Form 10 APPLICATION FORMAT FOR INTEREST SUBSIDY (Biomass Gasifier Projects above 100 kW and Grid connected power projects) PART - A [TO BE FILLED IN BY PROMOTER & FORWARDED THROUGH SNAs] 1. GENERAL (i) Name, Address, Phone, Fax & : Email of the Promoter. (ii) Name and designation of : authorised signatory (iii) Constitution (whether Co-operative/ : Private Sector/Public Ltd/ joint sector/Public Sector Company etc.) (iv) Location of the Project : (Village, District, State) 2. PROJECT DETAILS 3. POWER GENERATION (i) Installed capacity (MW) : (ii) Generation capacity (MW) : 4. TECHNOLOGY USED : (Please specify whether combustion, Gasification etc.) 5. BIOMASS (i) Biomass Used : (ii) Quantity used per day : 6. SUPPORT FUEL Type of other fuels, if proposed to be used as : Support / supplementary fuel 7. AVERAGE COST OF GENERATION (Rs/Kwh) : 8. FINANCING Total cost of project as approved by FIs : ¾ Means of financing (i) Debt : Equity Ratio : (ii) Promoter's contribution (Equity) : (iii) Term loans with rate of Interest (FI wise): (iv) Any other source : Loan repayment period (FI Wise) : AUTHORIZED SIGNATORY Enclosure check list / whether enclosed (Please tick) 1. One copy of DPR as accepted by FI(s) ( ) 2. Copy of PPA / No objection certificate under section 44 ( ) 3. Copy of Statutory clearances / State Government approvals ( ) 4. Authorised / attested copies of loan Agreement (s) ( ) 5. Sanction Order of FI(s) ( ) 6. Appraisal Note of FI(s) ( ) 7. Eligibility check list ( ) 8. Disbursement Schedule (FI-wise) ( ) 8. Any other (please specify) ( ) AUTHORISED SIGNATORY
