Apply Financial Assistance for Business

Application ID: (For office use)
APPLICATION FORM FOR FINANCIAL ASSISTANCE UNDER PRIME MINISTERS

EMPLOYMENT GENERATION PROGRAMME (PMEGP)
12 Name of the project / business activity proposed :
13 Amount of loan required (in Rs.)

Capital Expenditure Loan
Working
Building Type Workshed Machinery/ Pre
Capital /
Building Equipment/ Operative
Cash Credit Total
etc. Furniture Cost
Limit
Rented 0 0 0 0 0
Details of earlier or current Loan/Grant and subsidy availed from
14 Central/State Govt. Scheme/ or any other Similar Scheme.
Activity of the Project with Address Amount Year of Sanction
I certify that all information furnished by me is true; and that I and any of my dependent have not
borrowed any money under subsidy linked scheme from any Central / State Government or bank for
establishing any such project
Place:
Date: Signature of the Applicant
For Official Use only: (Rejected / to be placed before District Task force Committee)
Reason (if Rejected):
Place: Signature, Name & Designation of Officer

Date:
NOTE
• Own contribution must be invested 5% for SC/ST/OBC/PHC/woman/ Ex-serviceman/ North

East Reason/Hill Boarder Area and 10% for General
• Total Project Cost should not exceed 25 lakhs for Manufacturing unit and 10 lakhs for
service unit.
• Applicant will not be entitled for additional Margin Money(Subsidy) in case of Own
Contribution over and above the prescribed limit.
• VIIIth pass for Manufacturing Unit above Rs.10 lakhs project cost and under Service Sector
above Rs.5 lakhs
• Application should be submitted complete in all respect along with attested copies of the
following documents:
1. Certificate of qualification-academic and technical (if project cost above 5 lakhs under
service industry or above 10 lakhs under Manufacturing industry)
2. Relevant Certificate for SC/ST/OBC/Minority/Ex-Servicemen/PHC
3. if Entrepreneur Development programme(EDP) training undergone (at least for two weeks)
then submit photocopy of the certificate
DATA INPUT SHEET
Preference for sponsoring agency of the project to Bank: (mark √ )

KVIC √ KVIB DIC RURAL URBAN
1.1 Name of the Applicant/Institution
1.2
2 Gender Male
Select Gender from the list √ Female
3 Address of the Proposed location of Unit: Rural √ Urban
Taluk/Block:
District: Pin:
State:
Email: Mobile:
4 Qualification
Academic Technical
Select Academic
12th Pass Qualification from the list
5 Whether the applicant belongs to (mark √)

ST OBC PHC Ex- Minority Hill General
SC Service Boarder
man Area
√
Select Unit type from the
listManu- Service
6
Whether the facturing √ Unit
project (mark √) Unit
Select Unit type from the
list
8 Name of the project / business activity proposed :

31
32
33 Legal Status:
34
Enter Total Area in
35 Land ###
Sq.ft / Sq.mt
36
37
38 BUILDING DETAILS
39 Particulars Area Rate/Sq.ft Amount in Rs.
40 0.00
41 0.00
42 0.00
43 0.00
44 0.00
45 0.00
46 0.00
48
49
50
51 MACHINERY DETAILS
52 Particulars Qty. Rate Amount in Rs.
53 0.00
54 0.00
55 0.00 Male
56 0.00
57 0.00
58 0.00 KVIC
59 0.00
60 0.00 DIC
61 0.00
62 0.00
63 0.00 Rura
64 0.00
65
66 Total 0.00 No
67
68
69 d. Preliminary & Pre-operative Cost : SC
70
71 e. Furniture & Fixtures :
72
73 f. Contingency/Others/Miscellaneous
74
75 Working Capital : 0.00
76
77
78 Manu
79
80
81 Means of Financing ###
82
83 Own Contribution : 10%
84 Bank Finance : 90%
85 Margin Money (Govt. Subsidy) : 25%
86
87
88
89 DETAILS OF SALES Own
90 Rate/ Qantity Amount in Rs.
Particulars of Products
91 Unit
92 0.00
93 0.00
94 0.00
95 0.00
96 0.00
97 0.00
98 0.00
99
100 Total 0.00
101
102
103 RAW MATERIALS
104 Particulars Unit Rate/Unit Reqd. Unit Amount In Rs.
105 0.00
106 0.00
107 0.00
108 0.00
109 0.00
110 0.00
111 0.00
112 0.00
113 0.00
114 Total 0.00
115
116 WAGES
117 No. of Wages Per Month Amount in Rs.
Particulars
118 Worker Total Month 12 zzz
119 0.00
120 0.00
121 0.00
122 0.00
123 0.00
124 0.00
125 0.00
126 Total 0 0.00
127
128
129 SALARY DETAILS
130 No. of Wages Per Month Amount in Rs.
Particulars
131 Staff Total Month 12
132 0.00
133 0.00
134 0.00
135 0.00
136 0.00
137 Total 0 0.00
138
139
140 WORKING CAPITAL ESTIMATE
141 Element of Working Capital No. of Days
142
143
144 Stock in process
145
146 Finished goods
147
148 Receivable by
149
150
151 POWER ESTIMATE
152 Power Requirement
153 Enter Estimated power
154 requirement in
155 Repair and Maintanance HP/KW/W
Rs. 0.00
156
157 Power and Fuel Rs. 0.00
158
159 Other Overhead Expenses Rs. 0.00
Enter present rate
160 of Interest
161 Telephone Expenses Rs. 0.00
162
163 Stationery & Postage Rs. 0.00
164
165 Advertisement & Publicity Rs. 0.00
166
167 Building Rent Rs.
168
169 Other Miscelleneous Expenditure Rs. 0.00
170
171 Rate of Interest
172
173 Depreciation
174 On Building
175 On Machinery Enter No. of Quarter
176
227
228
229
230
231 INTRODUCTION
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248 ABOUT THE PROMOTER
249
250
251
252
253
254
255
256
257
PROJECT AT A GLANCE - TOP SHEET
1 Name of the Entreprenuer 0
2 Constitution (legal Status) Individual
3 Father's/Spouce's Name 0
4 Unit Address : 0
0
Taluk/Block: 0
District : 0
Pin: 0 State: 0
E-Mail : 0
Mobile 0
5 Product and By Product
6 Cost of Project : Rs. 0

Name of the project / business 0
activity proposed :
7 Means of Finance
Term Loan Rs. 0.0
KVIC Margin Money Rs. 0.00
Own Capital Rs. 0.00
8 Debt Service :
Coverage Ratio
9 Pay Back Period : 5 Years
10 Project : 0 Months
Implementation
Period
11 Break Even Point :
12 Employment : 0
13 Power Requirement : 0
14 Major Raw materials : ,,
15 Estimated Annual : Rs. 0.00

Sales Turnover
PMEGP Project Report Page 10

DETAILED PROJECT REPORT
1 INTRODUCTION :
2 ABOUT THE PROMOTER :
3 COST OF PROJECT
A. Fixed Capital Investment
a. Land : 0 Own
b. Workshed Area Sq.ft Rate in Rs. Amt. In Rs.

0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
Total 0.00
#REF!
C. Machinery Qty. Rate Amount in Rs.
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
Total 0.00

d. Preliminary & Pre-operative Cost : Rs. 0.00
e. Furniture & Fixtures : Rs. 0.00
f. Contingency/Others/Miscellaneous Rs. 0.00
Total Capital Expenditure : Rs. 0.00
Working Capital : Rs. 0.00
Total Cost Project : Rs. 0.00
3.1 Means of Financing :

Own Contribution 10% Rs. 0.00
Bank Finance : 90%

Term Loan Rs. 0.00
Working Capital Rs. 0.00
Total Rs. 0.00
Margin Money (Govt. Subsidy) From KVIC 25% Rs. 0.00
Margin Money Subsidy received From KVIC will be kept in term deposit as per norms of
PMEGP in the name of Beneficiary for three years in the financing branch.
3.2 STATEMENT SHOWING THE REPAYMENT OF TERM LOAN & WORKING CAPITAL :
TERM LOAN
Year Opening Balance Installment Closing Balance Interest @

0.00%
1st 0 0 0 0
2nd 0 0 0 0
3rd 0 0 0 0
4th 0 0 0 0
5th 0 0 0 0
6th 0 0 0 0
7th 0 0 0 0
8th 0 0 0 0
WORKING CAPITAL
Year Opening Balance Installment Closing Balance Interest @

0.00%
1st 0 0 0 0

2nd 0 0 0 0
3rd 0 0 0 0
4th 0 0 0 0
5th 0 0 0 0
6th 0 0 0 0
7th 0 0 0 0
8th 0 0 0 0

3.3 STATEMENT SHOWING THE DEPRECIATION ON FIXED ASSETS:
@ 0.00%
WORKSHED
Particulars 1st Year 2nd Year 3rd Year 4th Year 5th Year
Opening Balance 0 0 0 0 0
Depreciation 0 0 0 0 0
Closing Balance 0 0 0 0 0
MACHINERY @ 0.00%
Opening Balance 0 0 0 0 0
Depreciation 0 0 0 0 0
Closing Balance 0 0 0 0 0
TOTAL DEPRECIATION
Workshed 0 0 0 0 0
Machinery 0 0 0 0 0
Total 0 0 0 0 0
4 Schedule of Sales Realization :

4.1 Details of Sales
Particulars of Product Rate/ No. of Amount in Rs.
Pair/Unit Pair/Unit
0
0 0.00 0 0.00
0 0.00 0 0.00
0 0.00 0 0.00
0 0.00 0 0.00
0 0.00 0 0.00
0 0.00 0 0.00
0 0.00 0 0.00
Total 0.00
4.2 Capacity Utilization of Sales


Capacity Utilization 70% 80% 90% 90% 90%
Sales / Receipts 0 0 0 0 0
5 Rawmaterials :
Particulars Unit Rate/unit Reqd.Unit Amount in Rs.
0 0 0.00 0 0.00
0 0 0.00 0 0.00
0 0 0.00 0 0.00
0 0 0.00 0 0.00
0 0 0.00 0 0.00
0 0 0.00 0 0.00
0 0 0.00 0 0.00
0 0 0.00 0 0.00
0 0 0.00 0 0.00
Total 0.00
5.1 Wages :
Particulars No. of Wages Amount in Rs.
Worker Per Month (Per Annum)
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
Total 0 0.00
5.2 Repairs and Maintenance : Rs. 0.00

5.3 Power and Fuel : Rs. 0.00
5.4 Other Overhead Expenses : Rs. 0.00
6 Administrative Expenses :
6.1 Salary
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0.00 0.00
0 0.00 0.00
Total 0 0.00
6.2 Telephone Expenses 0.00
6.4 Stationery & Postage 0.00
6.5 Advertisement & Publicity 0.00
6.6 Workshed Rent 0.00
6.7 Other Miscellaneous Expenses 0.00
Total 0.00
7
Capacity Utilization of Manufacturing & Administrative Expenses :
Capacity Utilization 70% 80% 90% 90% 90%
Manufacturing Expenses

Rawmaterials 0 0 0 0 0
Wages 0 0 0 0 0
Repairs & Maintenance 0 0 0 0 0
Power & Fuel 0 0 0 0 0
Other Overhead Expenses 0 0 0 0 0
Administrative Expenses
Salary 0 0 0 0 0
Postage Telephone Expenses 0 0 0 0 0
Stationery & Postage 0 0 0 0 0
Advertisement & Publicity 0 0 0 0 0
Workshed Rent 0 0 0 0 0
Other Miscellaneous Expenses 0 0 0 0 0
Total: 0 0 0 0 0
8 Assessment of Working Capital :

Particulars Amount in Rs.
Sale 0.00
Raw Material 0.00
Wages 0.00
Repair & Maintenance 0.00
Power & Fuel 0.00
Other Overhead Expenses 0.00
Production Cost 0.00
Administrative Cost 0.00
Manufacturing Cost 0.00

Working Capital Estimate :
Element of Working Capital No of Days Basis Amount in Rs.
0 0 Material Cost 0.00
Stock in process 0 Production Cost 0.00
Finished goods 0 Manufacturing Cost 0.00
Receivable by 0 Manufacturing Cost 0.00
Total Working Capital Requirement Per Cycle 0.00
9 Financial Analysis
9.1 Projected Profit & Loss Account :
Particulars 0 Year 1st Year 2nd Year 3rd Year 4th Year
Sales / Receipts 0 0 0 0
0 0 0 0
Rawmaterials 0 0 0 0
Wages 0 0 0 0
Repairs & Maintenance 0 0 0 0
Power & Fuel 0 0 0 0
Other Overhead Expenses 0 0 0 0
Depreciation 0 0 0 0
Production Cost 0 0 0 0
Administrative Expenses
Salary 0 0 0 0
Postage Telephone Expenses 0 0 0 0
Stationery & Postage 0 0 0 0
Advertisement & Publicity 0 0 0 0
Workshed Rent 0 0 0 0

Other Miscellaneous Expenses 0 0 0 0
Administrative Cost 0 0 0 0
Interest on Bank credit @ 0%
Term Loan 0 0 0 0
Working Capital Loan 0 0 0 0
Cost of Sale 0 0 0 0
Net Profit Before Tax 0 0 0 0
Less Tax 0.00 0.00 0.00 0.00
Net Profit 0 0 0 0
9.2
CALCULATION OF DEBT SERVICE CREDIT RATIO (D.S.C.R) :
Net Profit 0 0 0 0
Add :
Depreciation 0 0 0 0
TOTAL - A 0 0 0 0
Payments :
On Term Loan :
Interest 0 0 0 0
Installment 0 0 0 0
On Working Capital
Interest 0 0 0 0
TOTAL - B 0 0 0 0
D.S.C.R = A/B #DIV/0! #DIV/0! #DIV/0! #DIV/0!
Average D.S.C.R

9.3 PROJECTED BALANCE SHEET :
LIABILITIES :
Promoters Capital 0 0 0 0
Profit 0 0 0 0
Term Loan 0 0 0 0
Current Liabilities 0 0 0 0
Sundry Creditors 0 0 0 0
0 0 0 0
ASSETS :
Gross Fixed Assets : 0 0 0 0
Less : Depreciation 0 0 0 0
Net Fixed Assets 0 0 0 0
Preliminary & Pre-Op. Expenses 0 0 0 0
Current Assets 0 0 0 0
Cash in Bank/Hand 0 0 0 0
Total 0 0 0 0
9.4 CASH FLOW STATEMENT :

Net Profit 0 0 0 0
Add : Depreciation 0 0 0 0
Term Loan 0 0 0 0
Promoters Capital 0 0 0 0
Total 0 0 0 0
Total Fixed Capital Invested 0

Repayment of Term Loan 0 0 0 0
Repayment of WC Loan 0 0 0 0
Current Assets 0 0 0 0
Total 0 0 0 0
Opening Balance 0 0 0 0
Surplus 0 0 0 0
Closing Balance 0 0 0 0
9.5 BREAK EVEN POINT AND RATIO ANALYSIS :

Fixed Cost 0 0 0 0
Variable Cost 0 0 0 0
Total Cost 0 0 0 0
Sales 0 0 0 0
Contribution (Sales-VC) 0 0 0 0
B.E.P in % #DIV/0! #DIV/0! #DIV/0! #DIV/0!
Break Even Sales in Rs. #DIV/0! #DIV/0! #DIV/0! #DIV/0!
Break Even Units #DIV/0! #DIV/0! #DIV/0! #DIV/0!
Current Ratio #DIV/0! #DIV/0! #DIV/0! #DIV/0!

Net Profit Ratio #DIV/0! #DIV/0! #DIV/0! #DIV/0!

This Project Report has been prepared based on the data furnished by the entrepreneur whose details are
given in the application.
Place :
Date:
Prepared by :
Full Name :
Signature of the Beneficiary

PROJECT REPORT FOR
Affix latest
attested
Photograph
1 Name of the Entreprenuer 0

1
2 Constitution (legal Status) Individual
3 Father's/Spouce's Name #REF!
5 Unit Address : 0
0
Taluk/Block: 0
District : 0
Pin: 0 State: #REF!
Phone #REF!
E-Mail #REF!
6 Background of the Proprietor/Partners/Directors : Furnished detailed information in the DPR
If the Proprietor /
7 Name of Business House/Group if any : Institution runs any other
existing activity which may
be clearly indicated here.
8 Details Other Companies/Units in the group : If any Company & Unit

exists in the name of
Other Companies / Units in the Group (Rs. in Lakhs)
Individual / Inst. the details
Name & Address Business Equity Reserves Loans Turnover *P.B.T as per table may be
**P.A.T
furnished
of Company / Unit
* Profit Before Tax ** Profit After Tax

`
8.1 How the activity was financed so far : ( To be filled up in case of existining unit Only )
*Source of Funds Security Rate of Repayment per Present O/s Amount of Default
Interest Month ( Rs. in '000 ) (if any)
Enter type of work

8.2 If the Unit is an ancillary one, undertaking to undertaking
Enter Name and
which it is catering and its address : Detailed Address of the
undertaking to which
the unit working as
ancillary.
8.3 Employment : Present Proposed
Enter the present
0 0
strength of manpower
0 0 firm
in the existing
other than REGP
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
Total 0
9 Project Details for Proposed New Unit : Copy of detailed project report is enclosed.
Enter 'Yes' or 'No'
a Expansion / Mordenisation :
b Setting up of New unit :

Enter name of product
Enter any one of the
c Activity for proposed new unit : here
following appropriate for the
proposed activity.
Manufacturing
d Product / Item proposed to undertake : Processing
Servicing
9.1 Capacity (Furnish the details of Installed capacity & production : (No. in Units/ Qty. in Kg./Volume in liter per annum)
Enter no. of shift per day
Capacity is arrived at on the basis of Days
Enter no.working on
of working Single shift basis
Product & Present Installed days of the unit per
Maximum Prod. annum Proposed Installed Two Maximum Prod.
Three
By-product if any Capacity Achieved Capacity of 1st Year envisaged
Enter name of main Enter installed capacity Enter the value of Enter installed
Enter the capacity
value of
Product and by-product of existing unit. 70.00%
maximum production of proposed proposed new0production
unit as
if any seperately Otherwise enter NA. achieved under existing estimated
underinnew
the unit
project
as per
unit, otherwise enter report
project report
NA
9.3 State the manufacturing process in brief :

Brief here the process of
manufacturing of the
proposed product. If more
space required insert more
rows and merge with the
existing one.
Indicate briefly on
Specific processing technique of
the product.
Suitability/adoptability of the process at
the location.
Indicate briefly on
9.4 Has the proposed process ever been tried in the Specific processing technique of
country or newly adopted? : the product.
Suitability/adoptability of the process at
the location.
Indicate briefly on
9.5 Technical Arrangements : Satisfactory arrangement for Know-how
Collaboration involvement if any and financial
participation.
Details of consultants if any.
9.6 Describe arrangement for Key Official

for managing the proposed unit :
Give brief on the source,
Technical Manpower experience, cost to meetout
the proposed tech. Manpower.
Administrative Manpower experience, cost to meetout
the proposed Admn.
Manpower.
Accounting personnel experience, cost to meet out
the proposed Accounting
personnel.
9.7 Particulars of Land Existing Proposed

Indicate the
Indicate the
Location of the Land : Village/Town/ Village/Town/
Indicate the total
Dist./State of the area
Area of Land Dist./State where the
of
ofthe
theproposed
proposed land
landinifSq.mt
itland /
in
is not
land is located.
Enter here
Status of the Land with Sq.mt Sq.ft.
/ Sq.ft.one.
the existing
Leased or
Enter here
Nature of Land Owned
Agricultural
Indicate here,
Availability of Water : Non-Agricultural
availability and
suitability of water for
the proposed project.
9.8 Particulars of Building Existing Proposed

(Enclose the plan & Estimation for the proposed Building) Area Value in Rs. Status Area Value Status
Indicate the status Indicate
of the status of
Factory Building : building building
Leased Leased
Owned
Indicate the status Owned
Indicate
of the status of
Ancillary Building building building
Leased Leased
Owned
Indicate the status Owned
Indicate
of the status of
Storage building building
Leased Leased
Owned Owned
Total 0.00 0.00
9.9 Plant and Machinery Existing (Value in Rs.) Proposed (Value in Rs.)
Indigenous 0.00
Imported
(Enclose the plan layout of the existing plant and machinery )

9.10 Rawmaterials / Components
Req. of Raw material/Components/Chemicals Qty. in Nos./Kgs./Ton Rate/Nos./Kgs/Tons Value in Rs.
List the required Raw Enter the Quantity in terms EnterEnter
the rate
Total
per
Value
unit
materials / of Nos./Kgs/Tons
Components/Chemicals
required for the projects
Total 0.00
9.11 Utilities (Furnish details on requirement, availability, adequacy, qualitative aspects etc..)
Particulars of Utilities Contracted Load Connected Load Further requirement
in HP/KW/W in HP/KW/W in HP/KW/W
Enter total requirement Enter Enter
connected
further
power
power
Power of power in HP/KW/W if any
connection
in HP/KW/Wif any in
HP/KW/W
Water
Fuel
Others (Specify)
9.12 Environment Aspect of the Project :
Brief here nature of atmospheric, soil
and water pollution likely to be created
by the proposed project and measures
proposed to control the same. Indicate
the clearance of pollution control board.
9.13 Requirement of Manpower for the Project :

Particulars of Manpower Total Requirement Salary/Wages per month Cost per Annum
Enter the Nature of
0 0
Manpower 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
Total 0 0.00
9.14 Schedule of Implementation : BAR CHART

Activities Date of Commencement Expected Date of Completion
a. Acquisition of Land
b. Development of Land
c. Civil Works for Factory / Building
Machinery / Foundation etc..
d. Plant & Machinery
Imported
Indigenous
e. Arrangement for power
f. Arrangement for water
g. Errection of equipment
h. Commissioning
I. Procurement of Raw materials/Chemicals
j. Trail Runs
k. Commercial Production
10 Cost of Project :
(Rs. in '000)
Sr.No. Particulars Already Incurred To be Incurred Total Cost
A Land including Development 0.00 0.00
B Building & Other Civil Works 0.00 0.00
C Plant and Machinery

1. Indigenous 0.00 0.00
2. Imported 0.00
D Furniture & Fixture 0.00 0.00
E Testing equipment 0.00
F Miscellaneous Fixed Assets 0.00
G Errection & Installation Charges 0.00
H Contingency 0.00 0.00
I Preliminary & Pre-Op. Cost 0.00 0.00
J Provision for
1. Buildings 0.00
2. Plant & Machinery 0.00
3. Other Fixed Assets 0.00
K Working Capital for one 0.00 0.00

Operating Cycle
L Total 0.00 0.00 0.00

11 Means of Financing :
(Rs. in '000)
Sr.No. Particulars Amount already Amount Proposed Total
Raised to be Raised
A Equity / Promoters Contribution 0.00 0.00
B Reserves 0.00
C Term Loans 0.00 0.00
D Unsecured Loans and Deposits 0.00

(Indicate sources, roi, repayment etc)
E Deferred Payment 0.00

Arrangements including Suppliers credit
F Subsidy
Central Government 0.00 0.00
State Government 0.00
G Seed Capital 0.00
H Internal Cash Accruals 0.00
I Other Sources (Specify) 0.00
J Total 0.00 0.00 0.00
11.1 In case internal accruals are taken as

source of finance explain the basis of
estimation of internal accruals :
11.2 Indicate source from which expenditure

already incurred has been financed :
11.3 % of Promoters contribution of the :

total cost of project
Enter Brief notes on

1. The Products and Uses
2. Scope for market &
Special features if any

3. Competition
4. Potential for export
5. Sales arrangement
made
12 Marketing & Selling Arrangements of the Product : Enter Brief notes on
1. The Products and Uses
2. Scope for market &
Special features if any

3. Competition
4. Potential for export
5. Sales arrangement
made
13 Projected Profitability : Projected Profitability Statement given in the

Detailed Project Report.
14 Projected Cash flow Statement : Projected Cash flow Statement given in the
Detailed Project Report.
% of Cash Sales in Total Sales :
Period in which payment is received Days

in respect of Credit Sales
Average Credit Available on Purchase : Days
Warning
15 Working Capital Required for the : Rs. 0.00 Do not enter any data
anticipated turnover here!
16 Repayment Programme : Detailed Repayment programme for Term loan and

Working capital loan have been given in the DPR.
17 Details of Securities to be Offered :
17.1 Primary ( Furnish details for term loan and : :

working capital loan separately )
17.2 Collateral, if any (Details) :
17.3 Details of Guarantor(s) : Enter

1. Name Name of Guarantor here
Enter here
2. Residential Address : Full address of the
guaranter
Enter here
3. Occupation : Occupation
List here
4. Details of movable & immovable Details of Movable /
Immovable property
properties owned by him /her/other owned by
family members him/her/them
Enter here
5 Details of any other similar guarantees: The property details and
bank
if any, given to other institutions
18 Government Consents :
(Give deatails of various licenses / consents required to be obtained from various authorities for the proposed project)
19 DECLARATION
I / We hereby declare that the information given herein before and the statements and other
papers enclosed are, to the best of our knowledge and belief, true and correct in all particulars
Date : 0 Signature of the Borrower

Place : 0 Name & Designation (In case of Regd. Inst.)
Project Report on
Prepared By:
#REF!
Khadi & V.I. Commission
#REF!
#REF!
#REF! State: #REF!
e-Mail:
Ph. No.: Fax:

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Application ID: (For office use)

APPLICATION FORM FOR FINANCIAL ASSISTANCE UNDER PRIME MINISTERS

13 Amount of loan required (in Rs.)

Place: Signature, Name & Designation of Officer

• Own contribution must be invested 5% for SC/ST/OBC/PHC/woman/ Ex-serviceman/ North

Preference for sponsoring agency of the project to Bank: (mark √ )

5 Whether the applicant belongs to (mark √)

8 Name of the project / business activity proposed :

1 Name of the Entreprenuer 0

2 Constitution (legal Status) Individual

6 Cost of Project : Rs. 0

9 Pay Back Period : 5 Years

11 Break Even Point :

14 Major Raw materials : ,,

15 Estimated Annual : Rs. 0.00

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2 ABOUT THE PROMOTER :

b. Workshed Area Sq.ft Rate in Rs. Amt. In Rs.

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e. Furniture & Fixtures : Rs. 0.00

f. Contingency/Others/Miscellaneous Rs. 0.00

Total Capital Expenditure : Rs. 0.00

Working Capital : Rs. 0.00

Total Cost Project : Rs. 0.00

3.1 Means of Financing :

Bank Finance : 90%

Total Rs. 0.00

Margin Money (Govt. Subsidy) From KVIC 25% Rs. 0.00

Year Opening Balance Installment Closing Balance Interest @

Year Opening Balance Installment Closing Balance Interest @

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4 Schedule of Sales Realization :

4.2 Capacity Utilization of Sales

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5.2 Repairs and Maintenance : Rs. 0.00

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5.4 Other Overhead Expenses : Rs. 0.00

6.2 Telephone Expenses 0.00

6.4 Stationery & Postage 0.00

6.5 Advertisement & Publicity 0.00

6.6 Workshed Rent 0.00

6.7 Other Miscellaneous Expenses 0.00

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Repairs & Maintenance 0 0 0 0 0

Power & Fuel 0 0 0 0 0

Other Overhead Expenses 0 0 0 0 0

Postage Telephone Expenses 0 0 0 0 0

Stationery & Postage 0 0 0 0 0

Advertisement & Publicity 0 0 0 0 0

Other Miscellaneous Expenses 0 0 0 0 0

8 Assessment of Working Capital :

Repair & Maintenance 0.00

Power & Fuel 0.00

Other Overhead Expenses 0.00

Production Cost 0.00

Administrative Cost 0.00

Manufacturing Cost 0.00

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Stock in process 0 Production Cost 0.00

Finished goods 0 Manufacturing Cost 0.00

Receivable by 0 Manufacturing Cost 0.00

Total Working Capital Requirement Per Cycle 0.00