ANNEXURE-I

FORM OF QUARTERLY PROGRESS

REPORT FOR THE QUARTER ENDING

(REPORT TO BE SENT TILL DATE OF FULL

IMPLEMENTATION OF SCHEME)

(AMOUNT IN Rs. LAKHS)

1. NAME OF THE PROJECT/SCHEME :

2. LOCATION OF PROJECT/SCHEME :

3. IMPLEMENTATION PERIOD :

AS PER SANCTION ACTUAL

i) Date of Commencement :

ii) Date of Completion :

4. BREAK UP OF NUMBER OF UNIT(S)

AS PER SANCTION ACTUALS

Male Female Male Female
(a) Rural
(b) Urban
Total

5. STATUS OF BENEFICIARIES
AS PER SANCTION ACTUAL
Rural Urban Rural Urban
M F M F M F M F
i) Educated unemployed/under employed
ii) Women
iii) Scavengers
iv) Artisans
v) Others
--------------------------------------------------
Total :
--------------------------------------------------

List of Beneficiaries to be enclosed as per Appendix-1.

6. COST OF PROJECT & ACTUAL EXPENDITURE
(Amount in lakhs)

Sl. ITEMS SANCTIONED ACTUALS

No.
i) No.of Units
ii) Cost per unit
iii) Total cost of scheme/project

Note: In case of projects in non-transport sector where NSFDCs share exceeds Rs.5.00 lakhs
per unit or profit centre details are to be given as per Appendix-3. For other schemes,
this appendix is not necessary.

7. DETAILS OF FUND SOURCES AND UTILISATION

Source Sanctioned Actual (Cumulative)

Per Unit Total for ___ Per unit Total for ___
No. of Units No. of Units
(i) Promoters contribution
(ii) NSFDCs Share
(a) Term Loan
(b) Seed Capital
(c) Bridge Loan
(d) Working Capital Loan
(ii) Channelising Agencys
Share
(iii) Subsidy
(iv) Others (Specify)
Total :

8. DETAILS OF RECEIPT AND UTILISATION OF NSFDCs SHARE

RECEIPT FROM NSFDC FUNDS RELEASED BY CHANNELISING

AGENCY TO SUPPLIERS
Cheque/ Date Amount Cheque Date In favour Amount
DD No. No.

a. 1st Disbursement

-------- --------
Total :
-------- --------

b. 2nd Disbursement
Subsequent
Disbursement

-------- --------
Total :
-------- --------
Note :
(i) Details of funds released by channelising agency to the beneficiaries/suppliers of assets
are to be furnished separately for each instalment disbursed by NSFDC incorporating
the particulars specified above. A separate sheet may be enclosed, if required.

(ii) In case funds are released to the beneficiaries directly details of the same to be
furnished in Appendix-1.

(iii) Transfer of funds by Channelising Agency to its Branches/District Offices/Field Offices

will not be treated as disbursement for the purpose of unutilised funds attracting higher
rate of interest.

9. REPAYMENT STATUS OF NSFDCs SHARE (CUMULATIVE)

(As on date)
(in Rs.)
Sl. Principal Interest Total
No.
01. Amount due
02. Amount paid
03. Balance

10. DEVIATIONS FROM THE SANCTION, :

IF ANY, ALONGWITH REASONS

11. OTHER RELEVANT INFORMATION, IF ANY :

 APPENDIX-1 TO ANNEXURE -1

DETAILS OF BENEFICIARIES ASSISTED

NAME OF THE CHANNELISING AGENCY :

NAME OF THE SCHEME (LOI NO.) :

Name & &Age Sex Unit NSFDCs Disbursement of NSFDCs Share Beneficiaries Category Annual Remarks
Address Cost Share Code Family
Income
Cheque No./ Date Amount Rural Urban
DD No. Disburse-
ment
M F M F

ADD : Reported in Previous Qtr.

Total :

CERTIFIED THAT ALL THE BENEFICIARIES COVERED UNDER THE LIST ARE
ELIGIBLE FOR ASSISTANCE AS PER ELIGIBILITY CRITERIA

SIGNATURE
(AUTHORISED SIGNATORY)
NAME & DESIGNATION OF OFFICIAL

Note :

(i) Details of type of vehicle may be indicated in the remarks column in case where single
sanction consists of different types of vehicles.
(ii) Separate sheet to be used for each scheme.
(iii) Please indicate Category Code as (1) for Educated Unemployed under employed (2) for
Women and (3) for Scavengers (4) for Artisans & (5) for others.
 ANNEXURE-II

FORMAT NO.1

NATIONAL SCHEDULED CASTES FINANCE & DEVELOPMENT CORPORATION,

NEW DELHI

FORMAT OF APPLICATION FOR FINANCIAL ASSISTANCE FOR NON-FARMING

AND OTHER ACTIVITIES
(THIS IS ONLY A FORMAT AND NOT AN APPLICATION FORM)

1. DETAILS OF PROMOTER(S)

(Name,Age, Address, Present Occupation, Present

Income Level, Details of Family Members)

2. PROPOSED ACTIVITY

(Details of Activity, Location

and Area of Operation, Skill
Level Required for Operating
the Activity & Experience in the
line)

3. COST OF PROJECT

Sl. No. Item Cost (Rs.)

(i) Building (to be supported by documents)

(ii) Plant & Machinery (to be supported with
quotation)
(iii) Misc. Fixed Assets (to be supported with
quotations)
(iv) Preliminary & Pre-operative expensesi
(v) Contingencies & Cost escalation
(vi) Others, if any (registration expenses insurance
expenses etc.)
(vii) Working Capital (Details of requirement of
working capital to be furnished)

Total

4. MEANS OF FINANCE
 Sl. No. Source Per Unit %age Total for
___ Units

(i) Promoters Contribution

(ii) Subsidy
(iii) Margin Money Loan (SCA)
(iv) Term Loan/Seed Capital
/Working Capial NSFDC

(v) Banks
(vi) Others, if any, specify
Total

5. DETAILS OF PROFITABILITY :

(Please give details of sales revenue

and details of expenditure of
operations for a normal year of
operation)

6. TECHNICAL DETAILS :

(Give technical details such as skill

requirement, raw material
requirement, power requirement
manufacturing process etc. In 200
words)

7. MARKETING ARRANGEMENTS :