FORMAT OF APPLICATION FOR FINANCIAL ASSISTANCE FOR AGRICULTURE AND ALLIED SECTOR (THIS IS ONLY A FORMAT AND NOT AN APPLICATION FORM) 1. DETAILS OF PROMOTER(S): a) Name & Address of the Promoter(s) : b) Constitution: Proprietorship/Partnership/: Cooperative Society/ Company (Attach documentary support) c) Present activities of the promoter (s) 2. PROPOSED ACTIVITY : a) Name of the Scheme: : b) No. of Unit(s) : Rural : Urban : Total : c) No.of Beneficiaries: Per Unit Total for....Units (Owners of Assets only) -------------------- --------------------------- Rural Urban Rural Urban ------ ------- ------ ------ i) Educated/ uneducated unemployed/ under employed ii) Women iii) Others ------ ------- ------ ------ Total ------ ------- -------- ------ b) Location(s) of Unit(s) : 3. COST OF THE PROJECT: (Rs in lakhs) S.No. Items Cost Per Unit Total for Units 1 2 3 Land (Area Per Unit and rate..) Cost of land development Building/Civil Works Irrigation facilities 4. 5. 6. Plant & machinery (Annex I) Cost of the animals Misc.fixed assets 7. 8. Fertilizers & Seeds Insurance ,including interest during implementation period & Cost escalations etc. 9. Working Capital ( Annex. II) 10. Others Specify Total: Note: i) Type of structure, dimensions, area and cost of construction per sq.ft. may be given for Building/Civil Works. ii) Details of Plant and Machinery, Misc. Fixed Assets and other major items may be furnished. iii) No.and cost of each animal and breed of the animals may also be mentioned. 4. MEANS OF FINANCE : (Rs.in lakhs) S.No. Source Per Unit %age Total for.. Units i) Promoter's Contribution ii) Subsidy iii) Loan - SCA iv) Term Loan - NSTFDC v) Others if any(specify) Total: 5. TECHNICAL DETAILS : Details of requirement and availability position regarding. seeds, manure, pesticides, fertilizers, irrigation, animals, feed, water supply, veterinary aid and marketing etc. may be furnished. 6. CROP PATTERN ETC. : Details of Crop pattern in the area, crops to be grown, gestation period of crops. 7. ECONOMICS OF THE PROJECT : Details of sales and expenses as per Annexure No.III may be given 8. IMPLEMENTATION SCHEDULE: S.No. Activity Commencement Completion Month/Year Month/Year i) Procurement of Land ii) Construction of Building iii) Installation of P&M. iv) Commencement of operations 9. REPAYMENT SCHEDULE: (i) Moratorium period in months. (ii) Repayment Period 10. OTHERS : i) Government Approval (if required) ii) Environmental clearance, if any. iii) Other Govt. clearance, if any. iv) List of Assumptions (Provide list of various assumptions ) NSTFDC FORMAT NO.2(ANNEXURE-1) TECHNICAL DETAILS (PER UNIT) PART -A BUILDING a) Location b) Own/Leased (Lease Period) c) Rent per month in case of leased/rented d) Construction Cost of New Building/Civil Works (Type of structure, dimensions, area and cost of construction per square feet etc. may be furnished). PART-B PLANT AND MACHINERY (Rs. in Lakhs) S.NO. Name of Machine& Cost PerUnit No. of Units Total Cost Specifications i) ii) iii) PART-C MISCELLANEOUS FIXED ASSETS S.No. Item Cost Per Unit Total Cost i) ii) iii) (ANNEXURE II) DETAILS OF WORKING CAPITAL (PER UNIT) AT FULL CAPACITY UTILISATION S.No. Items Period Qty. Unit Rate Total Amount 1. Raw Materials 2. Stores & Spares 3. Work in process 4. Finished Goods 5. Receivables/Debtors 6. Others (Specify) Total : Less: Credit on purchase Net Working Capital Requirement NSTFDC FORMAT NO.2 (ANNEXURE III) COST OF OPERATIONS AND PROFITABILITY STATEMENT (PER UNIT) (Rs. in lakhs) Sl.No. Particulars Ist Year IInd Year onwards A. Sales B Cost of operations 1. 2. 3. 4. 5. Interest 6. Depreciation 7. Others, Specify ----------------- --------------------- Total Cost of operations ----------------- ---------------------- C. Gross Profit (A-B) D. Cash Profit E. Net Profit (D-E) Note: Please furnish complete details of sales/earnings particularly regarding season, number of crops, yield and unit rate etc.
