Download Form for Availing Udyog Nivesh Samwardhan Sahayata Yojna

Application Form for availing Udyog Nivesh Samwardhan Sahayata & format for registering under the scheme for industrial units Revised Form No. 1 Application form for Registration under Madhya Pradesh Udyog Nivesh Samvardhan Sahayata Yojana ­2004 (To be submitted in duplicate) 1. (a) Name of the applicant Industrial Unit : (b) Factory Address : Telephone No. : Fax No. : e­mail address : (c) Address of the Registered Office : Telephone No. : Fax No. : e­mail address : (d) Name and Designation of the contact person : Telephone No. : Fax No. : e­mail Address : (e) Details of Fixed Assets/Property (Please write address specifically of property location or enclose a separate sheet) : (i) Assets/property in the name of Company/Firm. : (ii) Assets/property in the name of directors/Partners of Company/Firm : 2. Whether the Project (against which the application for registration is : being made) is for (Please write specifically) (a) Establishment of a new unit : (b) Expansion project in the existing unit (expansion/diversification/technology upgradation. : (c) Expansion project in a new Location 3. (a) Constitution: Public Ltd./ Private Ltd.Co. /Co­operative Society /Partnership Firm : (b) Date of incorporation/ Registration of the Company/Co­operative Society : 4. Location/address of the unit (a) Location of the project against which the Registration is sought : Name of the Location : Police Station : Municipality/Block : Post Office : District : Telephone No. : Fax No. : (b) Location of other units(if any) in Madhya Pradesh Location : District : 5. Project Cost: (Copy of project report be enclosed) 5.1 (A) For New Units (Rs. In lakhs) Particulars Estimated cost Land Site Development (maximum 10% of cost of Land & Building is permissible) Building Plant and machinery Electrical Installation Pollution Control Equipments Misc. fixed assets Total Fixed Assets Preliminary and preoperative expenses Margin money for working capital Grand Total 5.1 (B) Means of finance (Rs. In lakhs) Particulars Proposed Amount Share capital/own funds Terms Loan from Financial Institutions/Banks Unsecured Loans Other (if any) Total 5.2 (A) For Expansion/Diversification/Technology Upgradation Scheme: (Rs. In lakh) Particulars Investment in existing unit As on the last day of preceding financial year Please refer rule 3.8.1 ¼c½ Proposed Investment in Expansion/Diversification /Technology Upgradation Total Investment Land Site Development (maximum 10% of Cost of Land & Building) Building Plant and machinery Electrical Installation Pollution Control Equipments Investment in Technology Upgradation Misc. fixed assets Total Fixed Assets Preliminary and preoperative expenses Margin money for working capital Grand Total 5.2 (B) Means of Finance (Rs.in lakhs) Particular Proposed Amount Share capital/Own funds Term Loan from Financial Institutions/Banks Unsecured Loans Other (if any) Total 6. Name of proposed items of manufacture & annual capacity (for which Registration is sought ) 6.1 For New Units No. Name of Item Annual Capacity Estimated Annual Sales Realization (in Rs. lakhs) Estimated payable amount of Tax Amount (MPCT / VAT + CST) (in Rs. lakhs) in which tax on raw material is not included 6.2 In case of expansion/diversification/ technology upgradation No. Name of Item Existing Annual Capacity or Average Production of last 3 years (which ever is more) refer rule 3.8.2 ¼c½ Proposed Additional/ New Capacity for expansion/ diversification/ Technology up gradation Total Annual Capacity Estimated Sales Realization from additional capacity/ new capacity for one year Estimated payable of Tax Amount to be Paid (MPCT / VAT + CST) for additional/ new capacity, in which tax paid on raw material purchased is not included 7. (A) Provisional SSI Registration No. & Date : (B) Permanent SSI Registration No. & Date : 8. Number and date of IEM issued by Govt. of India Secretariat for Industrial Approval/ Letter of intent/Industrial Licence/Other approval : 9. Power requirement (KVA) : 10. Employment Potential in the project (a) Managerial : (b) Factory workers : (c) Other workers : (d) Total : 11. Whether the location conforms to Pollution Control Board norms If yes, write consent No. and date (a) Under air pollution act : (b) Under water pollution act : 12. Estimated daily requirement of water and source of supply : 13. Registration under MPCT Act 1994/ VAT Act 2002 & CST Act 1956 (copy enclosed) : 14. Likely date of commissioning of the production : CERTIFIED that the statement in the application are true to the best of my knowledge and belief. Signature of the applicant Name and Status of the Signatory Seal of the Industrial unit. Place: Date: Annexure (a) A copy of the Registration with Memorandum and Articles of Association issued by the Registrar of Companies. (b) A Statement of the Name and Residential Address of the Director/partners /owners of the company, including telephone no., fax no. & e­mail addresses. (c) A copy of the Acknowledgement Reference No. by SIA/Letter of intent/ Industrial licence/other Government of India approval/SSI Registration No. (d) A Project report­including pollution control measures envisaged. (e) Photocopy of sanction letter from the Central Financial Institution/State Financial Institution/Bank etc. sanctioning loan and other financial assistance towards meeting the cost of the project, certified by a Director of the company. (f) Copy of the audited balance­sheet for last 3 years. (in case of expansion project) (g) A list of plant and machinery required for the project (with value) (h) Statement in respect of requirement of raw material for the project (including names and quantity required per annuam). (i) Existing manufacturing activities in Madhya Pradesh stating items, annual approved capacity, annual installed capacity, annual producition during last three years (in quantity & value in Rs.lakhs) (j) Copy of the MPCT/VAT & CST Registrations issued by Commercial Tax Department. (k) Copy of Resolution passed by Board of Directors to establish new unit or Start expansion/diversification /technology of upgradation in the established unit and for assigning the powers to signature authority. Revised Form No.2 M. P. TRADE AND INVESTEMENT FACILITATION CORPORATION LIMITED (Government of Madhya Pradesh Undertaking) SECRETARIAT FOR SINGLE WINDOW SYSTEM "AVN Tower" Mezzanine Floor, 192, Zone - I, M P Nagar, Bhopal­462 011 CERTIFICATE OF REGISTRATION UNDER MADHYA PRADESH UDYOG NIVESH SAMVARDHAN SAHAYATA YOJANA 2004 Name of District Categoy of District Date of receipt of applicatin Registration No. Under Udyog Nivesh Samvardhan Sahayata Yojana 2004 Date of Registration Project Status certificate is for New Expansion/ Diversification/Tech. up gradation 1. Name of the Unit : 2. Location of the unit : 3. Item of Manufacture : Name of Annual Capacity For Existing Units Product For New Unit Existing Expansion/Diversification/Tech. Upgradation Total Capacity 4. Total Proposed Investment in the unit : 5. Provisional/Permanent SSI Regn.No./ : IEM/LI/IL/Any Other Regn.No. 6. (a) MP Commercial Tax Act 1994 Regn. No. : ................................................... (b) Central Sales Tax Act 1956 Regn. No. : ................................................... a) It may please be noted that the registration of the proposal does not necessary constitute acceptance or recognisation of any of the facts stated therein and the claim under Madhya Pradesh Udyog Nivesh Samvardhan Sahayata Yojana 2004 when preferred, will be considered as per rules in force. b) This certificate is being issued subject to the condition that item of manufacture mentioned above does not fall in the list of ineligible industries under the scheme being issued by the State Govt. If item of manufacture includes in the said list this registration certificate would be cancelled. MANAGING DIRECTOR M P TRIFAC Copy to: 1. Unit M/s. ............................................................................................................ 2. Commercial Tax Officer, .................................................................................... 3. General Manager, DTIC, .................................................................................... 4. Dy. Commissioner, Commercial Tax Division ................................................. 5. Industries Commissioner (FA Section), Vindhyachal Bhawan, Bhopal MANAGING DIRECTOR M P TRIFAC Revised Form No. 3 Format for application for issuing a Certificate showing the Sales Tax paid by the Unit during the year, for which the Certificate is being issued. From: ................................(Name of the unit) ................................ (Address) To, The Commercial Tax Officer, Madhya Pradesh, District ............................. (M.P.) Sir, I request you to issue a Certificate to the General Manager, District Trade and Industries Centre, ................ and Managing Director, M.P. Trade & Investment Facilitation Corporation Ltd., Bhopal, under Madhya Pradesh Udyog Nivesh Samvardhan Sahayata Yojana 2004 in revised form 4. 1. Name of the unit/dealer and address ..................................................... ..................................................... 2. Project status for New unit / Expansion / Diversification / Tech.upgradation. 3. Registration No. of the ...................................................... dealer under the M.P. Commercial ...................................................... Tax Act, 1994/VAT Act 2002 & Central Sales Tax Act, 1956. (whether the goods shown in column No. 5 are specified in the registration Certificate) 4. Registration No. & date of the dealer ............................................. issued by Managing Director ............................................. M P Trade & Investment Facilitation Corporation Ltd., Bhopal under Udyog Nivesh Samvardhan Sahayata Yojana 2004 5. Items of manufacture/annual capacity/actual sales/actual tax paid (for which assistance is sought) (i) For New Units (for the claimed Year.....) (Tax paid on sales of items in which tax paid on raw material purchased is not included) (ii) In case of expansion/diversification/ technology upgradation (a) Determination of Average Production of last 3 years. (refer 3.8.2 & 3.8.2 ¼c½) (b) Production (for the claimed year ...) (c) Tax paid on sales of goods (for the claimed year....) in which tax paid on raw material purchased is not included No. Name of Item Annual Capacity Actual Sales in year...... Actual & Assesed Tax Amount Paid (MPCT/VAT+ CST) in which tax paid on raw material purchased is not included in year..... Quantity Amount (Rs.in lakh) MPCT/ VAT CST Total No. Name of Item Existing annual capacity Production of last 1st year .... Production of last 2nd year .... Production of last 3rd year .... Average Production of last 3 years Qty. Amt. Qty. Amt. Qty. Amt. Qty. Amt. Existing Annual Actual Production in the year.... Capacity or No. Name of Item Average Production of last 3 years, which ever is more refer Rule 3.8.2 & 3.8.2 ¼c½ Additional/ New Capacity for expansion/ Diversification/ Technology Upgradation Total Annual Capacity Existing/ Average capacity Additional / New capacity Total Qty. Amt. Qty. Amt. Qty. Amt. No Name of the Item Tax paid on sales of Existing/ Average capacity in the year ...... in which tax paid on raw material purchased is not included Tax paid on sales of Additional/New capacity for Expansion/ diversification/ Tech.upgradation in the year ..... in which tax paid on raw material purchased is not included Total Tax paid in the year.... in which tax paid on raw material purchased is not included MPCT/ VAT CST Total MPCT/ VAT CST Total MPCT/ VAT CST Total 6.(a) Tax paid on sales of goods under : Rs. (in words) .................................. the M.P. Commerical Tax Act, 1994 /M.P. VAT Act 2002 for the year ............., in which tax paid on raw material purchased is not included (b) Central Sales Tax paid under CST : Rs. (in words) .................................. Act 1956 on sales of Inter State trade or commerce made from M.P. for the year............. in which tax paid on raw material purchased is not included (c) Total Tax (a) + (b) paid for the : Rs.(in figure).................................... year ............................. Rs. (in words) .................................. 7. Name of the Bank and it's branch ...................................................... with Bank account No.& challan No. through the payment was made. 8. Total Udyog Nivesh Samvardhan Sahayata taken upto the date of this application by the unit. (A) Eligible fixed investment ­Amount in Rs.............................. (B) Amount of assistance taken by ­Amount in Rs.............................. the unit upto date of this application (C) Amount to be sanction in current ­Amount in Rs.............................. year under MPIIPAS (50% or 75% of tax deposited by unit) (D) Remaining balance amount of ­Amount in Rs.............................. Udyog Nivesh Samvardhan Sahayata = [A - (B + C)] I duly verify that all the facts and figures furnished above are correct. Signature....................................... Name & Status of the Applicant in the unit ....................................... .............................................................................................. Copy to : 1. Managing Director, M P Trade & Investment Facilitation Corpn. Ltd., "AVN Tower", 192, Zone­I, M.P. Nagar, Bhopal ­for necessary action please. 2. General Manager, District Trade & Industries Centre .........................­for necessary action please. 3. Dy. Commissioner, Commercial Tax Division...... Signature ....................................... Name & Status of the Applicant in the unit ....................................... .............................................................................................. iqujhf{kr QkeZ&4 dk;kZy; okf.kfT;d dj vf/kdkjh ftyk­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­ Øekafnuka d­­­­­­­­­­­­­­­­­­­­­­­­­­­­­d ­­­­­­­­­­­­­­­­­­­­­­­­­­­izfr] egkizc/kd] aftyk O;kikj ,oa m|ksdsz] x Unftyk­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­ fo"k;%& vkS|kfxd bdkbZ esZ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­sll ds o"kZ ­­­­­­­­­­­­­­­­­­­­­­­­ esa tek dj jkf'k dh iqf"V ckcr~ A s laca/k esa vkS|ksfxd bdkbZ esllZ ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­dfuEu rF;ksa dk lR;kiu fd;k tkrk gS %& 1­ bdkbZ ­ dk uke o irk %& ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­ 2­ ­ e­iz­okf.kfT;d dj vf/kfu;e 1994 @ ewY; lao)Zu dj vf/kfu;e 2002 ds vUrxZr iath;u Øekad %& ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­ 3­ ­ dsUnzh; foØ; dj vf/kfu;e 1956 ds vUrxZr iath;u Øekad %& ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­ 4­ ­ mDr nksuksa oLrq,a vf/kfu;eksa ds vUrxZr iathd`r %& ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­ 5­ ­ e­iz­VªsM ,.M bUosLVesaV QsflfyVs'ku dkiksZjs'ku fy­ }kjk tkjh iath;u Ø­ ,oa fnukad ,oa ntZ mRikfnr gksus iath;u Ø­ ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­fnukad ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­ okyh oLrqvkasdk C;kSjk Ø­ oLrq dk uke okf"kZd {kerk uohu bdkbZ foLrkfjr bdkbZ LFkkfir foLrkfjr dqy 6­ o"kZ ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­esa bdkbZ Onkjk e/; izns'k esa mRikfnr fd;s x;oLrqvksa ds foØ; i'pkr~ tek dh x;h jkf'k] ftldk okf.kfT;d dj@ewY; lao)Zu dj ,oa dsUnzh; foØ; dj jkf'k dk vlslesa V bl foHkkx Onkjk fd;k tk pqdk gSA ¼lgk;rk ds izFke o"kZ ds fy;s dj fu/kkZj.k lR;kiu vko';d ugha gSA½ s 6­1 uohu LFkkfir bdkbZ ds fy;s %& o"kZ ­­­­­­­­­­­­­­­­­­esa mRikfnr eky dk foØ; ,oa e/;izns'k esa gq, foØ; ds fo:) tek dj jkf'k] ftlesa dPpseky ds Ø; ds fy;s pqdk, x;s dj dh jkf'k lfEefyr ugha gS %& Ø­ mRikn dk uke okf"kZd {kerk ¼ftyk O;kikj ,oa m|ksx dsUnz }kjk tkjh LFkkbZ iath;u izek.k i=@mRiknu {kerk izek.k i= vuqlkj½ o"kZ ­­­­­­­­­­­esa fd;k x;k foØ; okLrfod dj jkf'k ftldk dj fu/kkZj.k gks pqdk gS ,oa ftlesa Ø; fd;s x;s dPpseky ds pqdk, x, dj dh jkf'k lfEefyr ugha gS ¼jkf'k iw.kZ :i;ksa esa½ ek=k jkf'k MPCT/ VAT CST dqy jkf'k 6­2 foLrkj@'koyhdj.k@rduhdh mUu;u bdkbZ ds fy;s %& v½ foxr 3 o"kksZa ds vkSlr mRiknu dk fu/kkZj.k ¼fu;e 3­8­2 ¼c½ vuqlkj½ Ø­ mRikn dk uke LFkkfir okf"kZd mRiknu {kerk ¼ftyk O;kikj ,oa m|ksx dsUnz }kjk tkjh LFkkbZ iath;u izek.k i=@mRiknu {kerk izek.k i= vuqlkj½ foxr izFke o"kZ ­­­­­­­esa mRiknu foxr f}rh; o"kZ ­­­­­­­esa mRiknu foxr r`rh; o"kZ ­­­­­­­esa mRiknu foxr rhu o"kksZ esa vkSlr mRiknu ek=k jkf'k ek=k jkf'k ek=k jkf'k ek=k jkf'k c½ bdkbZ }kjk o"kZ ­­­­­easfd;k x;k okLrfod mRiknu Ø­ mRikn dk uke LFkkfir okf"kZd mRiknu {kerk vFkok foxr 3 o"kksZa dk vkSlr mRiknu tks Hkh vf/kd vfrfjDr foLrkj @'koyhdj.k@ rduhdh mUu;u dh {kerk dqy okf"kZd {kerk o"kZ ­­­­­­­esa fd;k x;k okLrfod mRiknu LFkkfir @ vkSlr mRiknu vfrfjDr {kerk dk mRiknu dqy mRiknu gks fu;e 3­8­2 ,oa 3­8­ ek=k jkf'k ek=k jkf'k ek=k jkf'k 2 ¼c½ vuqlkj l½ foLrkj@'koyhdj.k@rduhdh mUu;u bdkbZ ds fy;s o"kZ ­­­­­­­­­­­esa eky dk foØ; ,oa zn'k ea gq, foØ; ds fo:) tek dj jkf'k ftless e/;issa dPpeky ds Ø; ds fy;s pqdk, x;s dj dh jkf'k lfEefyr ugha gS %& Ø­ mRikn dk uke LFkkfir mRiknu {kerk @ vkSlr mRiknu {kerk ds fy;s o"kZ ­­­­­­­­­­esa pqdk;k x;k dj] ftlesa dPpseky ds Ø; ij pqdk;k x;k dj lfEefyr ugha gS vfrfjDr foLrkj @ 'koyhdj.k@ rduhdh mUu;u dh {kerk ds mRikfnr eky ds o"kZ ­­­­­­­­­esa foØ; eky dk pqdk;k x;k dj ftlesa dPpseky ds Ø; ij pqdk;k x;k dj lfEefyr ugha gS o"kZ ­­­­­­­­­­­­­­esa dqy pqdk;k x;k dj ftlesa dPpseky ds Ø; ij pqdk;k x;k dj lfEefyr ugha gS MPCT/ VAT CST Total MPCT/ VAT CST Total MPCT/ VAT CST Total 7­  bdkbds }kjk e/;iznsVªM ,.M bUoLVesV QflfyVsdkiksj'ku Z 'k ssas'ku Zsfy­] Hkksazek.k i= ds vuqØe easo"kZ ­­­­­­­­­­­­­­­­­rd izkIr iky }kjk tkjh ith;u i fuosaZu lgk;rk dh dqy jkf'k dk fooj.k & 'k lo) (i) bdkbZ ds LFkkbZ iwath os"Bu vuqlkj ;kstukarxZr ekU; iwath fuos'k :­  (ii) ;kstukarxZr iwoZ esa izkIr dqy lgk;rk jkf'k :­  (iii) pkyw o"kZ esa bdkbZ }kjk tek dqy dj jkf'k ds fo:) ;kt k Z k h bZ l k; k jkf'k ¼50 if 'k vFk k :­  ;kstukarxZr pkgh xbZ lgk;rk jkf'k ¼50 izfr'kr vFkok 75 izfr'kr½ (iv) m|ksx fuos'k lao)Zu lgk;rk ;kstukarxZr bdkbZ ds fy;s 'ks"k miyC/k lgk;rk jkf'k {(i) - [(ii) + (iii)]} :­  ¼gLrk{kj½ okf.kfT;d dj vf/kdkjh ftyk­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­ izfrfyfi%& 1½ iz/kla­VªsLVeasssjsWoj]tks capkyd] e­izM ,.M bUossV QflfyV'ku dkikZ'ku fyfe­192] ,­Ogh­,u­Vku&1] ,e­ih­uxj] HkksswZ iky dh vkj lpukFkA 2½ vk;qDr] okf.kfT;d dj] e/;izns'k] bUnkSj dh vksj lwpukFkZ izsf"krA 3½ mik;qDr] okf.kfT;d dj foHkkx] laHkkx ­­­­­­­­­­­­­­­­­­ dh vksj lwpukFkZ izsf"krA 4½ bdkbZ esllZ ­­­­­­­­­­­­­­­­­­­­­­­­dh vksj lwpukFkZ ,oa vko';d dk;Zokgh gsrq izsf"krA okf.kfT;d dj vf/kdkjh ftyk ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­ Revised Form No. 5 Application form for Receiving assistance under Madhya Pradesh Udyog Nivesh Samvardhan Sahayata Yojana 2004 (To be submitted in duplicate) 1. (a) Name of the applicant Industrial Unit : : (b) Factory Address Telephone No. Fax No. e­mail address : : : : (c) Address of the Registered Office Telephone No. Fax No. e­mail address : : : : (d) Name and Designation of the contact person Telephone No. Fax No. e­mail Address : : : : (e) (i) (ii) Details of Fixed Assets/Property (Please write address specifically of property location or enclose a separate sheet) Assets/property in the name of Company/Firm. Assets/property in the name of directors/Partners of Company/Firm : : : 2. Whether the being made) Project (against which the application for receiving assistanceis is for (Please write specifically) (a) Establishment of a new unit : (b) Expansion project in the existing unit (expansion/ diversification/technology upgradation : (c) Expansion project in a new location : 3. (a) Constitution : Public Ltd./ Private Ltd.Co /Co­operative Society /Partnership Firm (b) Date of incorporation/Registration : of the Company/Co­operative Society 4. Location/address of the unit : (A) Location of the project against which the grant is sought Name of the Location : Police Station : Municipality/Block : Post Office : District : Telephone No. : Fax No. : (B) Location of other units(if any) in Madhya Pradesh Location : District : Location : District : Location : District : 5. (A) Provisional SSI Registration No. & Date : (B) Permanent SSI Registration No. & Date : 6. Number and date of IEM issued by Govt. of India : Secretariat for Industrial Approval ./ Letter of intent/Industrial Licence/Other approval. 7. Power load installed & : date of power connection 8. Employment Potential in the project 9. Whether the location conforms to : Pollution Control Board norms No. Particular With in MP Out of MP Total 1. Managerial 2. Factory workers 3. Other workers 4. Total If yes , write consent No. and date (a) Under air pollution act (b) Under water pollution act 10. Daily requirement of water : and source of supply 11. Registration No. of the ...................................................... dealer under the M.P. Commercial ...................................................... Tax Act, 1994/VAT Act 2002 & Central Sales Tax Act, 1956. ...................................................... (whether the goods shown in column No. 6.1 & 6.2 are specified in the registration certificate) 12. Registration No. & date of the dealer ............................................. issued by Managing Director ............................................. M P Trade & Investment Facilitation Corporation Ltd., Bhopal under Udyog Nivesh Samvardhan Sahayata Yojana 2004 13. Date of commissioning of the commercial production in original unit/date of commissioning of the commercial production in expansion/diversification/ Tech.upgradation. .................. .................. .................. 14. Project Cost / Eligible Investment (Upto the date of commencement of Commercial Production) 14.1(A)For New Units (Please furnish original certificate from Chartered Accountant) Particulars Investment made as on date of commencement of commercial production Investment made in 3 years from the date of commencement of Commercial Production as on ......... Total Investment after 3 years Land Site development (10% of cost of land & Building) Building Plant and machinery Electrical Installation Pollution Control Equipments Misc.fixed assets Total Preliminary and preoperative expenses Grand Total 14.1(B) Means of finance (Please funish certificate from Chartered Accountant) Particulars Amount Share capital/own funds Terms Loan from Financial Institutions/Banks Unsecured Loans Other (if any) Total 14.2(A) For Expansion/Diversification/Technology Upgradation Scheme: (Please furnish certificate from Chartered Accountant) (Upto the date of commencement of Commercial Production) Particulars Original Investment as on Dt. ....... Please refer rule 3.8.1 ¼c½ Actual Investment as on date of production commenced in Expansion/Diversification /Technology Upgradation Total Investment Investment made in 3 years from the date of commencement of Commercial Production in Expan./ Divr./ Tech. up/ capacity as on ......... Total Investment after 3 years Expn. Divr. Tech.up Land Site development (10% of cost of Land & Building) Building Plant and machinery Electrical Installation Pollution Control Equipments Investment in Technology Upgradation Misc.fixed assets Total Preliminary and preoperative expenses Grand Total 14.2.(B) Means of Finance (Please furnish certificate from Chartered Accountant) Particular Amount Share capital/Own funds Term Loan from Financial Institutions/Banks Unsecured Loans Other (if any) Total 15. Items of manufacture/annual capacity/actual sales/actual tax paid (for which assistance is sought ) 15.1 For New Units (for the claimed Year.....) (Tax paid on sales of items in which tax paid on raw material purchased is not included) No. Name of Item Annual Capacity Actual Sales in year...... Actual & Assesed Tax Amount Paid (MPCT/VAT+ CST) in which tax paid on raw material purchased is not included in year..... Quantity Amount MPCT/ VAT CST Total 15.2 In case of expansion/diversification/ technology upgradation (A) Determination of Average Production of last 3 years. (refer 3.8.2 ¼c½) (B) Production (for the claimed year ...) (B) Tax paid on sales of goods (for the claimed year....) in which tax paid on raw material purchased is not included No. Name of Item Existing annual capacity Production of last 1st year .... Production of last 2nd year .... Production of last 3rd year .... Average Production of last 3 years Qty. Amt. Qty. Amt. Qty. Amt. Qty. Amt. Existing  Annual Actual Production in the year.... No. Name of Item Capacity or Average Production of last 3 years, which ever Additional/ New Capacity for expansion/ Diversification/ Technology Total Annual Capacity Existing/ Average capacity Additional / New capacity Total is more refer Upgradation Qty. Amt. Qty. Amt. Qty. Amt. Rule 3.8.2 ¼c½ No Name of the Item Tax paid on sales of Existing/ Average capacity in the year ...... in which tax paid on raw material purchased is not included Tax paid on sales of Additional/New capacity for Expansion/ diversification/ Tech. upgradation in the year ..... in which tax paid on raw material purchased is not included in which tax paid on raw material purchased is not included Total Tax paid in the year.... in which tax paid on raw material purchased is not included MPCT/ VAT CST Total MPCT/ VAT CST Total MPCT/ VAT CST Total 16.(a) Tax paid on sales of goods : Rs. (in words) .................................. under the M.P.CT Act, 1994/MPVAT Act 2002 for the year .............in which tax paid on rawmaterial purchased is not included. (b) Central Sales Tax paid under CST : Rs. (in words) .................................. Act 1956 on sales of goods of Inter State trade or commerce made from M.P. for the year.................. in which tax paid on raw material purchased is not included. (c) Total Tax (a) + (b) paid for the : Rs.(in figure).................................... year .............. in which tax paid on rawmaterial purchased is not included. Rs. (in words) .................................. 17. Name of the Bank and it's branch ........................................................ with Bank account No. & Challan No. throughthe payment was made to Commercial Tax Department. 18. Total Udyog Nivesh Samvardhan Sahayata taken upto the date of this application by the unit. (A) Eligible fixed investment ­Amount in Rs.............................. (B) Amount of assistance taken by ­Amount in Rs.............................. the unit upto date of this application (C) Remaining balance amount of ­Amount in Rs.............................. Udyog Nivesh Samvardhan Sahayata (A - B) CERTIFIED that the statement in the application are true to the best of my knowledge and belief. Signature of the applicant Name and Status of the Signatory Place: Seal of the Industrial unit. Date: Annexures (a) A copy of the Registration with Memorandum and Articles of Association issued by the Registrar of Companies. (b) A Statement of the Name and Residence Address of the Director/partners/owners of the company, including telephone no., fax no. & e­mail addresses. (c) A copy of the Acknowledgement Reference No. by SIA/Letter of intent/Industrial licence/other Government of India approval/SSI Registration No. (d) A Project report­including pollution control measures envisaged, from the second year claim project report does not require. (e) Photocopy of sanction letter from the Central Financial Institution/State Financial Institution etc. sanctioning loan and other financial assistance towards meeting the cost of the project, certified by a Director of the company. (f) Copy of the audited balance­sheet for last 3 years. (in case of expansion project) (g) A list of plant and machinery installed in the project (List included columns - name of machine - quantity - name of supplier - bill no. - date of purchase - value in Rs.) (h) Statement in respect of raw material consumed in the claimed year. (List included columns - name - quantity - bill no. of supplier - date of bill - purchase value). (i) Existing manufacturing activities in Madhya Pradesh stating items, annual approved capacity, annual installed capacity, annual producition during last three years (in quantity & value in Rs.). (j) List of sales of finish goods manufactured by the unit in the claimed year. (List included columns - name - quantity - invoice no. - date of invoice - total sale value - tax (MPCT / VAT & CST) amount - net sale value). (k) Copy of the MPCT/VAT & CST Registrations issued by Commercial Tax Department. (l) Copy of Resolution passed by Board of Directors for assigning the powers to Authorized Signatory. Revised Form No. 6 (A) MPIIPAS - 2004 OFFICE OF THE GENERAL MANAGER District Trade & Industries Centre ....................... District ......................., Madhya Pradesh No. Date SANCTION ORDER In pursuance of the decision taken by the District Level Industrial Investment Promotion Assistance Committee in its meeting No. ....................... held on ......................., an amount of Rs. ................................... (in words) Rupees .......................................................................................................................... is hereby sanctioned as an Industrial Investment Promotion Assistance (IIPA); under the Madhya Pradesh Industrial Investment Promotion Assistance Scheme - 2004 (MPIIPAS) to M/s .......................................................................................................; hereinafter called Assistance Receiver, for the period ........................................, subject to the conditions and particulars mentioned here under :­ Particulars Conditions : 1. Name of the unit : 2. Location of industry : 3. Category of the District : 4. Registration Numbers a) under MPIIPAS - 2004 : b) under MPCT/VAT Act : c) under CST Act d) Permanent SSI Registration / IEM No. & Date : 5. Date of commencement of commercial production : 6. Eligible period for assistance : 7. Maximum amount of assistance (IIPA) permissible i.e. total eligible investment : Rs. 8. Amount of Tax deposited during the period ............... : Rs. 9. Eligible percentage of MPCT / VAT & CST deposited by the unit for calculation of assistance : 10. Amount sanctioned under MPIIPAS a) Amount sanctioned till previous year ................. : Rs. b) Amount sanctioned for the period ................. vide this order : Rs. c) Total sanctioned amount : Rs. 11. Maximum remaining eligible amount for assistance [7 - 10(c)] : Rs. 1. that the Assistance Receiver shall execute an agreement with the State Government or with their Authorized Representative; hereinafter called Assistance Provider, in the enclosed format No. 7 with in 30 days of the issue of this order on the required stamp paper. 2. that the Assistance Receiver binds himself with the provisions, terms, conditions of the scheme and of the said agreement. 3. that the cheque/cheques towards the amount sanctioned through this order would be issued in the favour of Commercial Tax Officer ............... District ...................... and an deposition would be treated as an advance tax deposited by Assistance Receiver for the particulars stated above. Thus, the amount receiver acknowledges the receipt of Industrial Promotion Assistance from the Assistance Provider. 4. that the assistance may have to be released in installments keeping in view of the budget constraints or any other reason and for that no interest would be leviable. 5. that the said cheque/cheques would be sent to the concerned Commercial Tax Officer through a covering letter addressed to him; however the same would be delivered to the Assistance Receiver/ his Authorized Representative for timely delivery to the concerned officer. It shall be the responsibility of the amount receiver to arrange the receipt of same from concerned officer and to get it delivered to Assistance Provider with in 15 days. General Manager District Trade & Industries Centre............ No. Date Copy to : 1. Industries Commissioner, Directorate of Industries, Bhopal 2. Commissioner, Commercial Tax, Indore 3. Managing Director, M.P. Trade & Investment Facilitation Corporation Ltd., "AVN Tower", Mezzanine Floor, 192, Zone - I, M.P. Nagar. Bhopal - 462011. 4. Deputy Commissioner, Commercial Tax Division ............ 5. Commercial Tax Officer, Distt. ............ 6. M/s .................................................. (Assistance Receiver) for information and necessary action. General Manager District Trade & Industries Centre............ Revised Form No. 6 (B) MPIIPAS - 2004 M.P. TRADE & INVESTMENT FACILITATION CORPORATION LIMITED (Government of Madhya Pradesh Undertaking) AVN Tower", Mezzanine Floor, 192, Zone - I, M.P. Nagar. Bhopal - 462011 No. Date SANCTION ORDER In pursuance of the decision taken by the State Level Industrial Investment Promotion Assistance Committee in its meeting No. ....................... held on ......................., an amount of Rs. ................................... (in words) Rupees .......................................................................................................................... is hereby sanctioned as an Industrial Investment Promotion Assistance (IIPA); under the Madhya Pradesh Industrial Investment Promotion Assistance Scheme - 2004 (MPIIPAS) to M/s .......................................................................................................; hereinafter called Assistance Receiver, for the period ........................................, subject to the conditions and particulars mentioned here under :­ Particulars Conditions : 1. Name of the unit : 2. Location of industry : 3. Category of the District : 4. Registration Numbers e) under MPIIPAS - 2004 : f) under MPCT/VAT Act : g) under CST Act h) Permanent SSI Registration / IEM No. & Date : 5. Date of commencement of commercial production : 6. Eligible period for assistance : 7. Maximum amount of assistance (IIPA) permissible i.e. total eligible investment : Rs. 8. Amount of Tax deposited during the period ............... : Rs. 9. Eligible percentage of MPCT / VAT & CST deposited by the unit for calculation of assistance : 10. Amount sanctioned under MPIIPAS d) Amount sanctioned till previous year ................. : Rs. e) Amount sanctioned for the period ................. vide this order : Rs. f) Total sanctioned amount : Rs. 11. Maximum remaining eligible amount for assistance [7 - 10(c)] : Rs. 6. that the Assistance Receiver shall execute an agreement with the State Government or with their Authorized Representative; hereinafter called Assistance Provider, in the enclosed format No. 7 with in 30 days of the issue of this order on the required stamp paper. 7. that the Assistance Receiver binds himself with the provisions, terms, conditions of the scheme and of the said agreement. 8. that the cheque/cheques towards the amount sanctioned through this order would be issued in the favour of Commercial Tax Officer ............... District ...................... and an deposition would be treated as an advance tax deposited by Assistance Receiver for the particulars stated above. Thus, the amount receiver acknowledges the receipt of Industrial Promotion Assistance from the Assistance Provider. 9. that the assistance may have to be released in installments keeping in view of the budget constraints or any other reason and for that no interest would be leviable. 10. that the said cheque/cheques would be sent to the concerned Commercial Tax Officer through a covering letter addressed to him; however the same would be delivered to the Assistance Receiver/ his Authorized Representative for timely delivery to the concerned officer. It shall be the responsibility of the amount receiver to arrange the receipt of same from concerned officer and to get it delivered to Assistance Provider with in 15 days. Managing Director M.P. Trade & Investment Facilitation Corporation Ltd., Bhopal No. Date Copy to : 1. Industries Commissioner, Directorate of Industries, Bhopal 2. Commissioner, Commercial Tax, Indore 3. General Manager, District Trade & Industries Centre, .................... 4. Deputy Commissioner, Commercial Tax Division ............ 5. Commercial Tax Officer, Distt. ............ 6. M/s .................................................. (Assistance Receiver) for information and necessary action. Managing Director M.P. Trade & Investment Facilitation Corporation Ltd., Bhopal Revised Form No. 7 AGREEMENT REGARDING ASSISTNACE RECEIVED UNDER UDYOG NIVESH SAMVARDHAN SAHAYATA YOJANA This agreement is made on this .......................................................... day of ................................... 200...... between the Governor of Madhya Pradesh, acting through the GENERAL MANAGER, DISTRICT TRADE & INDUSTRIES CENTRE / MANAGING DIRECTOR, MADHYA PRADESH TRADE AND INVESTMENT FACILITATION CORPORATION LIMITED, BHOPAL (herein after called the "Assistance Provider" which expression shall, where the context so admits include his successors in office) on the one part and Shri ................................................................... S/o ................................... Resident of ................................................................... in the tehsil of ........................... district ................................ on behalf of M/s........................................................................................... (hereinafter called the "Assistance Receiver" which expression shall, where the context so admits include his heirs, administrators, representatives and assigns) on the other part. WHEREAS the Assistance Provider has sanctioned assistance under Madhya Pradesh Industrial Investment Promotion Assistance Scheme 2004; hereinafter mentioned as MPIIPAS to the Assistance Receiver subject to the terms and conditions herein after mentioned:­ AND WHEREAS the Assistance Receiver accepted the above assistance under MPIIPAS on the terms and conditions herein after mentioned. Now, therefore, the agreement witnesses and it is hereby agreed as follows:­ 1. that this agreement shall always be subject to the terms and conditions and instructions of MPIIPAS. 2. That in persuance of MPIIPAS the Assistance Provider has sanctioned an amount of Rs. ......................./­(in words Rs. ................................) for the period ............... as an assistance to Assistance Receiver vide sanction order No. ........... dt............ 3. that this assistance is not be available in respect of the purchase tax on the raw material consumed or used, incidental goods used in manufacturing of goods in such industrial units and pakaging materials used in the packing of goods; manufactured in the industrial unit, and is available only on - 50% / 75% of tax deposited after the sales of the principal products manufactured in the said industrial unit and by­products, waste products obtained in the course of manufacture in such units in previous year. 4. (a) that if Assistance Receiver establishes a new industrial unit but closes down or deliberately reduces production substantially in an existing industrial unit within the state, engaged in production of the same product, the assistance shall be liable to be cancelled by the authority sanctioning and such cancellation shall take effect from the date on which such substantial reduction in production has taken place. (b) that a substantial reduction in production shall be deemed to have occurred if the production of the same product has fallen below the level of the average production of the preceding 3 years of existing industrial unit. 5. Assistance Receiver confirms that in his claim the non eligible items as declared by the government with reference to this scheme have not been included. 6. that the Assistance Receiver shall maintain or cause to be maintained in good condition the premises, building, machinery, tools etc., described in the schedule attached and shall ensure the running of industial unit not only during the eligibility period i.e. from the date ................. up to date ................ but also continue to do so for a period of five years from the date of expiry of the period of eligibility. 7. (a) The Assistance Receiver shall not change the location of the whole or part of the industrial unit or effect any substantial contraction or dispose off any substantial part of his total capital investment or effect any change in the ownership during the period for which assistance under MPIIPAS has been availed of and also within a period of five years from the date of expiry of the period of receiving the assitance without the prior permission of the Managing Director, Madhya Pradesh Trade & Investment Facilitation Corporation Limited, Bhopal in writing. (b) that in case a change in ownership is permitted all the rights and liabilities under MPIIPAS shall pass on the new owner. 8. that the Assistance Receiver shall be bound to permit the Assistance Provider or any person deputed or authorized by general or special order in writing in this behalf by the Assistance Provider to inspect the Property (Premises, building, plants and machinery, tool etc.,) and Books of Accounts & the industry business or enterprise. 9. taht the Assistance Receiver shall maintain a ledger/Books of Accounts including details of materials purchased and products sold for which facility of receiving of Assistance under MPIIPAS has been availed of and shall furnish annual statement of production and sales to the General Manager, District Industries Centre and also to the appropriate Sales Tax Officer within 60 days from the close of the accounting year, for the eligibility period and thereafter another 5 years. 10. that the Assistance Receiver expressly agrees that the Assistance Provider has granted the said assistance under MPIIPAS relying on the statement made in the application dated ..................... for sanctioning the assistance and information furnished by the Assistance Receiver. The Assistance Receiver confirms that the information furnished by him are true to his knowledge and beliefs and no facts have been suppressed and has not been obtained by mis­representation as to the essential facts or by furnishing false information. In case after issue of sanction order under MPIIPAS or releasing the assistance, it is revealed that the assistance had been obtained by misrepresentation of facts or information, the amount of the assistance availed by the Assistance Receiver till date shall be recoverable from him at once together with penal interest at the rate of 24% per annum. 11. that on breach of any of the conditions of the agreement and of any contidion of MPIIPAS, the amount of Assistance shall be recovered from the Assistance Receiver at once together with interest @ 24 per annum. 12. that any amount due under this agreement may be recovered from the Assistance Receiver as an arrear of land revenue. 13. that if any dispute arises between the parties hereto, in respect of this agreement or any of the provision herein contained or any thing arising here about, the same shall be referred to Principal Secretary / Secretary to the Government of Madhya Pradesh] Commerce, Industries & Employment Department for arbritation and whose deicision thereon shall be final and binding on the parties. In witness where of the parties here to have signed this agreement on the date and year written in each case. Witness : Assistance Provider 1. ............................................... Managing Director, Madhya Pradesh Trade and Investment Facilitation 2. ............................................... Corporation Ltd., Bhopal / General Manager, District Trade and Industries Centre ................... On behalf of the Governor of Madhya Pradesh Name & Designation. Witness : Assistance Receiver 1. ............................................... Signature & Name Date : 2. ............................................... (Scheduled attached as per conditions 4 of the agreement) SCHEDULE (As per condition No. 5) The Assistance Receiver shall maintain or cause to be maintained in good condition the premises, building, machinery, tools etc., described in the schedule attached and shall ensure the running of industial unit not only during the eligibility period i.e. from the date ................. up to date ................ but also continue to do so for a period of five years from the date of expiry of the period of eligibility. 1. Land Rs. .......... Location ................................. 2. Building Rs. .......... Total Constructed Area .......... 3. Plant & Machinery Rs........... List enclosed 4. Pollution Control Equipments Rs. ............ List enclosed 5. Misccelleneous fxed Assets Rs. ........... List enclosed Total Rs. .......... Assistance Receiver Signature, Name & Address Date : Assistance Provider Signature, Name & Address Date :