(ON LETTER HEAD OF THE APPLICANT COMPANY) Application for financial investment under Bharatratna Dr. Babasaheb Ambedkar Investment Fund for SC/ST
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1 (ON LETTER HEAD OF THE APPLICANT COMPANY) Application for financial investment under Bharatratna Dr. Babasaheb Ambedkar Investment Fund for SC/ST Preliminary Information for investment in equity/debt I Particulars of enterprise 1 Name/ Constitution 2 No of years in existence/ operation 3 Website details, if any 4 Address of registered office and Factory (existing / proposed) 5 Industry/ Product Existing Brief particulars of current business Industry/ Product Proposed 6 Promoter s Name/ age 7 Whether belongs to Scheduled Caste or Scheduled Tribe
2 8 Whether promoters hold 100% of the paid up capital of the company 9 Promoters qualifications 10 No of years in same business 11 Net worth of main promoters (Name, net worth, net worth certificate details) 12 Shareholding pattern 13 Whether family business and if so details of family members involved in the business 14 Present status of the company Whether public limited or private limited Whether large, medium, small or micro enterprise 15 External rating if any Rating Agency name 16 Banking relationships existing
3 17 Board of Directors details including DIN and qualifications II. Financials (in case of existing company): (Rs. Lakh) FY 16 FY 17 FY 18 Sales/Revenues (operating) Non-operating income PBDIT Depreciation PAT NPM (%) DER Current ratio Debtors above 6 months Inventory holding days Creditor days Debtor days
4 (Rs lakh) FY 16 FY 17 FY 18 Liabilities Share Capital Share Capital + Reserves Long Term loans (secured) Unsecured loans promoters Unsecured loans others Bank borrowings for WC Total liabilities Assets Net Fixed Assets Current assets Total Debtors Inventory/ Stock Other Assets
5 Total Assets III. Information on Group Concerns and/or Associates (Rs. lakh) Name / location Activity Financial position/ results as on Sept 30, 2017 NW Sales PAT IV. Financial facilities availed (For company and all group/ associate concerns separately) Name of Bank/ branch Facility Amount availed Outstanding as on Security and date September 30, 2017 given Please specify whether there have been any defaults or whether declared NPA by banks at any time
6 V. Future Plans for capital expenditure or increase in working capital requirements Provide details of requirements of capital (equity/debt) and benefits to the enterprise. Is it a new project or an expansion project or diversification? Does the expansion require fixed assets or working capital or both? If there are fixed costs, fill in the details as under: Detailed Costs and means of finance Project cost (items/ heads) Amount (Rs. lakh) Land Civil construction/ building Deposits/ rentals for premises Main Plant and Machinery Miscellaneous Fixed Assets Equipment Marketing/ Product Development / R&D etc.
7 Margin for working capital Total Project Cost Means of finance Amount (Rs. lakh) Promoter share capital (additional) Requirement of equity/ debt from the Fund Unsecured loans Internal accruals/ earnings Secured term loan from Banks VI. Business projections (with brief assumptions) (Rs lakh) FY 18 FY 19 FY 20 Sales Cost of Production and other expenses Profit before Interest, Depreciation and Tax Interest
8 Depreciation Profit Before Tax Tax Profit after Tax VII. Market Information Market for company s products and marketing strategy/ selling arrangements Number of customers, top 5 customers and their share in the total sales Geographical reach whether local/ regional/ national/ exports (please name countries) Brief comments on main competitors Marketing and selling arrangements
9 VIII. Details of arrears of taxes and other statutory dues, if any. Details of litigation, if any.. IX. Key strengths and risk factors of the business (briefly) X. Any other relevant information Signature Date and Place: Name/ Designation
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