APPLICATION FORM FOR SME
To be submitted along with documents as per the checklist
1.0 Primary Information
1.1 Name of the Enterprise / Company / Firm / Projects
1.2 Head Quarter Address (with contact Tel/Fax numbers, e-mail, and website if available)
1.3 Address of Project Site (in case of Manufacturing Unit)
1.4 Constitution (Proprietary/Partnership firm/Company) and Local registration number (with supporting documents)
1.5 Date of Establishment and Business Commencement
1.6 Name of Owner /Partners/Directors of Company and details: (Top five by stake holding starting with main owners)
Name / Age / Qualifications / Net worth / Experience / Relationship with Main Owner
1.7. Project Type / Greenfield
Expansion
Restructuring
1.8 Name of Subsidiary / Associate concerns and nature of association: (if any)
Name of Subsidiary /
Associate concern / Address of Subsidiary
/Associate / Financiers / Nature of Association / Extent of Interest as a Prop / Partner / Director
2. Project Details
2.1 Project Title
2.2 Project Description
2.3 Project Objectives
2.4 Project Target
2.5 Process to be followed with flow-charts / schematic diagram etc (to be attached separately)
2.6 Products to be developed under the project along with specifications:
2.7 Raw materials and their availability and demand - supply gap
2.8 Environmental Impact, if any:
2.9 Project gestation period (in months):
2.10 Time schedule indicating important activities/milestones & duration:
2.11 Deliverables of the project:
2.12 List of existing facilities already available for the proposed project (land, building, machinery, software, manpower, utilities etc.)
2.13 Project Costing (detail cost breakup)
Project Head / Area / Qty./ Capacity / Total Cost of Project USD[1] (mn)
Cost of construction
Tech Know-how fee / patent / licensing fees
Equipment / Machinery / Utilities
Consumables / Raw Materials
Equipment for Testing & Evaluation / Quality Control
Manpower Salaries
Marketing related expenses
Working Capital Margin
Others (pl specify)
Contingency
Total Cost (USD mn)
3. Market Overview
Existing Product line, with names of product and any new product to be launch in near future
Company's / firm's cost benefit analysis and demand statistics in next 2/3 years in local and global market
Competing product in market with price differentials and your market share (please specify price of your product and competitors)
Technology know-how Partner and same technology used by competitors (if any)
4. Corporate Governance
List Board of Directors and Executive Management (Top five by hierarchy)
Name / Age / Qualifications / Net worth / Experience
Existing policy and processes for corporate governance, if any (to be provided separately)
5. Financial Overview
5.1 Financial position & working results for the past 3 years (Historical)
Financial Position / 20__ / 20__ / 20__ / Working Results / 20__ / 20__ / 20__
Net worth / Net Sales
Term Loan / Gross profit
Total Assets less Depreciation / Depreciation
Current Assets / Net Profit
Current Liabilities
Share Capital
Reserves & Surplus
Current Ratio
Debt Equity Ratio
5.2 Tentative Business Projections for 5 years
Particulars / Year-1 / Year-2 / Year-3 / Year-4 / Year-5
Sales
PAT
EBITDA
Fund Costing
Net worth
5.3 Credit Facilities(Existing)
Type of Facilities / Limit / Outstanding as on date / Financiers / Security Lodged / Collaterals / Cost of Fund / Repayment Terms
Current Account
Working Capital
Term Finance
LC/ BG
It is certified that our unit has not availed any financing from other Bank/Financial Institution in the past and I am not benefitted from any financing from any other Bank/Financial Institution other than those mentioned in 5.3 above
5.4. Credit Facilities (Required from ICD)
Type of facilities / Amount / Purpose for which required / Security Offered
Primary Security
(Details with approx. value to be mentioned) / Whether Collateral Security offered
(Please mention Yes or No)
(If Yes, then provide details in 5.5)
Working Capital / YES / NO
Term Finance / YES / NO
LC/BG / YES / NO
5.5 Details of Collateral Security offered, if any including 3rd party guarantee
5.6 Project Structure - Utilization of required finance
Capital Type / Amount / % of Total Borrowing
Equity financing
Credit financing
6.0 Any other relevant information (in case not available in above mentioned points)
Date: / Place:
I/We certify that all information furnished by me/us is true; that I/We have no financing arrangements for the unit except as indicated in the application; that there is no over dues/statutory dues against owners except as indicated in the application; that no legal action has been/is being taken against owner / company; 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, 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.
SIGNATURES OF PROPRIETOR/PARTNER/DIRECTOR WITH PHOTOGRAPH AND COMPANY SEAL / STAMP
To be submitted by SME to ICD along with application form for Approval
1.Proof of identity for company- Government issued Identification /Registration certificate issued by Govt
2.Proof of identity for owners / Directors – Government issued Identification
3.Proof of business address
4.Last three years balance sheets of the firm along with filings with authorities in that country
5.Memorandum and articles of association of the Company/Partnership Deed of partners etc.,
6.Assets and liabilities statement of owners and guarantors along with latest filings with authorities
7.Rent Agreement (if business premises on rent)
8.Local registration (if applicable).
9.Projected balance sheets for the next three to five (3-5) years
10.In case of takeover of advances, sanction letters of facilities being availed from existing banks/Financial Institutions along with detailed terms and conditions.
11.Last three years balance sheets of the Subsidiaries /Associate/Group companies (if any)
12.Project report (for the proposed project if term funding is required) containing details of the machinery to be acquired, from whom to be acquired, price, names of suppliers, financial details like capacity of machines, capacity utilization assumed, production, sales, projected profit and loss and balance sheets for the next 3 to 5 years till the proposed finance is to be paid, the details of labour, staff to be hired, basis of assumption of such financial details etc.,
13.Review of account containing quarterly sales (quantity and value both,) production (quantity and value) imported raw material (quantity and value), indigenous raw material (quantity and value), value of stocks in process, finished goods (quantity and value), debtors, creditors, bank’s outstanding for working capital limits, term finance limits, bills discounted.
14.Copies of lease deeds/title deeds of all the properties being offered as primary and collateral securities.
15.Position of accounts from the existing bankers and confirmation about the asset being Standard with them (In case of takeover)
16.Manufacturing process if applicable, major profile of executives in the company, any tie-ups, details about raw material used and their suppliers, details about the buyers, details about major competitors and the company’s strength and weaknesses as compared to their competitors etc.,
17.All values in USD thousand / million
Note:The checklist is only indicative and not exhaustive and depending upon the local requirements at different places addition could be made as per necessity

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