INDIAN OVERSEAS BANK
SMALL AND MEDIUM ENTERPRISES
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APPLICATION FORM FOR CREDIT FACILITIES OVER Rs.200 lacs

1.1. Name of the Unit (In Block letters)
1.2. Constitution PROPRIETARY / PARTNERSHIP FIRM / PVT. LTD.,
PUBLIC LTD. CO. / CO-OPPERATIVE SOCIETY
1.3 Name of the business house / group (if any)
2.1. Registration No. (as given by District Industries
Centre / Directorate of Industries)
2.2. Date of Incorporation / Commencement of business
3. Business Address with Telephone / Fax No. /Email address
3.1. Address of
Regd. Office 3.2. Adminstrative office
3.3. Factory
4. Background of the Proprietor / Partners / Directors
(Please furnish for each person as per the Annexure-1)
5. Brief Description of the Industrial Activity
5.1. Existing
5.2. Proposed

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6. How the activity was financed so far
(to be filled up in case of existing unit only)
Source of
fund
Security Rate of
int.
Repayment
Per month
Present
o/s.
(in 000s of
Rs.)
Amount
of default
(if any)
indicate sources of funds with name and address e.g. banks/financial
institutions / others (specify)
7. Arrears in Statutory Payments (if any)
i) Income Tax
ii) Sales Tax
iii) Provident Fund
iv) Employment State Insurance Corporation
v) Other (Specify)
8. Past performance (to be filled up by existing unit only)
(indicate in 000s of Rs.)
Particulars Last year Last but one
year
Last but two
years
Turnover
Net Profit
Retained profit
Monthly turnover for last twelve months

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9.1 MANAGEMENT
(Please furnish background of the main promoter other than those
furnished in Annexure-!, write up on other companies, if any,
promoted by him or with which he is associated together with a
copy of the latest balance sheet)
9.2. In case the promoter is limited company, please furnish a write up on
the activities and past performance of the company and any other
expansion programmes / diversification contemplated.
Please also enclose certified copies of the
Memorandum and Articles of Association
Audited Balance Sheet and Trading and Profit & Loss A/cs.
for the past three years of the promoter company.
Copy of the agreement(s), if any, entered into among the
promoters.
9.3 SHARE HOLDING
9.3.1 Please provide a list of shareholders under the heads:
a. Promoters
b. Other major groups
c. Foreign collaborators
d. NRI shareholders
e. Other institutions owning or controlling 5% or more of equity
shares, indicating the amount, owned and business relationship,
if any, with the company.

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9.3.2 In case of preference shareholders, please give a list of ten largest
shareholders:
9.3.3 Also furnish number of equity shareholders and preference
shareholders:
9.4 Present Proposed
Employment
Executives
Supervisory
Administrative/Office staff
Skilled Labour
Unskilled Labour
Others (Specify)

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9.5 Particulars of existing key technical and executive staff
(Please furnish data for existing as well as proposed staff)
Name
Designation
Qualification
Experience
Any special
achievement
(inventional/
Research
etc.)
Functional
duties at
the unit
10. If the unit is an ancillary unit, the undertaking
to which it is catering and its address
11. Name of the associate concern(s) if any
11.1. Nature of association and amount invested
11.2 Nature of activity
11.3 Items traded / manufactured
11.4 Turnover and profit during
preceding three years
12. Technical Feasibility (Please enclose the
feasibility / project report)
12.1 Name of the Product(s) including
by products & its (their) use:

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12.2 Manufacturing process, in brief
(indicate technical process, whether
it is a continuous process, whether
this has been tried in the country,
stage-wise capacity data, yield /
conversion data, material flow etc.)
12.3 Capacity No. of Units / Quantity in kg. / volume
in the litre per annuam)
Capacity for
each product
Licensed Installed Operating
No. of working days in a month &
No. of shifts in a day
12.4.1 In case of any collaboration, please furnish
a brief-write-up on the period of collaboration
agreement, the name of the collaborator
company, indicating the activities, size, turnover
particulars of the existing plants, other projects
in India and abroad set up with some collaboration
Please enclose –
a) Copy of the published brochure highlighting the
activities of the collaborator and balance sheet
for the latest year.
b) Copy of the collaboration agreement
c) Fess / Loyalties payable and the manner
in which payable
d) Copy of the Government approval,
if required, for the services of
foreign technicians, if any

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12.4.2 If there is no collaboration agreement, please furnish full details of
arrangement proposed to be made for obtaining technical
advice and service needed for the implementation of the
project.
12.4.3 Particulars of the consultants
a) Name and address of the consultants
b) Fees payable and the manner in which payable
c) Scope of work assigned to t hem
d) Brief particulars of consultants including
organizational set-up, bio-data of senior
personnel, names of Directors/Partners,
particulars of work done in the past and
work on hand.
Please enclose copy of the agreement with the consultant and in case
of foreign consultant(s) approval of the Government.
12.4.4 Whether any of Partners/Promoters/Directors have any interest in
Consultant / collaborator firm, if so details to be furnished.

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12.5 Locational advantages of existing and / or proposed premises with
reference to:
i) absence of civic restriction
ii) Proximity to the source of raw materials
iii) Market to the product
iv) Availability of
Power,
Water,
Labour,
Transport
v) Whether clearance has been obtained from the
Pollution control authority
12.6 Land & Building Area / Plinth Areas (in sq. meter)
Area / Plinth Areas
(in sq. meter)
Value (in 000s of Rs.)
Existing Proposed Existing Proposed
Factory Land
Factory
Building
Ancillary
building
Open storage
space

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12.7 Type of soil and load bearing capacity (enclose test report)
Enclosure:
a) Certified Xerox copy of sale / lease deed
b) Certified Xerox copy of the Govt. order converting the land into
industrial land, if applicable.
c) Locational Map
d) Certified Xerox copy of the site plan of the land and blue prints of
the building duly approved by Corporation/Municipality/
Panchayat.
12.8.1 Please furnish the following particulars of Architects
12.8.1.1 Name and address of the architects / firm
12.8.1.2 Scope of work
12.8.1.3 Rates quoted and detailed estimate of expenses
12.8.1.4 Fess payable and manner in which payable
12.8.1.5 Time schedule
12.8.1.6 Penalties
12.8.1.7 Past experience of the architects in the similar work
Contd…p/10
:: 10 ::
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12.9 Particulars of Machinery & other fixed assets.
(As per Annexure II)
12.9.1 If sub-contract of any portion of production is
envisaged, the production stages in which the
sub-contracting will be done.
Details indicate the availability of machinery
Particularly with sub-contractors with
Adequate spare capacity
12.9.2. Arrangement made for erection and
commissioning of the plant
12.10 Necessity and purpose for the proposed
Investment/addition to factory premises /
Machinery (in case where such investment
Is intended) for achievement of the
anticipated turnover
12.11 Raw materials / components (Please
Mention about the imported and
Indigenous items separately.
A B C D
Quantity required
Sources of supply
Minimum purchase quantity
Lead/Procurement time
Available throughout the year
If answer to the above is ‘no’
then No. of the months & period
when it is available
(Enclose copies of proforma invoices in respect of each item)

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13. UTILITIES (Give comments on requirement, availability / adequacy /
qualitative aspects etc.
13.1 Power
13.1.1 Sources of power supply
Voltage taken from Electricity Board
Own generation
Stand by arrangements
13.1.2 Maximum Demand
13.1.3 Contracted load
13.1.4 Connected load
13.1.5 Energy consumption per year
13.1.6 Power tariff
13.1.7 Cost of power per annum at maximum capacity utilization,
Please enclose
a) Certified Xerox copy of sanction for power
b) Certified Xerox copy of agreement with electricity board
c) Certified Xerox copy of electrical lay out of the plant
13.2 WATER
13.2.1 Indicate the requirement and suitability of water
13.2.2 Describe water treatment arrangements
13.2.3 Sources for supply of water arrangement proposed
and water charges payable

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13.3 STEAM
13.3.1 Requirement of steam
13.3.2 Capacity of the boiler
13.3.3 Arrangements proposed for steam
13.4 COMPRESSSED AIR
13.4.1 Requirements of compressed air
13.4.2 Arrangements proposed for compressed air
13.5. FUEL
13.5.1 Requirement of fuel
13.5.2 Arrangements proposed for supply
13.6 Arrangement proposed for carrying raw materials
14. EFFLUENT
Please furnish full details of the value of atmosphere, soil and water
Pollution likely to be created by the unit and the measures proposed
for control of pollution.
Indicate whether necessary permission for the disposal of effluent has
been obtained from the concerned authority; if yes, a copy of the
certificate should be furnished.

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15. Quality control
15.1. Details of arrangement made for quality control.
If BIS/FPO/ISO specifications are followed.
No. of BIS/FPO/ISCO standards and the
Particulars thereof should be provided
15.2. Particulars of R & D activity proposed.
16. Economic Feasibility
Marketing (Mention separately for each product)
(Please enclose a Market Survey Report)
16.1 Whether the product is reserved exclusively for SME sector?
If so, please furnish item code No.
16.2 Name of the major customers
16.3 Region / Area where the product is / will be sold
16.4 Extent of competition & No. of units engaged in similar line in the
area
16.5 How does the unit meet / proposed to meet the competition
(Comment on the competitive advantages enjoyed by the unit)
16.5.1 In price and quality, how does the
unit’s product compare with those
of its competitors
16.5.2 Is the unit selling direct to its customers?
If so, please furnish details like sales force,
Showrooms, depots etc.)
16.5.3 It a selling /distribution agency has been
appointed, its name, period of contract,
commission payable, period by which the
Bills will be paid by it etc (enclose copies of
agreement, wherever such agreement
has been entered into)

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16.6 Nature and volume of orders / enquiries
On hand (certified Xerox copies to be furnished)
16.7 If the unit is export oriented, please furnish exporter
Code No. if allotted, and relevant details
as per the following details in the proceeding Code No.
three years:
Name of the product
exported
Name of the country
where exported
F.O.B. value in US $
17 Cost of project
(Please furnish estimates of cost of project under the following heads,
indicate the basis for arriving at the cost of project)
(In 000s of Rs.)
Sl. No. PARTICULARS Already
incurred
To be
incurred
Total cost
A Land including
development
B Building & other civil
works
C Plant & Machinery
1) Indigenous
2) Imported
D Essential Tools,
Spares & Accessories
E Testing Equipment
F Misc. Fixed Assets
G Erection / install.
Charges
H Preliminary Expenses
I Pre-Operative
Expenses
J Provision for
contingencies
1. Building
2. Plant & Mach.
3. Other Fixed Assets
K Margin for working
capital required
L TOTAL

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18 Means of financing (Please furnish details of sources of finance for
meeting the cost under the following heads) (In 000s of Rs.)
Sl. No. Particulars Amount
already
Raised
Amount
proposed to
raised
Total
A Capital (specify
resources
contributing to
capital
B Reserves
C Term Loans
(give full
particulars)
D Unsecured loans
and deposits
(indicate sources,
rate of interest,
repayment, period
etc.
E Deferred payment
arrangement
including supplier’s
credit
F Subsidy
Central Govt.
State Govt.
G Seed Capital
(indicate sources)
H Internal Cash
Accruals
I Other Sources
(Specify)
J Total
18.1 In case internal accruals are taken as source of finance, explain
the basis for estimation of internal accruals by means of statement
18.2 Indicate sources from which expenditure already incurred
has been financed

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18.3 Promoter’s contribution to the
project as % of the total cost
(please furnish list of persons/
firms who would be contributing
to the promoter’s share of the capital
and the respective amounts and
their relationships)
19 . Financial Assistance required:
19.1 Rupee Loan
19.2 Foreign currency loan
19.3 Underwriting
19.3.1 Equity capital
19.3.2 Preference capital
19.3.3 Debentures
19.4 Guarantee of foreign currency
Loan / deferred credit
19.5 Working Capital
(As Worked out in Annexure VI)
19.6 Other forms of
Assistance (e.g. LCs, Bank Guarantees Etc.)

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20. SCHEDULE OF IMPLEMENTATION
Please indicate the progress made so far in the implementation of
the project and furnish the schedule of implementation as follows:
Date of
commencement
Expected date
Of completion
A. Acquisition of Land
B. Development of Land
C. for
Civil Works
Factory building
Machinery Foundation
Administrative Buildings
D. Plant and Machinery imported
Indigenous
E. Arrangement of power
F. Arrangement of water
G. Erection of equipment
H. Commissioning
I. Initial Procurement of raw material
J. Trial Runs
K. Commercial production
21. Future projections (To be given for the next five years)
Please furnish data on
21.1 Projected Profitability as per Annexure-III
21.2 Projected Cash Flow statement as per Annexure-IV
21.3 Projected Balance Sheet as per Annexure-V
21.4 Working Capital Requirement as per Annexure-VI
21.5 Percentage of cash sales in total sales ……. %
21.6 Period in which payment is received in respect of credit sales ….
days
21.7 Average credit available on purchase . . . . . days

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22. How far does the unit contribute to the establishment of ancillary units
in the region?
23. Please furnish international /CIF / FOB prices of all inputs which can be
imported
24. Government Consents
Please indicate whether the various licenses / consents required for the
Project have been obtained from the respective authorities
24.1 Specify and special condition attached to the licenses / consents
and the undertaking given by the company in connection
therewith.
25. Repayment programme

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26. Details of Securities to be offered
26.1 PRIMARY
Working capital and term loan securities to be indicated separately.
Collateral, if any (full details)
26.2 Details of Guarantor(s)
26.2.1 Name
26.2.2 Residential Address
26.2.3 Occupation (if in service, name & address of his / her employer)
26.2.4 Details of movable & immovable property(ies) owned by him / her
& other dependent family members)
26.2.5 Details of any similar guarantees, if any given to other institutions
27. Whether any Government enquiry, proceedings
or prosecution has been instituted against the
unit or its proprietor/partners/directors
for any offences? If so, please give details.
28. Details of pending litigation, if any against
and by the concern

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29. Please indicate whether the proprietor/any of the
Partners/Promoters/Directors have at any time
Declared themselves as insolvent.
If so, details there of.
I / We certify that all information furnished by me/us is true that I / We have no borrowing arrangements for the unit with any bank except as indicated in the application that there is no overdues / statutory dues against me / us / promoters except as indicated in the application; that no legal action has been / is being taken against me / us / promoters that I / We shall furnish all other information that may also be exchanged by you with any agency you may deem fit, and you, your representatives, representatives of the Reserve Bank of India / National Bank for Agriculture & Rural Development / Small Industries Development Bank of India / Credit Guarantee Fund Trust for Micro and Small Enterprises or any other agency as authorized by you, may at any time inspect / verify my/our assets, books of accounts in our factory business premises as given above.
Signature of the Applicant
(Name & Designation)
Encl: Certified Xerox copies of
Audited Balance Sheets with Trading and Profit & Loss account for the
last three years.
Memorandum and Articles of Association, Certificate of
commencement of business.
Income tax, wealth tax returns and assessment orders for the last three
years, for the unit as well as of Proprietor / Partners / Directors
Sales tax returns for the last three years