APPLICATION FORM FOR CLAIMING CAPITAL INVESTMENT SUBSIDY ANNEXURE-III (Please refer to Section 2.3 of the manual) From: M/s To : The General Manager, District Industries Centre, _________________(H.P.) Subject: Application for 10-15% State Investment Subsidy. Sir, In accordance with the 10-15% State Investment Subsidy Scheme, application is being submitted herewith for grant of subsidy of Rs. (Rupees ) on investment in fixed capital for the new unit / expansion of the unit namely M/s 1. The scheme for the new unit / expansion scheme of the unit has been approved by the following financial institutions / banks viz: i) HP Financial Corporation Shimla 2. The cost of the project as approved by the above institution / bank and the details of fixed assets acquired are as under:- Cost of Project (A) Total fixed capital investment Self financed As approved by Fin. Institutions (a) Land Land Development (b) Building (c) Plant & Machinery (d) Other assets i) Tools, jigs, dies and moulds ii) Goods carrier iii) Other assets (e) Promotional & pre-operative expenses capitalised or to be capitalised. (B) Margin Money for working capital TOTAL 3. Employment proposed or likely to be created is as follows a) Managerial: b) Supervisory/Technical c) Workers Skilled Semi-skilled Un-skilled d) Others 4. Expected date of commercial production Date of commercial production 5. The following certificate have been appended: i) A certificate from Chartered Accountants M/s certifying the extend of share capital subscribed and paid up value of fixed assets if any, acquired and paid for as stated above. ii) A certificate from an Engineer as prescribed in the manual certifying the value of civil work. ANNEXURE-VIII Detail of fixed capital investment should be given in the following proforma (please refer to section 5.3 of manual) (A) Land Date of purchase Value of purchase (B) Building Date of completion of building/or partthereof Value as per Engg. Amount spent Certificate on buildings upto (C) Plant & Machinery SNo. Date of purchase Item of purchase Value When installed iii) Details of the plant & machinery as per the project acquired/not acquired duly certified by the management in the proforma indicated in the appendix. 7. A copy of the latest audited accounts of the unit is also enclosed herewith. 8. I/We hereby agree that,I/We shall forthwith repay the amount disbursed to me/us under this scheme, if the amount of 10-15% investment subsidy is found to have been disbursed in excess of the amount actually admissible nor whatsoever reason. Further, we shall also be liable to pay interest at such rate as prescribed by the Govt. from time to time on such other charges/expenses which may be payable by us. 9. It is hereby further certified that I/we have neither to applied nor have received any amount by way of 10-15% grant or subsidy in respect of this unit from govt. financial institution. Yours faithfully, ( ) M/s Details of the plant & machinery as per the project acquired/not acquired duly certified by the management in the proforma indicated in the appendix. S.No. Name of the item Mfg. Capacity Date of purchase From whom purchased Value paid for Remarks
