Appendix - I Application Form For establishment / modernization / expansion of FPI unit A. PROMOTER'S DETAILS 1. Name & Address of firm (Telephone / Fax ) 2. Name & Address of Pramoter's (if proprietorship) 3. Background / Experience 4. Financial Status (Banker's Name, if any) 5. Existing Industry (if any) B. PROJECT DESCRIPTION 6. Name of Project 7. Location / Area 8. Products / Byproducts (their specifications & use) 9. Process (with flow chart) 10. Technology (Source: indigenous/imported) 11. Capacity of Plant / Manufacturing Unit (per day / per year) 12. In case of expansion/ modernization capacity and proposed capacity after expansion/modernization ___________________________________________________ 121 C. PROJECT COST Particulars 13. Land Area 14. Civil Works 15. Technical Civil Works 16. Plant & Machinery (indigenous) 17. Imported Machinery 18. Other Charges 19. Working Capital 20. Total Cost D. FINANCE 21. Equity 22. Term Loan (Loan Capital) 23. Loan (Working Capital) 24. Assistance from Other Sources 25. Fund requirement from Ministry (MFPI) 26. Total E. FINANCIAL BENCHMARKS 27. IRR 28. Break Even Point 29. Debt Equity Ratio 30. Debit Service Coverage Ratio 31. In case of expansion / modernization all the above benchmarks to be given Cost (Rs. in lacs) separately existing as well as projected _________________________________________________ 122 F. IMPLEMENTATION SCHEDULE 32. Submission of Application to SNA 33. Sanction of Term Loans by Bank 34. Completion of Civil Works 35. Placing order for main P&M (6) 36. Receipt of these P&M 37. Commercial Production G. PAST ASSISTANCE 38. Details of past Loans/Grants from MFPI taken by the Applicant or its sister concern H. EMPLOYMENT 39. Direct I. MARKETING 40. Existing market 41. Future market PlaceDate Encls to be attached: 1. D.P.R 2. Appraisal Report by Bank/FI _______________________________________ Indirect Signature of Applicant 3. List of plant & machinery and technical civil works with costs along with details and costs. 4. Sanction letter of Bank/FI for term loan 5. Latest Balance Sheet and PL Account for last three years, duly certified by CA. 6. Proof of land title/lease deed (notarized translation, if in vernacular) 7. IEM/SSI registration. 8. MMPO/FPO of license, if required 9. Quotation / invoice of all P&M over Rs. 1.00 lakh. 123
