venture
y. Any other relevant information

Name of
concern/
associate
concerns

Capital contribution
(` lakh)
At
At present
beginning

the
the

I declare that the above particulars are true & correct to the best of my knowledge and
belief.

(Signature)
Name of the Promoter

Signature
Name

Annexure 2
Signature Verification by Banker
Photograph
of the
Promoters /
Guarantors

Name
Signature

Signature
Name

Annexure 3
Networth of Promoters / Guarantors
1.
2.
3.
4.

Name of the promoter/ Guarantor

Fathers name
Age and Sex
Address & Contact Details
Correspondence

5.

--------------------------------------

--------------------------------------

--------------------------------------

Residential

--------------------------------------

Permanent

--------------------------------------

--------------------------------------

PAN No. and / or Passport no.

6.

DETAILS OF ASSETS (Rs lakh)

i)

MOVABLE ASSETS (other than shares held in the applicant enterprise)

a) Cash and Bank (Savings/ FD)
:
b) Liquid Shares/ Bonds/ Mutual Funds :
Bankers Verification

Name of the Bank:

Signature:
Name:
Designation:
Date:

c) Insurance policies (Surrender value):

d) Details of other securities like stake in
unlisted concerns, etc
:
e) Vehicles/ Jewellery
:
f) Others (kindly specify)
:
Total
:
ii)

Date of
Acquisiti
on

Kindly provide details of the pledge :

or hypothecation of the above assets

iii)
IMMOVABLE PROPERTIES
Locatio
Whether Land/
Extent of
n/
House/ Flat/
holding
Address
Commercial/
(%)
with
Agricultural
PIN
property

Name of
joint
owner, if
any

Value
( ` lakh)
Purcha Mkt.
se
Value
price

Details of
mortgages,
encumbranc
e

TOTAL
7.
DETAILS OF LIABILITIES
S.No
Borrowings from

Purpose

Secured by

Amount still to be
repaid (` lakh)

1
2

Signature
Name

DETAILS OF GUARANTEES GIVEN

Guarantee given to
On behalf of/
(name of bank/ person)
purpose

Guarantee valid
upto

Amount involved
(` lakh)

1
2
Debit Balance shown in Balance Sheet of any company/ firm
in which you have financial interest/ stake
Any other liabilities
Total Liabilities
8.

SUMMARY

Value of Movable assets

Value of immovable properties
Total Assets (` Lakh)
---------------------------------------

:
:

----------------------------------------------------------------------------:

Less: Total liabilities (` Lakh)

---------------------------------------

Net Assets (` Lakh)

---------------------------------------

9.

Profit in Business (` Lakh)

10.

DECLARATION

---------------------------------------

I declare that the above particulars are true and correct to the best of my
knowledge and belief and I undertake to furnish such other information as SIDBI may
require.
Place : --------------------Date : ---------------------

Signature: --------------------Name
: ---------------------

===================================================
CA Certification
Based on the verifications of all the relevant documents/ vouchers/ books of accounts /
bank accounts etc. of Shri/ Smt. ______________________________, we certify that the
above information is true & correct to the best of our knowledge.
Place : --------------------Date : ---------------------

Signature: --------------------Name/stamp of the Firm / Partner:

Membership No ---------------------

Note:
1. Net worth details should contain full details of the following :
a. immovable properties including complete address,
commercial etc.) and whether they are mortgaged with
thereof;
b. movable assets including the details of investments
debentures, fixed deposits indicating name of company/

area (residential,
others with details
in shares, bonds,
firm, amount, face

Signature
Name

value, interest rate, etc., and whether they are pledged with others with details
thereof;
c. full details of liabilities including names, amounts, terms etc. ;
2. Kindly enclose copies of sale deeds, demat statements of shares, debentures &
bonds held, policies, etc.
*****

Signature
Name

Annexure 4

PRESENT SHAREHOLDING PATTERN AS ON

--------------FOR PARTNERSHIP FIRMS / LLPs
S.No

Name of the Partner

Capital
as on

Share
holding
In %

profit / loss
sharing ratio

i.
ii.
Grand Total
(` Crore)
FOR PRIVATE LIMITED / LIMITED COMPANIES

Authorised
capital
Paid-up
capital
Name of
shareholder

Equity shares
` ---- lakh consisting of --- no of
equity shares of ` -- each
` ---- lakh consisting of --- no of
equity shares of ` -- each
Face
value of
shares
(` lakh)

Premiu
m
(` lakh)

%
holding
of
equity
shares

Preference shares
--- no of --- % preference
shares of ` each
--- no of preference shares of
` each
Face
value of
shares
(` lakh)

Premiu
m
(` lakh)

%
holdin
g

Promoters
Names
Relatives
Names
Friends
Names
VC/ PE Investor
Names
Others
viz
Strategic
Investor / Joint
Venture
Partner, if any
(specify)
Total
In case of premium, kindly give full details of raising of capital (date-wise) & premium
amt
In case of Preference shares, kindly furnish complete terms of investment (enclose term
sheet)
Kindly indicate convertible instrument, warrant, ESOP, shares issued other than cash, if
any
============================================

Signature
Name

Signature
Name

Proposed shareholding pattern

(including existing and additional shareholding proposed now)
S.No

Name of the Partner

Capital
as on

Share
holding
In %

profit / loss
sharing ratio

i.
ii.
Grand Total
FOR PARTNERSHIP FIRMS / LLPs
(` crore)

FOR PRIVATE LIMITED / LIMITED COMPANIES

Name of
shareholder

Equity shares
Face
Premiu
%
value of
m
holding
shares
(` lakh)
of
(` lakh)
equity
shares

Preference shares
Face
Premiu
%
value of
m
holdin
shares
(` lakh)
g
(` lakh)

Promoters
Names
Relatives
Names
Friends
Names
VC/ PE
Investor
Names
Others
viz
Strategic
Investor / Joint
Venture
Partner, if any
(specify)
Total

Signature
Name

Annexure 5

(
Details of the Associate Concerns &
Companies giving Corporate Guarantee
(Please use separate format for Secured Business Loan)

A.

Brief particulars of the associate concerns are given below

Name of the Associate Concern
Constitution
Factory Address
In Existance since
Active / Dormant
Nature of Activity
Products
Nature of Association
Shareholding of the chief / main
Promoters

B.

Credit facilities of the associate concerns are given below

Name
of the
Associa
te
Concer
n

Facility
Availed

Name
of the
Bank/F
I

Bank
branch
and
addres
s

Sancti
on
Amt &
date
(dealin
g
since)

Outstandin
g Amt

Overdu
e, if
any

Intere
st
Rate

Securi
ty
Offere
d

Cash
Credit
Term
Loan
LC/BG
Others
Total
Cash
Credit
Term
Loan
LC/BG
Others
Total

Please replicate the format to add details of associates (in case more than two)

Note:
Please provide last three years balance sheets of the associate concerns along
with income tax / sales tax returns.

Signature
Name

Annexure 5
Applicable for Secured Business Loan

Place: _____________
Date: /
/20__

The Branch In-charge

SIDBI, ____ Branch Office
Dear Sir,
Details of Subsidiary/JV/ Associate Concerns of the applicant Company/
Firm/ Concern
Please refer to our application for availing Secured Business Loan of Rs
______ lakh. Please find below the details of our Subsidiary/ JV/ Associate
Concerns:
Particulars
Relationship
with
borrower
(subsidiary/JV/Associate
etc)
Business Activity
Address

Entity-1

Entity-2

Entity-3

Credit
Facilities
Outstanding
[Name of Bank/ Branch/
Limit/ Outstanding]
Financial Year
Audited/Estimate/provisi
onal
Net worth (` lakh)
Net
sales/income
(`
lakh)
Net profit (` lakh)
Cash Profits (` lakh)
Total loan liabilities (`
lakh)
We certify that we dont have any other Subsidiary/ JV/ Associate
Concerns of the applicant company/ firm/ concern except mentioned in the
above table.
Yours faithfully,
(Authorised director/ Partner/ Proprietor)
Name of Applicant
================================================
============
We, M/s___________________________________, Chartered Accountants have
examined the Financial statements/ books of accounts and other relevant

Signature
Name

records/ documents for immediately two proceeding Financial Years viz. FY___
and FY______ (indicate the financial year) of the entities listed above and certify
that the information furnished above is true and correct.
We also certify that the above entities have not defaulted to any Bank/ FI
in payment of dues.
Name of Chartered Accountant:
Signature with Firms seal affixed
Membership No

Signature
Name

Annexure 6
A.
Sr
No

Status Regarding Statutory Obligations

Particulars

Approving
Institution
/
Authority

i.

Status

Registration under Shops

& Establishment Act
ii. Registration under MSME
(Provisional / Final)
iii. Drug License
iv. Latest Sales Tax Return
Filed
v. Latest Income Tax Returns
Filed
vi. Provident fund
vii. Employee State Insurance
Coroporation
viii. Consent of Pollution
Control Board
ix. Any other Statutory dues
remaining outstanding
x. Land use / NA permission
xi. Building plan approval
(Whether complied with (Select Yes/ No). If not applicable

Whether
complied
with

Expected
timeline
for
approval

Yes / No / NA
Yes / No / NA
Yes / No / NA
Yes / No / NA
Yes / No / NA
Yes / No / NA
Yes / No / NA
Yes / No / NA
Yes / No / NA
Yes / No / NA
Yes / No / NA
then select NA

Note:
Specify any special condition attached to the licenses / consents and the
undertaking given by the company in connection herewith.
B.

Contingent Liabilities details (if any)

Signature
Name

Annexure 7

Details of Management setup / Technical Staff & Employees and Succession Plan
A.

Structure of Board of Directors (applicable in case of body corporates only):

Name of
Director / Age

Representing
(promoters,
technical/
professional,
investors,
Bank, etc)*

Wholetim
e / non
executive
/
Independ
ent

Designation &
Functional
responsibilitie
s
in
the
enterpries

Existing
Shareholding
(%)

*The investor / shareholders / bank being represented by the repsective Director may be
highlighted.

B.

Professional management set up of applicant unit

(Brief particulars of key non promoter professionals handling important
responsibility areas like finance, marketing, production, technology etc)
Name of
professional / Age

C.

D.

Designation &
Responsibilites in
the enterprises

Past
experience
(Name of
previous
organisation/
Years

Shareholding,
if
any in applicant
unit (%)

Details of other executives and Staff:

Sr
No
i.

Particulars
Executives

ii.
iii.
iv.
v.
vi.

Supervisors
Administrative / Office Staff
Skilled Labour
Unskilled Labour
Others (specify)

Present

Proposed

Kindly comment on the management succession plan in the enterprise

business

Signature
Name

Annexure 8-(a)
A. Project Cost
Sr
No
i.
ii.
iii.
iv.
v.

Particulars

Already
Incurred

To be incurred
Firm
Non-firm

Total Cost

Land including
Development
Building & other Civil Works
Plant & Machinery*
Indigenous
Imported
Essential Tools, Spares &
Accessories
Testing Equipment

vi.
vii.
viii.
ix.
x.

Miscellaneous Fixed Assets*

Erection / Installation
Preliminary Expenses
Pre-operative Expenses
Provisions for Contingencies
Building
Plant & Machinery
Other fixed assets
xi.
Margin for working Capital
Required
xii.
Marketing Expenditure
xiii.
Any other (please specify)
Total
*indicate second hand, if any
B. Means of Finance
Sr
No

Particulars

i.

Capital (specify sources

contributing capital)
Reserves

ii.
iii.
iv.

v.
vi.
vii.
viii.
ix.

Amount already
raised

Amount
proposed to be
raised

Term
Loans
(give
full
particulars)
Unsecured Loans and
Deposits (indicate sources,
rate of interest, repayment
period, etc.)
Deferred
Payment
Arrangements
including
Supplier's Credit
Seed Capital
Internal Cash Accruals
Risk Capital Assistance from
SIDBI
Other sources (specify)

Signature
Name

Total

Total
In case of internal accruals are taken as source of finance explain the basis for
estimation of internal accruals by means of a statement
Indicate sources from which expenditure already incurred has been financed.

Signature
Name

Annexure 8 (b)
Particulars of Proposed Project/ Venture
Outlay
(applicable heads may be filled in with full details)
(A)
Land (Strike off whichever is not applicable)
A.1
Owned Land:
Address/
Type of Land (viz., Purchased /
Location (as agricultural,
To
be
per
industrial,
purchased
document)
commercial, etc.)

A.2
Leasehold Land:
Address / Type of Land (viz.,
Location
agricultural,
(as per
industrial
document)
commercial,
residential etc.)
Note:

Area of
Land
(sq.ft.)

Lease
Deposit
(All
inclusive)

Area
of
Land
(sq.
ft.)

Purchas
e Price
(` lakh)

Lease
Rent
payable
p.a.
(` lakh)

Name
of
seller/ vendor
and
relationship
with
promoters if
any

Date of
convey
ance
deed

Mortgages/
Encumbrance
s, created if
any

Name of
Key Lease
Mortgages/
lessor and
terms (tenure, Encumbrances,
relationship
date of lease
created if any
with
agreement,
promoters if
lock in,
any
escalation etc.)

1. Sale deed / Lease Deed/ Rent deed of the land to be enclosed.

2. Right to access from the lessor to SIDBI should be allowed for leasehold properties. Separate document may be
obtained, if necessary.
3. Recent valuation report, if any, to be enclosed

Signature
Name

(B)

Civil Works (Strike off whichever is not applicable)

B.1
Owned / Bought Out Building :
S. Description of civil works Type of
No
constru
ction

Total
Floor
area in
sq.ft.

Purchase
Price
(` lakh)

B.2
S.
N
o

Leased Building
Description of bldg. /
premises

B.3

Building / Premises Proposed to be Constructed

S.
No

Description
of civil
works

Type of
constructio
n

Total
Floor
area in
sq.ft.

Lease
deposit
(All
inclusiv
e)

Basis for Special

Details &
selection features Relationship
and price
of the
of previous
estimatio
bldg
owner with
n
promoters

Lease
Rental
per
annum
(` lakh)

Remarks

Basis for
Special Relationship of
selection features
lessor with
and rent
of the
promoters, if
estimation
bldg.
any

Type of
Total
Rate of
Total Cost Construction Expected
constructi Floor constructio
of
Stage
date of
on
area n per sq.ft. constructio
( To be
completio
in
(`)
n
started,
n
sq.ft
Under
Construction
, Completed)

Special
features
of the
bldg.

Basis for
estimatio
n

Note:
1. In case contract is awarded for construction of building, furnish details thereof such as name of contractor, amount of
contract, reputation of the builder / contractor / architect etc.
2. Other approvals from Inspector of Factories, Drug Controller, Building Plan / Layout, architect estimate etc. if any, should be
enclosed. Separate document may be obtained, if necessary.
3. Sale Deed / Lease, N.A permission, Right to access for leasehold properties to be enclosed.
4. Recent valuation report, if any to be enclosed.

Signature
Name

(C)
C.1.

Service Providers (Strike off whichever is not applicable)

Architects / Contractor/ Interior decorators (kindly indicate method of assigning work i.e tendering, etc)
S. Name & Address
No.

Scope of Cost of the work

Work
assigned
assigned

Terms of Fee
payment (amt.,
duration etc.)

Background and
past experience of
the service
provider

Basis for
selection

Architect
Contractor

Note:
1. In case contract is awarded for construction of building, furnish details thereof such as name of contractor, amount of
contract, reputation of the builder / contractor / architect etc.
2. Other approvals from Inspector of Factories, Drug Controller, Building Plan / Layout, architect estimate etc. if any, should be
enclosed.
3. Sale Deed / Lease, N.A permission, Right to access for leasehold properties to be enclosed. Separate document may be
obtained, if necessary.
4. Recent valuation report, if any to be enclosed.

Signature
Name

(D)
D.1
Sl.
No

PLANT & MACHINERY / TECHNICAL KNOWHOW / EQUIPMENTS *:

INDIGENOUS
Name of machinery /
Technology
(Model / specification/
manufacturer)

Name of
the
OEM/
Technol
ogy
Provider

Name of
Supplier
/ Dealer/
Agent

New (N),
Second hand
(SH),
Fabricated
(F), Self
fabricated
(SF)

Total Cost
(` lakh)
Basic Taxes
cost
/
Dutie
s etc

Names of 3
suppliers from
whom
competitive
quotations are
obtained and
attached

Basis of
selectio
n of
supplier

Bank Name
& A/c
details of
supplier
where
payment is
to be made

D.2
Sl.
N
o

IMPORTED
Name of
machinery /
Technology
(Model /
specification/
manufacturer)

Name of
the OEM/
Technology
Provider

Name of
Supplier
/ Dealer/
Agent

New (N),
Second
hand (SH),
Fabricated
(F), Self
fabricated
(SF)

Total Cost
(Forex &
` lakh)
Basic
cost

Taxes/
Dutie
s etc

Paymen
t Terms
(LC /
DA/DP)

Names of 3
suppliers
from whom
competitive
Quotations
are obtained
and
attached

Basis
of
selectio
n of
supplie
r

Bank Name &

A/c Details of
supplier
where
payment is to
be made

(E).
Sl.
No

MISCELLANEOUS FIXED ASSETS* :

Name of
Equipment/
Technology
(Model /
specification/
manufacturer)

Name of
the OEM/
Technology
Provider

Name of
Supplier /
Dealer/
Agent

New (N),
Second hand
(SH),
Fabricated
(F), Self
fabricated
(SF)

Cost
(` lakh)

Signature
Name

Names of 3
suppliers whom
who competitive
Quotations are
obtained and
attached

Basis of
selection
of
supplier

Bank Name &

A/c Details of
supplier
where
payment is to
be made

*Note:

1) Kindly attach latest competitive quotations on the letter head / email id of the supplier bearing the contact
details.
2) The total cost should tally with the cost of the Plant & Machinery mentioned in the Application/ Business Plan.
3) If used machinery is being considered, valuation report regarding age, performance and value from a competent
valuer to be submitted and reason to be indicated for going for the same. Prior permission from SIDBI would be required
if second hand / used machinery is being contemplated.
4) In case of imported machinery, kindly indicate mode of payment, price of the machinery in foreign currency, whether
procured directly or through local agent and the local service capability of the supplier.
5) In case of single source machinery supplier (no competitive quoataions) pl give adequate justification.
5). Details of machinery to be taken on lease/hire-purchase to be mentioned specifically with terms of the same.

(F).

INTANGIBLE EXPENSES @:
Sl. Particulars
Period
Expense
No
Amt. (` lakh)
1 Lease
/
Rental
Deposits
2 Fees
payable
to
experts
/
technical
know how
3 Marketing & Selling
Expenses
4 Others (Pl. specify)
@ Note: Detailed Notes and justification to be mentioned.

(G).

Basis of
estimation

Whom to
be paid

Purpose

PRELIMINARY & PRE-OPERATIVE EXPENSES:

Sl. Particulars
No
1 Preliminary expenses (
specify)
2 Pre-operative expenses
A) Establishment Expenses
B) Interest
on
loans
to
capitalised
C) Upfront fee, Insurance, etc
) Others (Pl. specify)

Period

Expense
Amt. (` lakh)

Pl.

be

Signature
Name

Basis of
estimation

To be paid
to

Purpose

(H)

Working Capital/ Working capital margin: Justification of requirement of Long term Working capital/ Margin
money for working capital, if included in Project Cost may be provided on the basis of details given in Annexure 16 (working
capital estimates) / as per Nayak Committee Formula / Any other approved method as applicable.
****

Signature
Name

Annexure 9

Technically Feasibility
(For cases other than those rated under CART)
i.

Name of the products (including by products) & (their ) use:

ii.

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.). Any R & D /
innovation involved.

iii.

Whether product / service has IPR value

iv.

Capacity (No. of Units / Quantify in Kg. / Volume in Litres)

Capacity
product

for

each

Licensed

Installed

Operating

v.

No. of working days in a month, No. of shifts in a day and No. of hours per shift

vi.

In case of any collaboration/ JV, please furnish a brief write-up on the period of
collaboration / JV agreement, the name of the collaborator company / JV
partner, indicating the activities, size, turnover, particulars of the existing
plants, and other projects in India and abroad set up with same collaboration /
JV.
Please enclose
(a) Copy of the published brochure highlighting the activities of the
collaborator /JV partner and balance sheet for the latest year
(b) Copy of the collaboration / JV agreement
(c) fees / royalties payable and the manner in which payable.
(d) copy of the government approval, if required, for the services of foreign
technicians, if any.

vii.

If there is no collaboration / JV agreement, please furnish full details of

arrangement proposed to be made for obtaining technical advice and services
needed for the implementation of the project.

viii.

Particulars of the Consultants :

(a) Name and address of the consultants
(b) Fees payable and the manner in which payable

Signature
Name

(c) Scope of work assigned to them

(d) Brief particulars of consultants including organisational 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
consultant and in case of foreign consultant (s), approval of the Government.
ix.
x.

Whether any of partners / promoters / directors have any interest in

consultant / collaboration firm. If so, details to be furnished.
Locational advantages of existing and proposed premises with reference to
(a) absence of civic restrictions
(b) proximity to the source of raw materials
(c) market for the product
(d) availability of
- power
- water
- labour
- transport
(e) whether backward area and benefits available

Signature
Name

Annexure 9

Technically Feasibility
(Applicable for CART Rated customers)
Please provide broad description of
1. Capacity utilization,
2. Manufacturing process,
3. Name of products,
4. Availability of
o

Power,

Water,

Labour

Transport

Fuel

Compressed Air

5. Details of Effluent discharge if any and pollution control measures adopted

including approvals obtained from PCB
6. Quality control certification (BIS, FPO, ISO etc) obtained if any

Signature
Name

Annexure 10

Raw Material & Components

FOR cases rated under RAM:
Sr
No
i.
ii.
iii.
iv.

v.
vi.
vii.
viii.

Material /
A
B
C
D
Component
Quantity Required*
Imported
/
Indigenous
Sources / Name of
Suppliers
Payment
terms
(Advance
payments/ LC /
Credit
period
available etc)
Quantity / unit cost
Lead / Procurement
Time
Available
throughout the
year#
Price Trend
* in the optimum year
# if the answer is no, then no. of months and period when it is available.

Note:
Enclose copies of proforma invoices in respect of each item.
****************************************************************
Annexure 10

Raw Material & Components

FOR cases rated under CART:

1
2
3
4
5
6
7

Major raw materials / components

Quantity required per annum
Imported / indigenous
Availability / sources of supply
Unit cost / price trends
Lead / procurement time
Names of major suppliers

Signature
Name

Annexure 11

UTILITIES, EFFLUENT & QUALITY CONTROL

(For cases other than those rated under CART)
A.

POWER
Sr No
i.

Particulars
Sources of Power and Supply Voltage

Remarks
Taken from
Electricity Board
Own Generation
Stand by
arrangements

MaxiMa
ii.
maximum demand
iii.

Contracted Load

iv.

Connected Load

v.

Energy consumption per year

vi.

Power Tariff

vii.

Cost of Power per annum at

maximum capacity utilisation

Note:
Please

B.

enclose:
Certified Xerox copy of sanction for power
Certified Xerox copy of agreement with electricity board
Certified Xerox copy of electrical lay out of the plant

WATER, AIR & FUEL

Sr No
i.
ii.
iii.
iv.

v.

vi.

Particulars
Requirements and suitability of
water
Describe water treatment
arrangements
Sources for supply of water,
arrangement proposed and water
charges payable
Steam
Requirement of steam
Capacity of boiler
Arrangements proposed for
steam
Compressed Air
Requirement of compressed air
Arrangements proposed for
compressed air
Fuel:
Requirement of fuel
Arrangements proposed for

Remarks

Signature
Name

supply
vii.

C.

Arrangement proposed for carrying

raw material

EFFLUENT
Please furnish full details of the nature of atmosphere, soil, and water pollution likely
to be created by the project and the 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 certificate should be furnished.

D.

QUALITY CONTROL
i.

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.

ii.

Particulars of quality assurance system / ERP system / R & D activity proposed

For cases rated under CART

Brief details of the above parameters may be provided.

Signature
Name

Annexure 12

ECONOMIC FEASIBILITY / MARKETING ASPECTS

(For cases other than those rated under CART)

i.

Marketing* - Industry Scenario (Demand supply, Growth rates, Regulatory

issues etc)

ii.

Consumer profile of the industry - Whether the product is reserved exclusively

for the SSI sector? If so, please furnish Item Code No.

iii.

Profile of the Major Customers

Current
FY
(no of
months
- .)

Last FY

Previous
FY

Total no of customers
Names of top 5 customers existing
Name of product/ service
supplied
Good/ services supplied (` lakh)
Total no of customers
Names of top 5 customers existing
Name of product/ service
supplied
Good/ services supplied (` lakh)
Total no of customers
Names of top 5 customers existing
Name of product/ service
supplied
Good/ services supplied (` lakh)
Terms of supply (against LC,
advance
received,
receivable
days, etc)

II

III

IV

II

III

IV

II

III

IV

iv.

Region / Area where the product is / will be sold

v.

Extent of competition & major players engaged in similar line in the area

vi.

How does the unit / meet propose to meet the competition (comment on the
competitive advantages enjoyed by the unit)

vii.

In price and quality, how does the unit's product compare with those of its
competitors?

viii.

Existing marketing, selling, distribution arrangements: 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)

Signature
Name

ix.

Details of existing / new customers (with major names) proposed to be

serviced through the new venture may also be provided, alongwith terms of
supply.

x.

Scalability potential of business operations in next 3-5 years.

xi.

Whether the business model allows for creation of value by way of intellectual
property, patents, copy right, brands, etc.

xii.

Nature and volume of orders / enquiries on hand (xerox copies to be

furnished)

xiii.

If the unit is export oriented, please furnish exporter code no., if allotted, and
relevant details as per the following details for the preceding three years.
Code No. _________________________

Name of the product

exported

Name of the Country

where exported

F.O.B. value in US

*please enclose a Market Survey Report

===================================================

For CART rated Cases

Annexure 12

ECONOMIC FEASIBILITY
Sr
N
o
i.
ii.

Particulars
Marketing arrangement
Whether the product is reserved
exclusively for the SSI sector?
Name of the Major Customers
Region / Area where the product is / will
be sold
Extent of competition & No. of Units
engaged in similar line in the area
Nature and volume of orders / enquiries
on hand (xerox copies to be furnished)
If the unit is export oriented, please
furnish exporter code no., if allotted, and
relevant details as per the following
details for the preceding three years.
Code No. _________________________

Name of
the
product
exported

Name of
the
Country
where
exported

F.O.B.
value
US

Signature
Name

in

Annexure 13

Project schedule & Anticipated Drawl schedule

A.

SCHEDULE OF IMPLEMENTATION
Sr
No
i.

Likely date of
commencement

Development of Land

iii.

Civil Works for

iv.

Factory Building
Machinery Foundation
Administrative Building
Plant & Machinery
Imported
Indigenous
Arrangement for Power

vi.
vii.
viii.
ix.

Expected
Completion

Acquisition of Land

ii.

v.

B.

Project Activity

Arrangement for Water

x.

Erection of equipment
Commissioning
Initial Procurement of Raw
Material
Trial Runs

xi.

Commercial Production

SCHEDULE OF ANTICIPATED DRAWLS OF ASSISTANCE

For the quarter (future)
Anticipated amount of
drawal of assistance for the
quarter
Pl specify usage of
assistance in which project
head/ expenditure (name)

Q1

Q2

Q3

Q4

Q5

Q6

Signature
Name

(` lakh)
Q7

Annexure 14
Minimum Information To Be Declared By Borrowing Entities to
Banks while approaching For Finance under Multiple Banking
Arrangements
A. Details of borrowing arrangements from other banks (institution wise
and facilities wise)
1. Name and address of bank/institution
2. Facilities Availed
a) Fund- Based credit facilities (Kindly indicate
the nature of facilities e.g. working capital /
demand loan / term loan / short term) /
Foreign currency loan, corporate loan / line
of credit / Channel financing , Bill of
discounting etc. amount and purposes)
b) Non- fund based facilities other than
derivatives (Kindly indicate the nature of
facilities e.g. L/C, BG, DPG (I & F) etc. amount
and the purposes)
c) Derivatives contracts entered into with the
bank (Kindly indicate the nature of the
contract, maturity, amount and the purposes)
3. Date of sanction
4. Present outstanding (In the case of derivatives
contracts, the negative MTM i.e. which is not
due for settlement may be indicated)
5. Overdues position, (In the case of derivatives
contracts, the negative MTM i.e. amount
payable to the bank under the contract but not
yet paid may be indicated)
6. Repayment terms (for demand loans, term
loans, corporate loans, project - wise finance)
7. Security
offered
(complete
details
of
security both primary and collateral including
specific cash flows assigned to project wise
finance/loan raised &
personal/ corporate
guarantee, to be furnished)
8. Requests for facilities which are under process
[The information is to be given for domestic and overseas borrowings from
commercial banks, Financial Institutions and NBFCs]
Contd...

Signature
Name

B. Miscellaneous Details
1. CPs raised during the year and current
outstanding
2. Details of financing outside banking
system e.g. L/C Bills discounting
3. Amount of un-hedged foreign currency
exposure (kindly give currency wise
position in format given below)
i. Short term exposures (less than one
year)
Long positions
Short positions
Net short term Exposure (a-b)
ii. Long term exposures (one year and
beyond)
Long positions
Short positions
Net Long term Exposure (a-b)
4. Overall Net position (i-ii) for each
currency
5. Overall
Net
position
across
all
currencies
6. Main and allied activities with locations
7. Territory of sales and market share
8. Details of financial aspects incl. DSCR
Projections wherever applications as per
requirements of bankImp. Financial
covenants, if any, agreed to / accepted
with other lenders.
9. CID A/cs, within/outside financing
Banks, being operated, if any
10. Demands by statutory authorities/
current status thereof
11. Pending litigations
12. A declaration authorizing the bank to
share information with other financing
banks

Signature
Name

Annexure 15
(Applicable for loans rated under CART in lieu of project report)
Profitability projections for the Unit/ Company as a whole*
S.No
.

Item

Actuals for
previous
year

Total Income

Raw materials

Y1

Y2

Y3

Y4

Power and fuel

Wages and salaries
Selling expenses
Other expenses
Total Cost
3
4

Profit before depreciation,

Interest and taxes (PBDIT) (2
- 1)
Interest on Term Loan

Interest on Working Capital

Interest on unsecured loans

Depreciation

Profit before Tax (3 - 4 - 5 - 6 7)

Tax

9
10

Profit after Tax (8 - 9)

11

Dividends/ Withdrawals

12

Cash Accruals ( 10 - 11 + 7)

13

Repayments of all term

liabilities (Principal)

14

Debt Service Coverage Ratio

((10+7+4)/(13+4))

15

Average DSCR (Total of

10+7+4 for projected period/
(Total of 13+4 for projected
period)

* Please give projections for the entire tenure of SIDBI loan.

Calculation of DSCR including Escrowable cash flow from rentals***
16

Escrowable cash flow**

17

Total cash flows (16+12)

Signature
Name

Y5

18

Repayment of all term

liabilities (principal)

19

Debt Service Coverage

Ration((10+7+4+16)/(18+4))

20

Average DSCR (total of

10+7+4+16) for projected
period /(total of 18+4) for
projected period.

** Escrowable / chargeable cash flow from lease / rental of collateral property (other
than owned by borrower) to be mortgaged to SIDBI to be included in cash accruals at
point no 16 above.

Signature
Name

Annexure 16

Information related to sanction of working capital limit / WCTL (> `25 lakh)
I.
S. N.
1
2
3
4

Production cycle (no. of days)

Product
Lead time for procuring raw material
Production time
Assembly / Packaging (despatch of finished goods)
Receipt of payment for bills / invoices raised

No. of days

II. Monthly turnover / level of inventory, debtors & creditors for the last 6
months
(` lakh)

Months
Net sales
Stock holding
Sundry debtors
Sundry creditors
III. Second Method:
Sr.
No.
1
2
3
4
5
6
7
8

Particulars

(` lakh)

Last year
(actual)

FY ..
(Proj)

FY ..
(Proj)

Total Current Assets (TCA)

Less Current Liabilities
Working Capital Gap (1-2)
Minimum stipulated Margin Money for Working
Capital (25% of Total Current Assets)
Actual/ projected net working capital
Net Working Capital (4 or 5 whichever is higher)
Permissible Bank Borrowing (3-6)
Existing WC limits with banks
Assistance sought
(a) Shortfall in WC margin
(b) Shortfall in WC
Justification of requirement of Long term Working capital/ Margin money for working
capital, if included in Project Cost may be provided on the basis of above table.

Signature
Name

Annexure 17

Application format under various Government Schemes viz CLCSS, TUFS, etc or under
different lines of Credit (World Bank / JICA / KfW)

Format will be as per that prescribed under respective schemes of GoI / State
Government / International Development Agencies viz. world Bank, JICA, KfW etc.

Signature
Name

Annexure 18
(Applicable for Risk Capital Assistance only)

Details of Existing Unsecured Loans, Debtors and Creditors

1. Unsecured loans :

Break-up of unsecured loans

(a) Interest bearing USL
(b) Interest free USL

From
whom

Amt o/s as on
(` lakh)

Interest
(%) p.a.

Repayment
terms

FY 12

FY 11

1.
2.
1.
2.

2. Sundry Debtors and Creditors

(` lakh)
Break-up of Sundry creditors
Trade Creditors
Creditors for Expenses
Creditors for Capital goods
Others (specify)
Break-up of Sundry debtors outstanding for :
More than one year
Six months to one year
Three to Six months
Less than three months

3. Operational details for the immediately preceding 12 months from the date
of application (latest month figures in 1st column)
(` lakh)
1
2
3
4
5
6
7
8
9
10 11 12
Gross Sales
Holding of Raw material
Holding of Finished goods
Sundry Debtors
Sundry Creditors
O/s in CC limit
4. Statement of future installments payable in case of the applicant enterprise

(` lakh)
Bank/ F.I.

Outstandin
g amt

FY 12

Repayment of annual installments

FY 13
FY 14
FY 15
FY 16

Bank
Bank
Unsecured loans (from promoters, relatives, etc)
(a) Interest free
(b)Interest
bearing
Signature
Name

FY 17

Annexure 19
(Applicable for Risk Capital Assistance only)

on CAs letterhead
Certificate from the Chartered Accountant
This is to certify that we have verified the Books of Accounts and other records of M/s.
_________________________, a partnership firm within the meaning of the Indian Partnership Act 1932/ a
limited liability partnership within the meaning of the Limited Liability Partnership Act 2008 / proprietorship
concern/ company within the meaning of the Companies Act, 1956 and having its office/ registered office at
_______________ and we hereby certify the following on the basis of the Books of Accounts and other
relevant particulars furnished by the company/ firm/ concern.
1. The present shareholding pattern of the enterprise as on date is as given below :
Equity shares
` ---- lakh consisting of --- no of equity shares of
` -- each
` ---- lakh consisting of --- no of equity shares of
` -- each

Authorised capital
Paid-up capital

Name of
shareholder

Face value of
shares
(` lakh)

Premium
(` lakh)

% holding
of equity
shares

Preference shares
--- no of --- % preference shares of `
each
--- no of preference shares of ` each
Face value
of shares
(` lakh)

Premium
(` lakh)

% holding

Promoters
Names
Relatives
Names
Friends
Names
VC/ PE Investor
Names
Others (specify)
Total

Details of shares
issued other than
cash
2. The following are the age-wise debtors, creditors and finished goods as on ---------S. No.
1.
2.
3.
4.

Particulars
upto 90 days
> 90 days to 180 days
> 180 days to 365 days
more than 365 days
TOTAL

Debtors

(` lakh)
Creditors

3. Details of the bad debts provided for and written off during the immediately preceding three years
are as under:
Amt. provided for (` lakh)

Amt. written off (` lakh)

FY 2012

Signature
Name

FY 2011
FY 2010
4. Details of existing unsecured loans in the enterprise are as under :

Break-up of unsecured loans

(a) Interest bearing USL
(b) Interest free USL

From
whom

Amt o/s as on
(` lakh)

Interest
(%) p.a.

Repayment
terms

1.
1.

5. No of instances of overdrawals in the Working Capital/ CC Account (more than 10%) during the
immediately preceding 12 months.
6. Details of returns of cheques in the WC/ CC account/s due to INSUFFICIENCY OF FUNDS during
the immediately preceding 12 months ending on -------- are as under :
Date

Cheque No

Cheque Amount (`)

Drawn On

7. Break-up of the remuneration to the promoters, directors and key management/ technical people for
the past 3 years.
8. Details of the Related party transaction.
9. Status of IT assessment of promoters & enterprise for past 3 years.
10. Names of other companies/ firms etc in which promoters/ directors/ partners of the applicant
enterprise are promoters/ directors/ partners or have substantial financial stake.
I/We hereby note that this certificate would be an input for decision making by SIDBI, the Lender of /
Investor in __________ (the Borrower/ investee). Therefore, I/ We hereby agree and confirm that SIDBI may
seek any clarifications as may be required to investigate the matter and fix responsibility in the event our
certification as aforesaid turns out to be untrue and factually incorrect causing loss to the Lender(s). I / We
hereby further agree and give consent for the disclosure of my / our name to the Indian Banks Association
(IBA) for inclusion in the Caution List (maintained by IBA for circulation amongst members Banks/ Financial
Institutions) by SIDBI, the lender of/ Investor in the said Borrower/ investee, if it is found that there was
gross negligence on my/our part, or I /We have colluded with the said Borrower/ Investee in causing
pecuniary damage/ loss to the lender/ Investor.
For: Name of the Chartered Accountants Firm
Date:
(Signature &
Seal)
(Name of Partner/ Proprietor)
(Membership
No..)
Note : Kindly enclose details of debtors and creditors above 180 days.

The certificate should be signed on each page by the concerned CA, and his
membership number with ICAI should be indicated
Signature
Name

Annexure 20
(Applicable for Risk Capital Assistance only)

Particulars of Existing Assets of the enterprise

Kindly provide the following details in respect of all the existing facilities (including
registered office/ administration office/ factories/ operation places, godowns etc) of the
enterprise :
Particula
rs

Location
(area in
sft)

Owned property
Purchase
date/
Price (`
lakh)

Present
Market
Value (`
lakh)

Leased/ Rented property

Lessor
details

Annual
rent/
lease (`)

Lease period
valid till (pl
mention
month and
year)

Plane land
Building
factory
Building admin

Kindly enclose copy of sales/ lease/ rent deed of the land and recent valuation report if any.

Signature
Name

Lease /
rental
renewal
terms