Application Form For Credit Facilities to MSME (10 Lacs-50 Lacs)

INDIAN OVERSEAS BANK
SMALL AND MEDIUM ENTERPRISES
SME-6

APPLICATION FORM FOR CREDIT FACILITIES OVER Rs.10 lacs & UPTO Rs.50 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
2. Business Address with Telephone / Fax No. /Email address
3.1. Address of
Regd. Office 3.2. Administrative 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. 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
8. Arrears in Statutory Payments (if any)
a) Income tax
b) Sales tax
c) Provident Fund
d) Employees State Insurance Corporation
e) Others (specify)
9. If the unit is an ancillary unit, the undertaking to which it is catering
and its address
10. Name of the associate concern(s), if any
10.1 Nature of association and amount invested
10.2 Nature of activity
10.3 Items traded / manufactured
10.4 Turnover and profit during proceeding three years. Contd..p/3

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11. Present Proposed
Employment
Executives
Supervisory
Administrative/Office staff
Skilled Labour
Unskilled Labour
12. Technical Feasibility
12.1. Name of the Product(s) including
bye-products & its (their) use
12.2 Manufacturing Process, in brief (indicate
to the extent possible, stage-wise capacity
data, yield / conversion data, material
In flow, etc.)
12.3 Capacity (No. of Units / Quantity in Kg. /volume in liter
Per annum)
Capacity for
each product
Licensed Installed Operating
12.4. 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 to the product
iv) Availability of Power, Water, Labour, Transport
v) Whether clearance has been obtained from the
Pollution control authority

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12.5. 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
12.6 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.
12.7. Particulars of Machinery & other fixed assets.
(As per Annexure II)
12.8. Necessity & purpose for the proposed investment /
addition to factory premises / machinery (in case
where such investment is intended) for
achievement of the anticipated turnover)

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12.9 Raw Materials / Components (Please mention about the imported
and indigenous items separately)
Name / Brief description of the items
A B C D
Quantity Required
Sources of supply
Minimum Purchase
quantity
Land / Procurement time
Available throughout the
year
If answer to the above is
‘no’ then No. of months it
is available
Enclose proforma invoices in respect of each item, if available.
13. Utilities (Give comments of requirement, availability / adequacy,
qualitative aspects etc.)
13. A. POWER
Contracted Load
Connected Load
Future Power consumption
(in No. of units) per month
Stand-by Arrangements
(Enclose certified Xerox copy of sanction for power connection)
13. B. WATER (Enclose certified Xerox copy of sanction for water
connection)
13. C FUEL
13. D OTHERS (Specify)

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14. Economic Feasibility, Marketing (Mention separately for each product)
14.1 Whether the product is reserved exclusively for SME sector
14.2 Name of the major customers
14.3 Region / Area where the product is / will be sold
14.4 Extent of competition & No. of units engaged in similar line in the
area
14.5 How does the unit meet / purpose to meet the competition
(Comment on the competitive advantages enjoyed by the unit)
14.5.1. In price and quality, how does the unit’s product compare with
those of its competitors
14.5.2. Is the unit selling direct to its customers?
If so, please furnish details like sales force,
Showrooms, depots etc.)
14.5.3. 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)
14.6. Nature and volume of orders / enquiries
On hand (certified Xerox copies to be furnished)

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14.7 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 $
15. 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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16. Means of financing (Please furnish details of sources of finance for
meeting the cost under the following heads)
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
16.1 In case internal accruals are taken as source of finance, explain
the basis for estimation of internal accruals by means of a statement
16.2 Indicate sources from which expenditure already incurred
has been financed

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16.3. 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)
17. Schedule of implementation (Please furnish 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. Civil works for
Factory Building
Machinery Foundation
Administrative Building
D. Plant and Machinery
Imported
Indigenous
E. Machinery Foundation
F. Arrangement of water
G. Erection of equipment
H. Commissioning
I. Industrial Procurement of
Raw Materials
J. Trial runs
K. Commercial production

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18. Future projections -
Projected Profitability, Projected Cash Flow (To be given for next five
years) Please furnish data on projected profitability as per Annexure-III
Please furnish data on projected cash flow statement as per Annexure-IV
Projected balance sheet as per Annexure-V
Percentage of cash sales in total sales ……. %
Period in which payment is received in respect of credit sales …. Days
Average credit available on purchase . . . . . days
19. Working capital required for the Anticipated Turnover
(Please furnish data as per Annexure-VI)
20. Repayment programme
21. Details of Securities offered
21.1 Working capital and term loan securities to be indicated separately.
21.2 Collateral, if any (full details)

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21.3 Details of Guarantor(s)
21.3.1. Name
21.3.2. Residential Address
21.3.3. Occupation (if in service, name & address of his / her employer)
21.3.4. Details of movable & immovable property(ies) owned by him / her
& other dependent family members)
21.3.5 Details of any similar guarantees, if any given to other institutions
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 indicatged 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 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 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