Beruflich Dokumente
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2.
3.
Proprietorship/ Partnership/
Company/ Society/ Others
4.
8.
9.
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2.
5.
6.
Date of Possession
3.
4.
Rented / Leased
4.
Expiry date
Rs. .................
Note: Only Micro & Small enterprises owned by women entrepreneurs, SC, ST
& Physically challenged shall be eligible for reimbursement of CGTMSE fees.
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New/Expansion/Diversification/
Modernization
For New Projects
(Rs.In lakhs)
16.
Sr.No
Cost of Project
Particulars
Amount
Sr.
No
1.
Means of finance
Particulars
Amount
Promoters
contribution
1
Land
2
Building
2. Term loan
3
Plant & M/c
3. Unsecured Loan
4
Others assets
4. Internal
accruals/others
Total
Total
(Above information shall be certified by the Bank OR Chartered Accountant )
Particulars
(Rs.In lakhs)
Gross Fixed capital
investment before
Expansion /
Diversification/
Modernization (Rs. In
lakhs) up to
Dt. / /20
Proposed/ actual
Gross Fixed capital
Investment for
Expansion /
Diversification/
Modernization.
1
2.
3.
4.
Increase
in %
Land
Building
Plant & Machinery
*
Other asset related to
manufacturing of the
product
Total
(*In case of expansion /diversification 60% of proposed project cost shall be in the plant
& machinery )
B. Means of finance
Sr.No
1.
2.
3.
4.
Means of finance
Particulars
Amount (Rs. In lakhs.)
Promoters contribution
Term loan
Unsecured Loan
Internal accruals/others
Total
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19.
20.
21.
Rs.................. Lakhs
Date / /20
Date / /20
Date
/20
Date / /20
22.
Approval CTE/CCA No...........
Date / /20
Valid up to Date / /20
23. Employment Details for Existing Enterprise:Sr.
Particulars
Total
Local
% of Local
no.
Employment
1
Manager/Supervisor
2
Workers
Total
Employment Details for proposed project:Sr.
Particulars
Total
Local
% of Local
no.
Employment
1
Manager/Supervisor
2
Workers
Total
24. Details of any other financial assistance granted by YES/NO
GOG/GOI
If, Yes Pl. attach details in
separate sheet.
25. If any Government dues are outstanding or not?
YES/NO
(And court case against Govt.? If Yes Give details
If, Yes Pl. attach details in
Application From Capital & Int Subsidy
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thereof.)
separate sheet.
26. I /we hereby opt for date of eligibility for Interest Subsidy from the
Date of production
[ ] Dt.
DD/MM/YYYY
OR
Date of first disbursements [ ] Dt.
DD/MM/YYYY
27. Declaration:
It is hereby declare that the information, statements & other papers given
herein are to the best of my knowledge & belief, true and correct in all
particulars, incentive government resolutions and prevailing government rules
and regulations.
28. I/we also declare that I am duly authorized to sign an application and details
and documents submitted in this application.
Note: All documents signed by the authorized signatory of the enterprise.
Date:
Place:
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