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RIICO APPLICATION FORM FOR MEDIUM TERM
MULTI PURPOSE LOAN
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GENERAL 1.
Amount of assistance required. 2.
Name of Industrial concern. 3.
Constitution. 4.
Date of incorporation/ registration & commercial production. Details (date, period, reasons, etc)
of information, if any. 5.
Location (along with phone numbers) of registered office, factory
& whether the factory is located in notified backward area. 6.
Nature of Industry & products. 7.
Name of business house/group to which the concern belongs (whether
MRTP) |
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MANAGEMENT 1.
Name of present directors. 2.
Details of shareholding
of promoters, directors
and other major shareholders
(Annex.III). 3.
Particulars of present collaboration, if any (name and address,
nature of collaboration periods, terms of collaboration,etc.) 4.
Name of Chief Executive Officer and senior most executive. 5.
Brief history of the company/concerns (indicating various developments, prospects in chronological order (Annex I). 6.
Other ventures of the promoter group. |
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FINANCIAL 1.
Working results (enclose balance sheet for the last three
years). In case the last
audited balance sheet and profit loss is more than six months
old, provisional balance sheet and profit & loss account as on date. Comments on the operation of the unit
since the last audited balance sheet
should be furnished (Annex.IV). 2.
Debt. Equity ratio& current ratio. 3.
Details of term loan, working capital, deferred credit, lease, etc.
availed from institution/bank (Annex.II). |
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Institution Sanctioned Disbursed Outstanding Amt.
Date Amt.
Date. |
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Note : Please enclose no
overdues certificate from financial
institution/bank. 4.
Name of bankers of company and associate concerns from where the
promoter group has obtained term
loan/CC in past three years. 5.
A note on the requirement and utilisation of proposed loan alongwith benefits expected. 6.
Projected profitability, cash flow and balance sheet for the next
five years. 7.
Capacity utilisation (product-wise) during the last three years. |
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Particulars
I II III |
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Licensed /regd. Installed Capacity Utilised capacity Paid up Capital Reserve & Surplus Net Worth Gross Block Net Block Sales Gross Profit Interest Depreciation Operating profit Net profit Dividend (Rate %) Cash Generation % of recoverable to sales % of finished goods to sales %of net profit to paid up
capital % of operating profit to
sales |
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GENERAL Security proposed, with
computation of value of security as
per guidelines given in the scheme.
Wherever the loan is proposed to be secured by collateral security, please furnish
valuation of property from approved valuer. |
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DECLARATION We hereby declare that the information given here in
before and the statements and other papers enclosed are to the best of
or knowledge and belief true
and correct in all respect. We further, declare that we are not in
arrears to the term lenders and are up to date in payment of fues to the Government and local bodies
as also other statutory dues. We also
declare that we have not availed of
any benefit under one time settlement and proposed loan shall not be used to prepay the existing loan of the
corporation carring higher interest rate.
In any eventuality of use of this loan for prepayent of loan of
corporation of higher interest rate, we agree to pay prepayment premium on
the same. Signature
of Director Place: Date:
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