Project proposal submitted under MSME Scheme

“Support for Entrepreneurial and Managerial Development of SMEs: Through Incubators”

1.ApplicantInformation

  1. Applicant(entrepreneur)name:
  2. Age:
  3. EducationalQualifications:
  4. PostalAddress:
  1. Telephone/mobile:
  2. Fax :
  3. Email :
  4. Website (if any):
  5. Current professional/employmentstatus :

2.CompanyInformation

A)Haveyou registeredacompany,

If yes, givedetails:

B)Nameof applicantcompany/firm:

B)Locationfromwhichcompanyis

Operating:

D)Relationship with the Business

Incubator/ HostInstitute:

E)Companysector :

F)Investment inplant and machinery

(For manufacturing sector)/Investment

inequipment(Forservicessector):

G)Companytype:Definitionsaregiven in:

3.ProjectInformation

  1. Detailsofproposedidea/innovation

A1)Titleofthetechnology/innovation:

A2) Categoryoftechnology/innovation(specify process/ product/new

application / other):

A3) If the idea involves use of existing intellectual property, give details of the

owner of the same and arrangements of sourcing the innovation and terms of

itscommercialization.

A4)Specify the potential areas of application in industry/market

A5)Specifynewness/uniquenessoftheinnovation(betterperformance/new

features/ improvements)

A6) What is already available in market? What is the market potential? What

value it Would add in market?

  1. Current Development Status of Innovation

B1)What is the current development status of the innovation / product orservice

offerings?(Whetherstill an idea orready to launch).

B2) Idea readiness level:

B3) Specify the time period in months required for innovation to be completely

developed for field testing / ready for intended end- user?

  1. Financial requirements

C1) Do you have a business plan for taking innovation from lab to market?

C2) What level of funding is required for making innovation market ready?

C3) Please give activity wise break-up (Activities include design/prototype development/lab/bench scale production/professional services/hiring staff/ trials/test marketing/ miscellaneous)(use annexure if space is not sufficient)

S.No / Group as per guideline / Eligible Items / Budget
in Rs / Own Contribution in Rs / MSME
Support in Rs
1 / Technology Fee / Technology Transfer Fee
Design
Prototype Development
Lab Testing
Bench scale production
Trails and Test Marketing
2 / Telephone, Fax Computer Facility / Miscellaneous Expenditure
3 / Machinery Hiring or leasing from out side / Hiring
4 / Guidance fee per mentors / hand holding persons / Guidance fee/ Handholding
Product Testing and Certification
5 / Electricity, Accommodation charges / Incubation rental charges
Total Project Cost
Funding from MSME
Incubatee Contribution @ 15%( for micro)
or
25 % (for SSI) of the project cost

4.OtherRelatedInformation

A)Are there any team members/partner and mentors/guides in your innovative project. If so give name and complete contact address with phone and e-mail)

B)Information on Patents filed/granted (if any)

C)Any awards or recognition related to the innovation

D)Please include any further information that you wish to communicate to us to help us in judging your application

5.Other

I, ,herebycertifythattheinformationfurnishedin theapplicationformfromItem1-4istrue,completeandbesttomyknowledge.

Date:

Place:Signatureoftheapplicant