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 925000 22270 42270 989540
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
WAMAN SAKHARAM GAWALI
1.2
SAKHARAM GAWALI
2 Gender Male Female
3 Address of the Proposed location of Unit: Rural Urban
AT POST.PISHORE

Taluk/Block: KANNAD
District: AURANGABAD Pin: 431104
State: MAHARASHTRA
Email: Mobile: 8806558447

4 Qualification
Academic Technical
8th Pass

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 :
KIRANA SHOP & GENERAL STORES

Legal Status:

Land 800 ###

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

0.00
0.00
0.00
0.00
0.00
0.00

MACHINERY DETAILS
Particulars Qty. Rate Amount in Rs.
ALL KIRANA STORES MATERIALS 905000.00 905000.00
0.00
0.00 Male
0.00
0.00
0.00 KVIC
0.00
0.00 DIC
0.00
0.00
0.00 Rura
0.00

Total 905000.00 No

d. Preliminary & Pre-operative Cost : 15000.00 SC

e. Furniture & Fixtures : 20000.00

f. Contingency/Others/Miscellaneous 7270.00

Working Capital : 42270.00

 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
12000.00 80 960000.00
0.00
0.00
0.00
0.00
0.00
0.00

Total 960000.00

RAW MATERIALS
Particulars Unit Rate/Unit Reqd. Unit Amount In Rs.
50.00 2554 127700.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Total 127700.00

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 15

Finished goods 10

Receivable by 5

POWER ESTIMATE
Power Requirement 05.HP

Repair and Maintanance 3.00% Rs. 28800.00

Power and Fuel 3.00% Rs. 28800.00

Other Overhead Expenses 2.00% Rs. 19200.00

Telephone Expenses Rs. 0.00

Stationery & Postage 1.00% Rs. 9600.00

Advertisement & Publicity Rs. 0.00

Building Rent Rs. 5000.00

Other Miscelleneous Expenditure Rs. 0.00

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 WAMAN SAKHARAM GAWALI

2 Constitution (legal Status) Individual

3 Father's/Spouce's Name SAKHARAM GAWALI

4 Unit Address : AT POST.PISHORE

Taluk/Block: KANNAD
District : AURANGABAD
Pin: 431104 State: MAHARASHTRA
E-Mail :
Mobile 8806558447
5 Product and By Product

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

Name of the project / business SHUBHAM KIRANA AND GENERAL STORES
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
S
11 Break Even Point :

12 Employment : 3

13 Power Requirement : 05.HP

14 Major Raw materials : ,,

15 Estimated Annual : Rs. 960000.00

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 : 800 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.
ALL KIRANA STORES MATERIALS 0 905000.00 905000.00
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 905000.00

PMEGP Project Report Page 11

 d. Preliminary & Pre-operative Cost : Rs. 15000.00

e. Furniture & Fixtures : Rs. 20000.00

f. Contingency/Others/Miscellaneous Rs. 7270.00

Total Capital Expenditure : Rs. 947270.00

Working Capital : Rs. 52730.00

Total Cost Project : Rs. 1000000.00

3.1 Means of Financing :

Own Contribution 5% Rs. 50000.00

Bank Finance : 95%

Term Loan Rs. 899907.00
Working Capital Rs. 50094.00

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 899907 0 899907 112488
2nd 899907 179981 719926 112488
3rd 719926 179981 539944 89991
4th 539944 179981 359963 67493
5th 359963 179981 179981 44995
6th 179981 179981 0 22498
7th 0 0 0 0
8th 0 0 0 0

WORKING CAPITAL

Interest @
Year Opening Balance Installment Closing Balance
12.50%
1st 50094 0 50094 6262
2nd 50094 10019 40075 6262
3rd 40075 10019 30056 5009
4th 30056 10019 20038 3757
5th 20038 10019 10019 2505
6th 10019 10019 0 1252
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 905000 905000 905000 905000 905000
Depreciation 0 0 0 0 0
Closing Balance 905000 905000 905000 905000 905000
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 12000.00 80 960000.00
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 960000.00

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 672000 768000 864000 864000 864000

5 Rawmaterials :
Particulars Unit Rate/unit Reqd.Unit Amount in Rs.
0 0 50.00 2554 127700.00
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 127700.00
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. 28800.00

PMEGP Project Report Page 13

5.3 Power and Fuel : Rs. 28800.00

5.4 Other Overhead Expenses : Rs. 19200.00

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 9600.00

6.5 Advertisement & Publicity 0.00

6.6 Workshed Rent 60000.00

6.7 Other Miscellaneous Expenses 0.00

Total 69600.00
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 89390 102160 114930 114930 114930
Wages 201600 230400 259200 259200 259200
Repairs & Maintenance 20160 23040 25920 25920 25920
Power & Fuel 20160 23040 25920 25920 25920
Other Overhead Expenses 13440 15360 17280 17280 17280
Administrative Expenses
Salary 0 0 0 0 0
Postage Telephone Expenses 0 0 0 0 0
Stationery & Postage 6720 7680 8640 8640 8640
Advertisement & Publicity 0 0 0 0 0
Workshed Rent 60000 60000 60000 60000 60000
Other Miscellaneous Expenses 0 0 0 0 0
Total: 411470 461680 511890 511890 511890
8 Assessment of Working Capital :
Particulars Amount in Rs.
Sale 960000.00

Manufacturing Expenses
Raw Material 127700.00
Wages 288000.00
Repair & Maintenance 28800.00
Power & Fuel 28800.00
Other Overhead Expenses 19200.00

Production Cost 492500.00

Administrative Cost 69600.00
Manufacturing Cost 562100.00

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 15 Production Cost 24625.00

Finished goods 10 Manufacturing Cost 18737.00

Receivable by 5 Manufacturing Cost 9368.00

Total Working Capital Requirement Per Cycle 52730.00

9 Financial Analysis
9.1 Projected Profit & Loss Account :
Particulars 0 Year 1st Year 2nd Year 3rd Year 4th Year
Sales / Receipts 672000 768000 864000 864000
672000 768000 864000 864000
Manufacturing Expenses
Rawmaterials 89390 102160 114930 114930
Wages 201600 230400 259200 259200
Repairs & Maintenance 20160 23040 25920 25920
Power & Fuel 20160 23040 25920 25920
Other Overhead Expenses 13440 15360 17280 17280
Depreciation 0 0 0 0
Production Cost 344750 394000 443250 443250
Administrative Expenses
Salary 0 0 0 0
Postage Telephone Expenses 0 0 0 0
Stationery & Postage 6720 7680 8640 8640
Advertisement & Publicity 0 0 0 0
Workshed Rent 60000 60000 60000 60000
Other Miscellaneous Expenses 0 0 0 0
Administrative Cost 66720 67680 68640 68640
Interest on Bank credit @ 12.5%
Term Loan 112488 112488 89991 67493
Working Capital Loan 6262 6262 5009 3757
Cost of Sale 530220 580430 606890 583140
Net Profit Before Tax 141780 187570 257110 280860
Less Tax 0.00 0.00 0.00 0.00
Net Profit 141780 187570 257110 280860

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 141780 187570 257110 280860
Add :
Depreciation 0 0 0 0
TOTAL - A 141780 187570 257110 280860
Payments :
On Term Loan :
Interest 112488 112488 89991 67493
Installment 0 179981 179981 179981
On Working Capital
Interest 6262 6262 5009 3757
TOTAL - B 118750 298732 274982 251231
D.S.C.R = A/B
1.19 0.63 0.94 1.12
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 141780 187570 257110 280860
Term Loan 899907 899907 719926 539944
Working Capital Loan 50094 50094 40075 30056
Current Liabilities 0 0 0 0
Sundry Creditors 0 0 0 0
1141781 1187571 1067111 900861
ASSETS :
Gross Fixed Assets : 925000 925000 925000 925000
Less : Depreciation 0 0 0 0
Net Fixed Assets 925000 925000 925000 925000
Preliminary & Pre-Op. Expenses 15000 11250 8438 6328
Current Assets 50094 50094 40075 30056
Cash in Bank/Hand 166687 212477 102036 -54196
Total 1141781 1187571 1067111 900861

9.4 CASH FLOW STATEMENT :

Particulars 0 Year 1st Year 2nd Year 3rd Year 4th Year
Net Profit 141780 187570 257110 280860
Add : Depreciation 0 0 0 0
Term Loan 899907 899907 719926 539944
Working Capital Loan 50094 50094 40075 30056
Promoters Capital 50000 0 0 0
Total 1141781 1137571 1017111 850861

Total Fixed Capital Invested 947270

Repayment of Term Loan 0 179981 179981 179981

Repayment of WC Loan 0 10019 10019 10019
Current Assets 50094 50094 40075 30056
Total 50094 240094 230075 220057

Opening Balance 0 1091687 1989164 2776199

Surplus 1091687 897477 787035 630804
Closing Balance 1091687 1989164 2776199 3407003

9.5 BREAK EVEN POINT AND RATIO ANALYSIS :

Particulars 0 Year 1st Year 2nd Year 3rd Year 4th Year
Fixed Cost 179208 180168 158631 136133
Variable Cost 351012 400262 448259 447007
Total Cost 530220 580430 606890 583140

Sales 672000 768000 864000 864000

Contribution (Sales-VC) 320988 367738 415741 416993

B.E.P in % 55.83% 48.99% 38.16% 32.65%

Break Even Sales in Rs. 375179 376271 329669 282065

Break Even Units 31 31 27 24

Current Ratio 0.42 0.16 0.14 0.12

PMEGP Project Report Page 16

 Net Profit Ratio 21.10% 24.42% 29.76% 32.51%

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 : WAMAN SAKHARAM GAWALI

Signature of the Beneficiary

PMEGP Project Report Page 18

 PROJECT REPORT FOR

Affix latest
attested
Photograph

1 Name of the Entreprenuer WAMAN SAKHARAM GAWALI

1
2 Constitution (legal Status) Individual

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

5 Unit Address : AT POST.PISHORE

0
Taluk/Block: KANNAD

District : KANNAD
Pin: 431104 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% 344750

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 905000.00

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 905000.00 905000.00
2. Imported 0.00

D Furniture & Fixture 20000.00 20000.00

E Testing equipment 0.00

F Miscellaneous Fixed Assets 0.00

G Errection & Installation Charges 0.00

H Contingency 7270.00 7270.00

I Preliminary & Pre-Op. Cost 15000.00 15000.00

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

K Working Capital for one 52730.00 52730.00

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. 52730.00

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: