Nabkisan Finance Limited (Nkfl)

NABKISAN FINANCE LIMITED (NKFL)

(A subsidiary of NABARD)

APPLICATION FORM FOR PRODUCERS’ ORGANSIATIONSEEKING LOAN ASSISTANCE

PART – 1

A. Applicant’sParticulars

1. Name of the Applicant/s or/Borrowing concern:

2. Legal Status:

3.Details of Registration / Incorporation /:

Commencement of business (enclose copy/ies of registration certificate).

Act/s under which registered / Date & Place / Registration No. / Validity Period / Remarks

4. Address

Registered Office
Administrative Office
Project Site/Field office etc.

5. Other particulars of the Applicant /Borrowing concern

Permanent Account NO (PAN)
Phone No.
Mobile No.
FAX No.
Email ID
Website

6. Particulars about Promoter Organisation (if applicable):

i)Name of the Organisation:

ii)Activities undertaken:

iii)Infrastructure facilities available:

iv)Major programmes/projects currently under implementation:

v)Support extended so far, to PO:

vi)Association with NABARD and if so details of the same:

B. Objectives of the Producer Organisation:

i)Main objectives of the organization:

ii)Activities taken up so far:

C. Borrowing powers / authority as per bye laws:

D. Management

1. Please give details of organization structure / Chart

2. Name of the members of governing body / Board of Directors:

Name /Designation / Qualification / PAN / Age / Address / Occupation / Experience / Association with other institutions

3. Profile of Chief Executive Officers / Key Persons:

Name / Designation / Qualification / Experience / Date of appointment / Association with other institutions

E. Details of Existing infrastructure available

Type of infrastructure / Description / Approx. cost of acquisition / Year of acquisition / Purchased out of Grant / Loan / own funds

F. Staff

Present staffing pattern:

(Numbers)

Year / Technical Staff / Officers / Supervisor / Field staff / Others / Total

G. Financials (for last 1-3 years): (Please attach last one to three years audited balance sheets/income expenditure/payments and receipts statements)

Year / Share Capital / Reserves / Borrowings / Turnover / Net Profit/surplus / Activity pursued

7. Particulars of bank account:

Name of the Bank
Branch Address
Type of Account

Particulars of loan availed:

Name of the Bank/organisation from which loan is availed / Type of loan / Amount / Rate of Interest / Processing Fee if any / Security Offered / Repayment Schedule / Defaults, if any

PART – II

PROJECT PROPOSAL

1.Purpose of the project:

2. Justification for the Project

3. Site Description

Place:

Area(Acre / Cents / Sq.ft):

Cost:

Connectivity to Road, Train, air:

Own / Rental / Lease:

Whether there is any restriction against :

mortgage of the land? If so, whether

permission to mortgage the land has been

obtained

Whether the name of borrower/s is :

mutated in Revenue records

Whether the land is subject to any :

restrictions under local land ceiling Act

Whether all the original title deeds / :

documents receipts etc. are available?

If not give reason

Whether the lands free from :

encumbrances. If not give details

Whether any proceedings are taken for :

recovery of land revenue, rents, royalties

or other taxes and dues of public nature?

If so give particulars

Whether any suit appeal or other :

proceedings pertaining to the land is

pending in any court

Whether the borrower(s) willing to :

mortgage the land(s) to NKFL as security

against the loans

4. Availability of Raw Material/source/proximity/quantity/etc.

5. Machinery (details of suppliers, cost, capacity, etc)

6. Technology support (sourcing, efficacy, etc.)

7. Availability of power, storage, water and other services.

8. Implementation Schedule of the Project:

9. Market arrangements and major customers;

10. Risk Assessment of the project:

11. Financial appraisal covering:

a)Assumptions made:

b)Break-even point:

c)Debt Service Coverage Ratio:

d)Sensitivity Analysis:

e)Critical issues for success of the project:

12. Working capital requirements (details such as basis for arriving at the requirements may be explained)

13. Details of the project cost (pl. enclose quotations / estimates)

Particulars / Description / Cost / Expected month of
Acquisition / Installation
I. Term Loan
Land
Building
Plant & Machinery
Furniture & Fixtures
Vehicles
II. Inputs/Working Capital
i
ii
iii
iv
Total

14. Details of production / sales for the unit:

Sl.
No. / Particulars / Year 1 / Year 2 / Year 3 / Year 4 / Year 5
1 / Installed Capacity
2 / Capacity utilization
3 / No. of units produced
4 / No. of units sold
5 / Opening stock
6 / Closing stock
Total

15. Means of financing

Particulars / Amount already raised / Amount proposed to be raised / Total / % to Total
Equity
Subsidy / Incentive
Loans
Unsecured Loans
Others (Specify)
Total

16. Financial Assistance requested from NKFL (pl. give justification & detailed workings)

Term Loans / Rs.
Working Capital / Rs.

17. Collateral offered by the organisation:

(a)Details of Collaterals

i)Immovable Property

Particulars / Market Value / Govt. guideline Value
Name of the owner
Place of property
Survey No. or Plot No
Extent
(in addition to mortgage / hypothecation of the assets created under the project)

ii)Liquid Collateral like Bank Deposits,etc.

(b) Details of Guarantors

Particulars / 1 / 2 / 3
Name
Address
Occupation
Net Worth (Rs.)
(attach commitment letters of Guarantors)

18. Projected Profit and Loss A/c:

Particulars / Year 1 / Year 2 / Year 3 / Year 4 / Year 5
INCOME
Sales Revenue
Other Revenues (Specify)
Closing Stock
Total
EXPENDITURE
Opening Stock
Raw Material Stock
Operating Cost (Specify)
Marketing Cost (Specify)
Interest on Term Loans
Interest on Working Capital
Depreciation
Total
Net Profit
Tax
Profit after Tax

19. Projected Balance Sheet:

LIABILITIES / Year
1 / Year
2 / Year
3 / ASSETS / Year
1 / Year
2 / Year
3
Equity / Land
Secured Loan / Building
Unsecured Loan / Plant & Machinery
Current Liabilities / Furniture & Fixtures
Others (Specify) / Current Assets
Others (Specify)
Total / Total

20. Repayment schedule proposed:

Year / Loan Amount / Interest / Total / Repayment / Closing Balance
1
2
3
4
5
Space for photo / Space for photo / Space for photo

(Signature of the individual (s) / Proprietor / Partner / Director – sign across photos)

Certificate:

We hereby certify that the information furnished by me / us is correct. In the event of any of the information furnished by us is found to be false, we may be liable for any action under the law of the land.

Place:Signature

Date:SealName & Designation

List of Enclosures to be submitted with the Application Form (As applicable)

Certificate of Registration
Proof of address - Utility bills such as electricity, water and landline telephone bills in the name of the concern
Copy of PAN Card
Rent / Lease agreement
Project report with supporting documents
Copies of Licenses / permission granted by local authority
Valid title deeds of manufacturing / business premises
Clearance from pollution control board
Declaration in Proforma I
Letter to Bankers – Proforma II
Annual Accounts & Annual Reports for the last 1-3 years along with income tax / sales tax returns.
Company

a) Memorandum and Articles of Association

b) Certificate of Registration / Incorporation

c) Board Resolution for availing loan /borrowing power /borrowing authority

d) List of Directors

Copies of sanction letters for loans / grants , if any

PROFORMA – I

NET WORTH STATEMENT OF GURANTOR

(to be given separately for each Guarantor)

Photograph

1. Name of the Gurantor (s):

Age:

Address and Tel. Nos.:

Residence*:

Land Line / Mobile

2. Furnish the following details:

a) Immovable property details like

land / buildings, location, date of

acquisition, cost, present value etc.

b) Other assets:

c) Personal liabilities, if any :

d) Net Worth :

e) Any other information:

3) Declaration: I / we hereby undertake to abide by all the

Terms & Conditions indicated in Annexure I of the loan application form.

Signature :

Place :

Date :

*Certified copy of address proof viz. Passport or Ration Card or Voter ID Card with photograph to be enclosed with application.

PROFORMA – II

LETTER TO BANKERS

Form of letter addressed to the banker of the applicant concern / promoter, director, to be forwarded to NABKISAN Finance Ltd.

(This letter should, in the case of the applicant or any other concern, be written on printed letter head and signed by a person or persons authorized to operate the account with the banker. It should be forwarded to the bank, endorsing a copy to NABKISAN Finance Ltd.)

Date :

The Manager

(Name and address of the bank)

Dear Sir

We hereby authorize you to discuss with the NABKISAN Finance Ltd to which we are making an application for financial assistance, our affairs or any matter relating thereto, and to disclose such information as the NABKISAN Finance Ltd may request of you, or as you may consider fit to disclose.

We also authorize you to disclose to NABKISAN Finance Ltd such information as it may require on a continuing basis.

Yours faithfully,

Name:

Account No.