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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 910018 28732 77732 1016482
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
PRATIBHA RAMESHWAR MOTINGE
1.2
RAMESHWAR MOTINGE
2 Gender Male Female
3 Address of the Proposed location of Unit: Rural Urban
AT.POST.GARAJ

Taluk/Block: VAIJAPUR
District: AURANGABAD Pin: 431115
State: MAHARASHTRA
Email: rameshwarmotinge@gmail.com Mobile: 7588812488

4 Qualification
Academic Technical
Graduate

5 Whether the applicant belongs to (mark )


Ex- Hill
SC ST OBC PHC Service Minority Boarder General
man Area

Manu-
Whether the

Service
6 facturing
Unit
project (mark ) Unit
8 Name of the project / business activity proposed :
BEAUTY PARLOUR

Legal Status:

Land 300 ###

BUILDING DETAILS
Particulars Area Rate/Sq.ft Amount in Rs.
0.00
0.00
0.00
0.00
0.00
0.00
0.00

MACHINERY DETAILS
Particulars Qty. Rate Amount in Rs.
For a beauty parlor : Mirror (2.0 m x 1.0 m) 20 10000.00 200000.00
Hair salon Cabinet 4 130000.00 520000.00
Artificial nails 20 kit 1500.00 30000.00 Male
Rinsing Sink 4 5000.00 20000.00
Scissors 3 set 5000.00 15000.00
Standard Hair Dryer 10 3000.00 30000.00 KVIC
Hair straightener 5 3000.00 15000.00
Plastic Hair Curler with rubber attaching 3 dozen 3000.00 9000.00 DIC
Plastic Cap used for dying hair 8 1500.00 12000.00
Combs 5 500.00 2500.00
bath caps 6 1000.00 6000.00 Rura
Plastic Gloves 3 packet 506.00 1518.00

Total 861018.00 No

d. Preliminary & Pre-operative Cost : 15199.00 SC

e. Furniture & Fixtures : 49000.00

f. Contingency/Others/Miscellaneous 13533.00

Working Capital : 77732.00


Man

Means of Financing ###

Own Contribution : 5%
Bank Finance : 95%
Margin Money (Govt. Subsidy) : 35%

DETAILS OF SALES Own


Rate/ Qantity Amount in Rs.
Particulars of Products
Unit
500.00 1585 792500.00
0.00
0.00
0.00
0.00
0.00
0.00

Total 792500.00

RAW MATERIALS
Particulars Unit Rate/Unit Reqd. Unit Amount In Rs.
900.00 150 135000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Total 135000.00

WAGES
No. of Wages Per Month Amount in Rs.
Particulars
Worker Total Month 12
3 8000.00 288000.00
0.00
0.00
0.00
0.00
0.00
0.00
Total 3 288000.00

SALARY DETAILS
No. of Wages Per Month Amount in Rs.
Particulars
Staff Total Month 12
0.00
0.00
0.00
0.00
0.00
Total 0 0.00

WORKING CAPITAL ESTIMATE


Element of Working Capital No. of Days

Stock in process 20

Finished goods 15

Receivable by 3

POWER ESTIMATE
Power Requirement 01. HP

Repair and Maintanance 2.00% Rs. 2000.00

Power and Fuel 1.50% Rs. 3000.00

Other Overhead Expenses 1.00% Rs. 2500.00

Telephone Expenses 1.00% Rs. 1500.00

Stationery & Postage 2.00% Rs. 1500.00

Advertisement & Publicity 3.00% Rs. 10000.00

Building Rent Rs. 8000.00

Other Miscelleneous Expenditure Rs. 3000.00

Rate of Interest 12.50%

Depreciation
On Building
On Machinery

INTRODUCTION

ABOUT THE PROMOTER


PROJECT AT A GLANCE - TOP SHEET
1 Name of the Entreprenuer PRATIBHA RAMESHWAR MOTINGE

2 Constitution (legal Status) Individual

3 Father's/Spouce's Name RAMESHWAR MOTINGE

4 Unit Address : AT.POST.GARAJ


AURANGABAD
Taluk/Block: VAIJAPUR
District : AURANGABAD
Pin: 431115 State: MAHARASHTRA
E-Mail : rameshwarmotinge@gmail.com
Mobile 7588812488
5 Product and By Product

6 Cost of Project : Rs. 10,00,000


Name of the project / business BEAUTY PARLOUR
activity proposed :
7 Means of Finance
Term Loan Rs. 9,50,001.00
KVIC Margin Money Rs. 3,50,000.00
Own Capital Rs. 50000.00

8 Debt Service :
Coverage Ratio

9 Pay Back Period : 5 Years

10 Project : Months
Implementation
Period

11 Break Even Point :

12 Employment : 3

13 Power Requirement : 01. HP

14 Major Raw materials :

15 Estimated Annual : Rs. 792500.00


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 : 300 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.
For a beauty parlor : Mirror (2.0 m x 1.0 m) 20 10000.00 200000.00
Hair salon Cabinet 4 130000.00 520000.00
Artificial nails 20 kit 1500.00 30000.00
Rinsing Sink 4 5000.00 20000.00
Scissors 3 set 5000.00 15000.00
Standard Hair Dryer 10 3000.00 30000.00
Hair straightener 5 3000.00 15000.00
Plastic Hair Curler with rubber attaching 3 dozen 3000.00 9000.00
Plastic Cap used for dying hair 8 1500.00 12000.00
Combs 5 500.00 2500.00
bath caps 6 1000.00 6000.00
Plastic Gloves 3 packet 506.00 1518.00
Total 861018.00

PMEGP Project Report Page 11


d. Preliminary & Pre-operative Cost : Rs. 15199.00

e. Furniture & Fixtures : Rs. 49000.00

f. Contingency/Others/Miscellaneous Rs. 13533.00

Total Capital Expenditure : Rs. 938750.00

Working Capital : Rs. 61250.00

Total Cost Project : Rs. 1000000.00

3.1 Means of Financing :


Own Contribution 5% Rs. 50000.00

Bank Finance : 95%


Term Loan Rs. 891813.00
Working Capital Rs. 58188.00

Total Rs. 950001.00

Margin Money (Govt. Subsidy) From KVIC 35% Rs. 350000.00

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

Interest @
Year Opening Balance Installment Closing Balance
12.50%
1st 891813 0 891813 111477
2nd 891813 178363 713450 111477
3rd 713450 178363 535088 89181
4th 535088 178363 356725 66886
5th 356725 178363 178363 44591
6th 178363 178363 0 22295
7th 0 0 0 0
8th 0 0 0 0

WORKING CAPITAL

Interest @
Year Opening Balance Installment Closing Balance
12.50%
1st 58188 0 58188 7274
2nd 58188 11638 46550 7274
3rd 46550 11638 34913 5819
4th 34913 11638 23275 4364
5th 23275 11638 11638 2909
6th 11638 11638 0 1455
7th 0 0 0 0
8th 0 0 0 0

PMEGP Project Report Page 12


3.3 STATEMENT SHOWING THE DEPRECIATION ON FIXED ASSETS:
WORKSHED @ 0.00%
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 861018 861018 861018 861018 861018
Depreciation 0 0 0 0 0
Closing Balance 861018 861018 861018 861018 861018
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
Rate/ No. of Amount in Rs.
Particulars of Product Pair/Unit Pair/Unit
0
0 500.00 1585 792500.00
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 792500.00

4.2 Capacity Utilization of Sales


Particulars 1st Year 2nd Year 3rd Year 4th Year 5th Year

Capacity Utilization 70% 80% 90% 90% 90%

Sales / Receipts 554750 634000 713250 713250 713250

5 Rawmaterials :
Particulars Unit Rate/unit Reqd.Unit Amount in Rs.
0 0 900.00 150 135000.00
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 135000.00
5.1 Wages :
No. of Wages Amount in Rs.
Particulars Worker Per Month (Per Annum)
0 3 8000.00 288000.00
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 3 288000.00

5.2 Repairs and Maintenance : Rs. 2000.00

PMEGP Project Report Page 13


5.3 Power and Fuel : Rs. 3000.00

5.4 Other Overhead Expenses : Rs. 2500.00

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 1500.00

6.4 Stationery & Postage 1500.00

6.5 Advertisement & Publicity 10000.00

6.6 Workshed Rent 96000.00

6.7 Other Miscellaneous Expenses 3000.00


Total 112000.00
7 Capacity Utilization of Manufacturing & Administrative Expenses :
Particulars 1st Year 2nd Year 3rd Year 4th Year 5th Year
Capacity Utilization 70% 80% 90% 90% 90%
Manufacturing Expenses
Rawmaterials 94500 108000 121500 121500 121500
Wages 201600 230400 259200 259200 259200
Repairs & Maintenance 1400 1600 1800 1800 1800
Power & Fuel 2100 2400 2700 2700 2700
Other Overhead Expenses 1750 2000 2250 2250 2250
Administrative Expenses
Salary 0 0 0 0 0
Postage Telephone Expenses 1050 1200 1350 1350 1350
Stationery & Postage 1050 1200 1350 1350 1350
Advertisement & Publicity 7000 8000 9000 9000 9000
Workshed Rent 96000 96000 96000 96000 96000
Other Miscellaneous Expenses 2100 2400 2700 2700 2700
Total: 408550 453200 497850 497850 497850
8 Assessment of Working Capital :
Particulars Amount in Rs.
Sale 792500.00

Manufacturing Expenses
Raw Material 135000.00
Wages 288000.00
Repair & Maintenance 2000.00
Power & Fuel 3000.00
Other Overhead Expenses 2500.00

Production Cost 430500.00


Administrative Cost 112000.00
Manufacturing Cost 542500.00

PMEGP Project Report Page 14


Working Capital Estimate :
Element of Working Capital No of Days Basis Amount in Rs.
0 0 Material Cost 0.00

Stock in process 20 Production Cost 28700.00

Finished goods 15 Manufacturing Cost 27125.00

Receivable by 3 Manufacturing Cost 5425.00

Total Working Capital Requirement Per Cycle 61250.00


9 Financial Analysis
9.1 Projected Profit & Loss Account :
Particulars 0 Year 1st Year 2nd Year 3rd Year 4th Year
Sales / Receipts 554750 634000 713250 713250
554750 634000 713250 713250
Manufacturing Expenses
Rawmaterials 94500 108000 121500 121500
Wages 201600 230400 259200 259200
Repairs & Maintenance 1400 1600 1800 1800
Power & Fuel 2100 2400 2700 2700
Other Overhead Expenses 1750 2000 2250 2250
Depreciation 0 0 0 0
Production Cost 301350 344400 387450 387450
Administrative Expenses
Salary 0 0 0 0
Postage Telephone Expenses 1050 1200 1350 1350
Stationery & Postage 1050 1200 1350 1350
Advertisement & Publicity 7000 8000 9000 9000
Workshed Rent 96000 96000 96000 96000
Other Miscellaneous Expenses 2100 2400 2700 2700
Administrative Cost 107200 108800 110400 110400
Interest on Bank credit @ 12.5%
Term Loan 111477 111477 89181 66886
Working Capital Loan 7274 7274 5819 4364
Cost of Sale 527300 571950 592850 569100
Net Profit Before Tax 27450 62050 120400 144150
Less Tax 0.00 0.00 0.00 0.00
Net Profit 27450 62050 120400 144150

9.2 CALCULATION OF DEBT SERVICE CREDIT RATIO (D.S.C.R) :


Particulars 0 Year 1st Year 2nd Year 3rd Year 4th Year
Net Profit 27450 62050 120400 144150
Add :
Depreciation 0 0 0 0
TOTAL - A 27450 62050 120400 144150
Payments :
On Term Loan :
Interest 111477 111477 89181 66886
Installment 0 178363 178363 178363
On Working Capital
Interest 7274 7274 5819 4364
TOTAL - B 118750 297113 273363 249613
D.S.C.R = A/B
0.23 0.21 0.44 0.58
Average D.S.C.R

PMEGP Project Report Page 15


9.3 PROJECTED BALANCE SHEET :
Particulars 0 Year 1st Year 2nd Year 3rd Year 4th Year
LIABILITIES :
Promoters Capital 50000 50000 50000 50000
Profit 27450 62050 120400 144150
Term Loan 891813 891813 713450 535088
Working Capital Loan 58188 58188 46550 34913
Current Liabilities 0 0 0 0
Sundry Creditors 0 0 0 0
1027451 1062051 930401 764151
ASSETS :
Gross Fixed Assets : 910018 910018 910018 910018
Less : Depreciation 0 0 0 0
Net Fixed Assets 910018 910018 910018 910018
Preliminary & Pre-Op. Expenses 15199 11399 8549 6412
Current Assets 58188 58188 46550 34913
Cash in Bank/Hand 59245 93845 -26168 -180780
Total 1027451 1062051 930401 764151

9.4 CASH FLOW STATEMENT :


Particulars 0 Year 1st Year 2nd Year 3rd Year 4th Year
Net Profit 27450 62050 120400 144150
Add : Depreciation 0 0 0 0
Term Loan 891813 891813 713450 535088
Working Capital Loan 58188 58188 46550 34913
Promoters Capital 50000 0 0 0
Total 1027451 1012051 880401 714151

Total Fixed Capital Invested 938750

Repayment of Term Loan 0 178363 178363 178363


Repayment of WC Loan 0 11638 11638 11638
Current Assets 58188 58188 46550 34913
Total 58188 248188 236551 224913

Opening Balance 0 969263 1733126 2376976


Surplus 969263 763863 643850 489238
Closing Balance 969263 1733126 2376976 2866213

9.5 BREAK EVEN POINT AND RATIO ANALYSIS :


Particulars 0 Year 1st Year 2nd Year 3rd Year 4th Year
Fixed Cost 218677 220277 199581 177286
Variable Cost 308624 351674 393269 391814
Total Cost 527300 571950 592850 569100

Sales 554750 634000 713250 713250

Contribution (Sales-VC) 246127 282327 319981 321436

B.E.P in % 88.85% 78.02% 62.37% 55.15%

Break Even Sales in Rs. 492880 494659 444874 393389

Break Even Units 986 989 890 787

Current Ratio 0.49 0.19 0.16 0.13

PMEGP Project Report Page 16


Net Profit Ratio 4.95% 9.79% 16.88% 20.21%

PMEGP Project Report Page 17


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 : PRATIBHA RAMESHWAR MOTINGE

Signature of the Beneficiary

PMEGP Project Report Page 18


PROJECT REPORT FOR

Affix latest
attested
Photograph

1 Name of the Entreprenuer PRATIBHA RAMESHWAR MOTINGE


1
2 Constitution (legal Status) Individual

3 Father's/Spouce's Name #REF!

5 Unit Address : AT.POST.GARAJ


0
Taluk/Block: VAIJAPUR

District : VAIJAPUR
Pin: 431115 State: #REF!
Phone #REF!
E-Mail #REF!

6 Background of the Proprietor/Partners/Directors : Furnished detailed information in the DPR

7 Name of Business House/Group if any :

8 Details Other Companies/Units in the group :


Other Companies / Units in the Group (Rs. in Lakhs)
Name & Address Business Equity Reserves Loans Turnover *P.B.T **P.A.T
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)

8.2 If the Unit is an ancillary one, undertaking to


which it is catering and its address :
8.3 Employment : Present Proposed
0 3
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
Total 3

9 Project Details for Proposed New Unit : Copy of detailed project report is enclosed.
a Expansion / Mordenisation :

b Setting up of New unit :

c Activity for proposed new unit :

d Product / Item proposed to undertake :

9.1 Capacity (Furnish the details of Installed capacity & production : (No. in Units/ Qty. in Kg./Volume in liter per annum)
Capacity is arrived at on the basis of Days working on shift basis
Product & Present Installed Maximum Prod. Proposed Installed Maximum Prod.
By-product if any Capacity Achieved Capacity of 1st Year envisaged
70.00% 301350

9.3 State the manufacturing process in brief :


9.4 Has the proposed process ever been tried in the
country or newly adopted? :

9.5 Technical Arrangements :

9.6 Describe arrangement for Key Official


for managing the proposed unit :
Technical Manpower

Administrative Manpower

Accounting personnel

9.7 Particulars of Land Existing Proposed


Location of the Land :
Area of Land
Status of the Land
Nature of Land
Availability of Water :

9.8 Particulars of Building Existing Proposed


(Enclose the plan & Estimation for the proposed Building) Area Value in Rs. Status Area Value Status
Factory Building :

Ancillary Building

Storage

Total 0.00 0.00

9.9 Plant and Machinery Existing (Value in Rs.) Proposed (Value in Rs.)
Indigenous 861018.00

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.

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
Power

Water

Fuel

Others (Specify)
9.12 Environment Aspect of the Project :

9.13 Requirement of Manpower for the Project :


Particulars of Manpower Total Requirement Salary/Wages per month Cost per Annum
0 3 8000.00 288000.00
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 3 288000.00

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 861018.00 861018.00
2. Imported 0.00

D Furniture & Fixture 49000.00 49000.00

E Testing equipment 0.00

F Miscellaneous Fixed Assets 0.00

G Errection & Installation Charges 0.00

H Contingency 13533.00 13533.00

I Preliminary & Pre-Op. Cost 15199.00 15199.00

J Provision for
1. Buildings 0.00
2. Plant & Machinery 0.00
3. Other Fixed Assets 0.00

K Working Capital for one 61250.00 61250.00


Operating Cycle

L Total 0.00 1000000.00 1000000.00


11 Means of Financing :
(Rs. in '000)
Sr.No. Particulars Amount already Amount Proposed Total
Raised to be Raised
A Equity / Promoters Contribution 50000.00 50000.00

B Reserves 0.00

C Term Loans 950001.00 950001.00

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 350000.00 350000.00
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 1000001.00 1000001.00

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
12 Marketing & Selling Arrangements of the Product :

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

15 Working Capital Required for the : Rs. 61250.00


anticipated turnover

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) :


1. Name
2. Residential Address :

3. Occupation :
4. Details of movable & immovable
properties owned by him /her/other
family members

5 Details of any other similar guarantees:


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!
District Industries Center
#REF!
#REF!
#REF! State: #REF!
e-Mail:
Ph. No.: Fax:

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