Form No. 1. Revised Application form for Registration under Madhya Pradesh Udyog Nivesh Samvardhan Sahayata Yojana 2010

Transcription

1 Revised Application form for Registration under Madhya Pradesh Udyog Nivesh Samvardhan Sahayata Yojana 2010 Form No (a) Name of the applicant Industrial Unit (b) Location Address Village Tehsil District Telephone No. Fax No. e mail address (c) Address of the Registered Office Telephone No. Fax No. e mail address (d) Category of the industrial unit (Micro/ Small/ Medium/ Large) 2. Name and Designation of the contact person Telephone No. Fax No. e mail Address 3. Whether the Project is for (for which registration is applied) (a) Establishment of a new unit (b) Expansion project in the existing unit (Expansion/Diversification/Technology Upgradation) (c) Expansion project in a new Location (d) Whether the unit is established by reviving a closed /sick industry, if yes (i) Purchased directly or through BIFR/ State Government's under taking / (ii) Purchase value & name of the old unit

2 (iii) Product of the purchased / acquired unit and their capacity (iv) Tax liability, if any on the purchased industry (if yes, details), (if no, no dues from the concerned department) (e) Constitution (Constitution Public Ltd./ Private Ltd. /Cooperative Society/Partnership Firm) (f) Date of incorporation/ Registration of the Company/Co operative Society 4. Details of other industrial units of the company / group, if any in Madhya Pradesh Location District Product and their capacity Fixed capital investment 5.1 Project cost for new units Particulars (Clause 3.10 of the scheme) a. Land (Max. allowable cost, as per the scheme) b. Site Development (maximum 10% of cost of Land & Building is permissible) c. Building d. Plant and machinery e. Electrical Installation f. Pollution Control Equipments g. Misc. fixed assets h. Total Fixed Assets i. Preliminary and preoperative expenses j. Margin money for working capital k. Grand Total Estimated / actual Cost

3 5.2 Project cost for Expansion/Diversification/Technology Upgradation (Rs. In lakhs) Particulars Investment in the existing Proposed Investment in Total unit, as on the last day of Expansion/Diversification Investment preceding financial year of /Technology Upgradation Expansion /Diversification project /Technical Upgradation Land (Allowable cost, as per clause 3.10 of the scheme) A Site Development (maximum 10% of Cost of Land & Building) Building Plant and machinery Electrical Installation Pollution Control Equipments Investment in Technology Upgradation Misc. fixed assets Total Fixed Assets Preliminary and preoperative expenses Margin money for working capital Grand Total 5.3 Means of Finance for new or Expanded/Diversified / Technology Upgradation project. (Rs.in lakhs) Particular Amount Share capital/own funds Term Loan from Financial Institutions/Banks Unsecured Loans Other loans (if any) Total

4 6. Name of the proposed items of manufacture & annual capacity (for which Registration is applied) 6.1 For New Units No. Name of Annual Estimated Rate of tax Estimated payable Estimated 50% of Total Item Capacity Annual Sales Realization (in Rs. lakhs) (VAT and CST) amount of Tax Amount (VAT + CST) (in Rs. lakhs) in which tax on raw material is not included the input tax, imposed on stock transfer of the finished goods, out of the state (for Textile and Automobile units only) In case of Expansion/Diversification/ Technology Upgradation No. Name Existing Annual Proposed new Total Estimated of Capacity capacity under Annual Sales Item (Originally registered capacity or for expansion/ diversification/ Technology up Capacity Realization from additional Average of last 3 gradation year's production before capacity/ new capacity for one year Expansion / Diversification / Technical Upgradation which ever is higher Rate of Tax VAT/ CST Estimated Estimated Total payable of 50% of the Tax input tax, Amount to imposed on be Paid stock (VAT + transfer of CST) for the finished goods, out of the state (for Textile and Automobile units only)

5 7. (A) EM Part I (Issued by DTIC) (B) EM Part II (If unit has commenced production) (C) (d) Number and date of IEM issued by Govt. of India Secretariat for Industrial Approval/ Letter of intent/industrial License /Other approval (for large scale industry only) No. & date of production certificate (issued by DTIC, if large scale unit has commenced production) 8. Power requirement (KVA) 9. Employment Potential in the project (a) Managerial (b) Factory workers (c) Other workers (d) Total 10. Whether the location conforms to Pollution Control Board norms If yes, write consent no. and date (a) Under air pollution act (b) Under water pollution act 11. Estimated daily requirement of water and source of supply 12. Registration under VAT/CST Act 13. Likely or actual date of commencement of production 14. Application fee (only for medium/large scale unit, Rs. 5000/, Rs / respectively) 15. Bank Account details in which claim amount is to be deposited 1. Name (Company's name) 2. Account number 3. MICR Code 4. IFSC Code Amount Rs.... Bank Name... Bank Draft No.... Date... CERTIFIED that the statements in the application are true to the best of my knowledge and belief. Place Date Signature, Name and Designation of the applicant or authorized signatory along with Seal of the company.

6 Annexure to be attached/sent by post 1. A copy of the Acknowledgement Reference No. by SIA/Letter of intent/ Industrial licence/other Government of India approval/em Part I/EM Part II (if applicable)/production certificate (If applicable) 2. Copy of Resolution passed by Board of Directors to establish new unit or Start expansion/diversification /technology of upgradation in the established unit and for assigning the powers to signature authority. 3. Copy of the VAT & CST Registrations issued by Commercial Tax Department. 4. Declaration (on affidavit) by the unit that proposed industry is not included in the negative list under the scheme. 5. In case of Expansion/Diversification /Technical Upgradation, CA certificate for fixed capital investment in the existing unit. 6. Memorandum and Articles of Association. 7. Project report. 8. Existing manufacturing activities in Madhya Pradesh stating items, annual approved capacity, annual installed capacity, annual production during last three years (in quantity & value in Rs. lakhs) ( Documents mentioned in 1 to 5 above are to be attached online. Rest all documents are to be attached separately as hard copy along with a copy of acknowledgmen)