STATE BANK OF INDIA
SMALL SCALE INDUSTRIES
Application Form For Credit Facilities of over Rs.5 crores.

1.1 Name of the Unit
1.2 Constitution Proprietary/Partnership/Private Limited Concern/
Co-operative Society
(Please strike out which are not applicable)
1.3 Name of the business house/group to which the unit belongs
2.1 Registration No. :
(as given by the District Industries Centre, Directorate of Industries)
2.2 Date of incorporation/commencement of business
3. Business Address with Telephone/Telex/Fax No.
3.1 Registered Office
3.2 Administrative Office
3.3 Factory
4. Background of Proprietor/Partners /Promoters/Directors
(Please furnish information for each person as per in Annexure-I)
5. Description of the Industrial Activity
5.1 Existing
5.2 Proposed
6. How the Activity was financed so far (to be filled in case of existing unit only)
Source of
Funds(*)
Security Rate of Unit Repayment
per month
Present
O/s.
Amount of
Default (if any)
(*) Indicate source of funds with name & address e.g. Banks/financial institutions/others
(specify)
State Bank of India
7. Arrears in Statutory Payments (if any)
a) Income Tax
b) Sales Tax
c) Provident Fund
d) Employees State Insurance Corporation
e) Other (specify)
8. Past Performance for the last three years (in case of existing units)
Particulars 20__ 20__ 20__
Turnover
Net Profit
Retained Profit
9. Monthly Turnover for last twelve months.
JAN FEB MAR APR MAY JUN
JUL AUG SEP OCT NOV DEC
9.1 MANAGEMENT
(Please furnish background of the main promoter other than those furnished in
Annexure-1. write-up on other companies, if any, promoted by him or with which
he is associate together with a copy of the latest balance sheet)
9.2 In case the promoter is a Limited Company, please furnish a write-up on the
activities and past performance of the company and any other expansion
programme(s)/diversification contemplated
(a) Memorandum & Article of Association
(b) Audited Balance Sheet and Trading and Profit Loss A/cs for the last three
years of the promoter company.
Copy of the agreement(s), if any, entered into among the promoters.
State Bank of India
9.3 SHAREHOLDING
9.3.1 Please provide a list of shareholders under the heads
a) Promoters
b) Other major groups
c) Foreign collaborations
d) NRI shareholders
e) Other institutions
Owing or controlling 5% or more of equity shares, indicating the amount owned
and business relationship, if any, with the company.
9.3.2 In case of preference shareholder, please give a list of ten largest shareholders.
9.3.3 Also furnish number of equity shareholders and preference shareholders
9.4 Employment Present Proposed
Executives
Supervisory
Administrative/Office Staff
Skilled Labour
Other (specify)
9.5 Particulars of existing key technical and executive staff
(Please furnish for existing as well as proposed staff)
Name Designation Qualification Experience Any Special
achievement
(Inventions/
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 associated concern(s), if any and
11.1 Nature of Association and amount invested
11.2 Nature of Activity
11.3 Items traded/manufactures
11.4 Turnover and profit during preceding three years.
State Bank of India
12. Technical Feasibility (Please enclose the
Feasibility / project report)
12.1 Name of the Products (including by-products)
& its (their) use
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, y ield/conversion data,
Material flow etc.)
12.3 Capacity of Units/Quantity in Kg./Volume in Liters)
Capacity of
each product
Licensed Installed Operating
12.4 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 same collaboration.
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) Fees/royalties payable and the manner in which
payable.
d) Copy of the government approval, if required
for the service of foreign technicians, if any.
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.
State Bank of India
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 them
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 a copy of
the agreement with the consultants, and in
case of foreign consultant(s) approval of
the Government.
12.4.4 Whether any of the partners/
promoters/directors have any interest in
consultant/collaborator firm. If so, details to
be furnished
12.5 Locational advantages of existing and/or
proposed premises with reference to :
i) absence of civic restrictions
ii) proximity to the source of raw materials
iii) market for the product
iv) availability of
a) power
b) water
c) labour
d) transport
12.6 LAND & BUILDING
Area/Plinth area
(in sq. metres)
Value (in 000sof Rs.)
Existing Proposed Existing Proposed
Factory Land
Factory Building
Ancillary Building
Open Storage Space
(enclose Test Report)
State Bank of India
12.7 Type of soil and load bearing capacity
Enclosures :
a) Certified zerox copy of sale/lease deed
b) Certified zerox copy of the Govt. Order converting
the land into industrial land, if applicable.
c) Locational map
d) Certified zerox copy of the site plan of the land showing contour lines, the
internal road, power receiving station, railway siding, tube-wells, etc. 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 Fees 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
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 to indicate the availability of machinery particulars with the subcontractors
with adequate spare capacity.
12.9.2 Arrangements made for erection and commissioning of the plant.
12.10 Necessity & purpose for the proposed investment/addition to factory
premises/machinery (in case where such investment is intended) for
achievement of the anticipated turnover.
State Bank of India
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 above is
no then no. of months
& period when it is
available
(enclose copies of proforma invoices in respect of each item)
13. UTILITIES (Give comments on requirement, availability/adequacy, qualitative
aspects etc.)
13.1 Power
13.2 Sources of Power and Supply Voltage
- Taken from Electricity Board
- Own generation
- Stand-up 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 zerox copy of sanction for power
b. Certified zerox copy of agreement with electricity board.
c. Certified zerox copy of electrical layout of the plant.
13.2 Water :
13.2.1 Indicate the requirements and suitability of water
13.2.2 Describe the water treatment arrangement
13.2.3 Sources for supply of water arrangement
Proposed and water charges payable
13.3 Steam :
13.3.1 Requirement of steam
13.3.2 Capacity of boiler
13.3.3 Arrangements proposed for steam
State Bank of India
13.4 Compressed 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 project and 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 certificates should be
furnished.
15. QUALITY CONTROL
15.1 Details of arrangements made for quality control
If BIS/FPO/ISO specifications are followed, no. of
BIS/FPO/ISO standards and 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 the SSI Sector? If so, please
furnish Item Code No.
16.2 Names 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 units meat/propose 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.
State Bank of India
16.5.3 If 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 applicable)
16.6 Nature and volume of orders/enquiries on hand (zerox 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 preceding three years.
Code No.:
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 000’s of Rs.)
Sr.No. Particulars Already
Incurred
To be
Incurred
Total cost
A. Landing including
development
B. Building & Other Civil
Works
C. Plant & Machinery
i) Indigenous
ii) Imported
D. Essential Tools, Spares &
Accessories
E. Testing Equipment
F. Miscellaneous Fixed
Assets
G. Erection/Installation
Charges
H. Preliminary Expenses
I. Pre-operative Expenses
J. Provision for
Contingencies
1. Buildings
2. Plant & Machinery
3. Other Fixed Assets
K. Margin for Working
Capital Required
L. Total
State Bank of India
18. Means of Financing
(Please furnish details of sources of finance for meeting the cost under the
following heads)
(in 000s of Rs.)
Sr.
No.
Particulars Amount
Already
Raised
Amount
Proposed to
be Raised
Total
A. Capital
(specify resources
contributing 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
Arrangements including
Suppliers Credit
F. Subsidy
- Central Govt.
- State Govt.
G. Seed Capital (indicate
sources)
H. Internal Cash Accruals
I. Other sources (specify)
J. Total
19.1 In case internal accruals are taken as sources of f inance explain the basis for
estimation of internal accruals by means of a statement.
19.2 Indicate sources from which expenditure already incurred has been financed.
19.3 Promoter’s contribution to the project as % of the total cost.
(Please furnish list of persons/firms who would be contributing to the promoters’
share of the capital and the respective amounts and their relationships).
20. Financial Assistance required :
20.1 Rupee Loan
20.2 Foreign Currency Loan
20.3 Underwriting
20.3.1 Equity Capital
20.3.2 Preference Capital
State Bank of India
20.3.3 Debentures
20.3.4 Guarantee of foreign currency loan/Deferred Credit
20.4 Guarantee for foreign currency loan/Deferred Credit
20.5 Working Capital (Please furnish as per Annexure-VI)
20.6 Other forms of assistance (e.g. LC’s, Guarantees, etc.)
21. Schedule of Implementation :
Please indicate the progress made so far in the implementation of the project and
furnish the scheduled of implementation as follows :
Date of Expected
Commencement Date of Completion
a) Acquisition of Land
b) Development of Land
c) Civil Works for
- Factory Building
- Machinery Foundation
- Administrative Building
d) Plant & Machinery
- Imported
_ Indigenous
e) Arrangement for power
f) Arrangement for water
g) Erection of equipment
h) Commissioning
i) Initial procurement of Raw Material
j) Trial Runs
k) Commercial Production.
22. Future Projections
(To be given for the next five years)
Please furnish data on :
22.1 Projected profitability as per Annexure-III
22.2 Projected cash flow statement as per Annexure-IV
22.3 Projected balance sheet as per Annexure-V
22.4 Working Capital requirement as per Annexure –VI
22.5 Percentage of Cash Sales in total Sales - -------%
22.6 Period in which payment is received in respect
of Credit Sales _______days
22.7 Average credit available on purchases _______ days
23. How far does the unit contribute to the establishment of ancillary units in the
region.
State Bank of India
24. Please furnish International/CIF/FOB Price of all inputs, which can be imported.
25. Government Consents:
Please indicate whether the various licenses / consents required for the project
have been obtained from the respective authorities.
24.1 Specify any special condition attached to the licenses / consents and the
Undertaking given by the company in connection therewith.
26 Repayment programme:
27 Details of securities to be offered
27.1 Primary
(working capital & term loan securities to be indicated separately)
27.2 Collateral (full details)
27.3 Details of guarantors(s)
27.3.1 Name
27.3.2 Residential address
27.3.3 Occupation
(if in service, name & address of his / her employer)
27.3.4 Details of Movable & Immovable Property (ies) owned by him / her & other
Dependent family members
27.3.5 Details of any similar guarantee, if any, given to other institutions.
28 Whether any Government enquiry proceedings of prosecution has been instituted
against the unit or its proprietors / partners / promoters / directors for any
offences? if so, please give details.
29 Details of pending litigation, if any, against and by the concern.
30. Please indicate whether any of the promoters of directors have at any time
declared themselves as insolvent.
State Bank of India
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 over dues / statutory dues against me / us / promoters except as indicated
in the application; no legal action has been / is being against me / us / promoters; that I /
We shall furnish all other information that may be required by you in connection with my
/ our application; that this 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 of Agriculture and Rural Development / Small Industries Development Bank of
India / Deposit Insurance & Credit Guarantee Corporation or any other agency as
authorized by you, may, at any time, inspect / verify, my / our assets, books of accounts,
etc., in our factory / business premises as given above.
Signature of the Borrower
(Name & Designation)
Date
Place
Encl: Certified Xerox Copies of
a) Audited balance Sheets with Trading and Profit & Loss Account, for the
last three years.
b) Memorandum and Articles of Association, Certificate of
Commencement of Business in case of limited companies..
c) Income tax, Wealth tax Returns and assessment orders for the last three
years, for the unit as well as proprietor / partners / promoters / directors.
d) Sales Tax Returns and assessment order for the last three years
Forms as per Appendix – SSI-I to Appendix – SSI- VI given hereafter should also be
submitted along with the application for advances above Rs. 10 lacs,