Application to the Branch for a Corrective Action Plan under Restructuring / Rehabilitation of MSME Units

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Application to the Branch for a Corrective Action Plan under Restructuring / Rehabilitation of MSME Units A. Brief Profile of the Enterprise: Name of the Enterprise / Borrower Constitution Proprietary Partnership Pvt. Ltd. Ltd. Company Others Current Business Activity Current Office Address / Residential Address (For Existing Loan Exposure up to Rs.10 Lakh) ( To be submitted along with documents as per the check list ) Contact No. Land Line: Mobile : E-Mail GST Registration No. Udyog Aadhaar No./ Registration No. Date of incorporation / Establishment Activity Mfg. / Trading / Services / Others Brief of Business activity Banking with since SMA Status as on SMA-0 / SMA-1 / SMA-2

B. Details of Proprietor/ Partners/ Directors: (Amount in Rs.) Name of Residential PAN No. Net Worth % of Share Proprietor/ Address with /DIN No. as on Partners/ Directors Contact No. holding Other dues as Borrower / Guarantor C. Details of Associate Concern / Sister Concern: (Amount in Rs.) Name of Associate Concern / Sister Concern Business Activity IRAC status Banking With Loan Limit Financials as on.. FB NFB Net Sales Net Profit Net Worth D. Social Category: Gender Man Woman Trans gender Physically challenged Yes or No Social Category SC ST OBC Women Physically Handicapped Minority If Minority Community Buddhists Muslims Christians Sikhs Jains Zoroastrians

E. Details of Existing Liabilities with the Bank: (Amount in Rs.) Limit Market Advance DrawingP O/s Overdues value of value of ower Facility stocks stocks Fund based working capital (CC / OD/EPC etc.) Others (please specify) Fund based sub-total LC/BG for working capital Others (Please specify) Non Fund based Sub-total Total Working Capital Term Loans Any Other (Specify) Total Exposure Banking arrangement and sharing pattern: Financial Arrangement: Sole Banking/Consortium/Multiple Banking FB NFB Total % Share WC TL Bank 1 Bank 2 Banks (Total) Total Limit O/s limit O/s Limit O/s Loans with Financial Institutions / NBFCs and overdues, if any: F. Details of Other Liabilities: (Amount in Rs.) Details of Statutory dues remaining Details of Unsecured Creditors. outstanding with State Government or Central Government (Furnish reason for incurring liability)

G. Past Performance & Future Estimates: (Actual performance for two previous years, estimates for current year and projections for next two years to be provided for additional working capital facilities) (Amount in Rs.) Net Sales Net Profit Capital (Net Worth of the Enterprise) TNW Adjusted TNW Current Ratio TOL/Adjusted TNW Cash Accruals Past Year-II (Actual) Past Year-I (Actual) Present Year(Estimate) Next Year-I (Projection) Next Year-II (Projection) H. In case of additional Working Capital: (Amount in Rs.) Actual Sales Projected FY- FY- Sales Working Cycle (in days) Inventory (in days) Debtors (in days) Creditors (in days) Promoter s Contribution I. For additional term loan facilities projections to be provided till the proposed year of repayment of loan.

J. (a) Details of Existing Security: (Amount in Rs.) Particulars of Primary Security Nature of charge Date of Valuation Value Particulars of Collateral Security SARFAESI Complaint (Y or N) Nature of charge Date of Valuation Value (b) Details of Proposed Additional Security to be offered: Particulars of Primary Security Nature of Date of Valuation charge (Amount in Rs.) Value Particulars of Collateral Security SARFAESI Complaint (Y or N) Nature of charge Date of Valuation Value K. (a) Details of Existing Guarantors: (Amount in Rs.) Name and addresses Age Occupation Annual Income Net Worth as Other dues as of the Guarantors on Borrower / Guarantor (b) Details of Proposed Guarantors: (Amount in Rs.) Name and addresses of the Guarantors Age Occupation Annual Income Net Worth as on Other dues as Borrower / Guarantor

L. Details of stress faced by the Enterprise: Indicative List of Stress Details of stress faced by the Enterprise Outstanding balance in cash credit account remaining continuously at the maximum. Inability to maintain stipulated margin on continuous basis. Failed to make timely payment of instalments of principal and interest on term loans. Decline in production. Decline in sales and fall in profits. Overdue Receivables / Bad debts Increase in level of inventories. Failed to pay statutory liabilities. Delay in meeting commitments towards payments of installments due, crystallized liabilities under LC/BGs. M. Suggested Remedial Measures with the estimated time frame to justify the action plan: Indicative Remedial Measures Suggested remedial measures with the estimated time frame by the Enterprise with supporting details to justify the action plan /solution, duly supported/vetted by TEV as the case may be. Rectification: Restructuring: Reschedulement of Instalments. Capitalisation of interest. Fresh and/or additional WC / WCTL. Fresh term loan assistance for need based expansion.

Declaration: I/We hereby certify that all information furnished by me/us is true, correct and complete to the best of my/our knowledge and belief. I/We shall furnish all other information that may be required by Bank in connection with my/our application. The information may also be exchanged by you with any agency you may deem fit. You, your representatives or any other agency as authorised by you, may at any time, inspect/ verify my/our assets, books of accounts etc. in my/our factory/business premises. You may take appropriate safeguards/action for recovery of bank s dues. Signature of Borrowers Date: Signature of Existing & Proposed Guarantors Place: CHECK LIST: (The check list is only indicative and not exhaustive and depending upon the requirements of banks addition/deletion could be made as per necessity) 1) Last two years balance sheets (wherever applicable as per Statutory requirements / Bank s instructions) of the units along with income tax/sales tax return etc. 2) Projected balance sheets for two years in case of working capital limits and for the period of the loan in case of term loan. 3) Sales achieved during the current financial year up to the date of submission of application/provisional Balance sheet as at Previous Quarter End. 4) Asset & Liability statement of Proprietor/ Partners/ Directors. 5) If funds proposed to be infused by borrower, please specify Sources. 6) Detailed Particulars of securities primary/collateral proposed, if any. 7) Details of all liabilities of the enterprise, including the liabilities owed to the State or Central Government and unsecured creditors, if any. 8) Supporting details for the suggested remedial measures with the estimated time frame by the Enterprise to justify the action plan /solution.

Acknowledgement Office Copy: Received form Mr/Ms/M/s... (Name & Address) an application dated... for corrective action plan under revival & rehabilitation of MSMEs. Date Branch Manager Name: Name of the Bank: -------------------------------------------------------------------------------------------------------------------- Customer copy: Received from Mr/Ms/M/s... (Name & Address) an application dated. for corrective action plan under revival & rehabilitation of MSMEs. Date Branch Manager Name: Name of the Bank: Please Note that: 1. This is only an acknowledgement for having received the application and this should not be construed as an indication of our acceptance of the proposal, a decision on which will be taken only after due consideration of the proposal on its merit and / or on fulfilment of conditions if any, that may be stipulated by the Bank. 2. The application will be taken up for consideration only after all the particulars / data / documents as may be required are received by the Bank. 3. The application will be disposed of within days from the date of receipt of all the details /papers/documents /clarifications sought by the Bank. 4. In case the proposal is rejected/not considered the reasons for the same will be intimated to the applicant.

Application to the Committee for a Corrective Action Plan under Restructure & Rehabilitation of MSME A. Brief Profile of the Enterprise: Name of the Enterprise /Borrower Constitution Proprietary Partnership Pvt. Ltd. Ltd. Company Others Current office Address/ Residential Address Current Business / Activity Corporate office / Registered Office address of the borrower (For Existing Loan Exposure above Rs.10 Lakhs and up to Rs.25 Crore) ( To be submitted along with documents as per the check list ) Contact No. Land Line: Mobile E-Mail GST Registration No. Udyog Aadhaar No./ Registration No. Date of Incorporation / Establishment Date of commencement of operations: Activity Mfg./ Trading/ Services/Others Banking with since: Banking arrangement : SMA Status as on Sole Banking /Consortium/ /Multiple Banking SMA-0 / SMA-1 / SMA-2 External Credit Rating Name of the Agency Current Rating Previous Rating Valid upto

B. Details of Proprietor/ Partners/ Directors: (Amount in Lacs) Name of Proprietor/ Partners/ Directors PAN No. /DIN No. Net Worth as on Residential Address with Contact No. Other dues as Borrower / Guarantor % of Share holding C. Details of Associate Concern / Sister Concern / Group Companies: (Amount in Lacs) Name of Associate Concern / Sister Concern / Group Companies Business Activity IRAC status Banking With Loan Limit FB NFB Financials as on Net Sales Net Profit Net Worth D. Social Category: Gender Man Woman Trans gender Physically Challenged Yes or No Social Category SC ST OBC Women Physically Handicapped Minority If Minority Community Buddhists Muslims Christians Sikhs Jains Zoroastrians E. Details of Existing Liabilities with Banks: (Amount in Lacs) Facility Market value of Stocks Advance Value of Stocks Drawing Power O/s Over Dues Fund based working capital (CC/OD etc.) Export Packing Credit (Rupee/PCFC) Bills Discounting PSFC Fund based Sub-total LC/BG for working capital

Letters of comfort# Non Fund based Sub-Total Total Working Capital Term Exposures (Other than Project Loans) (Balance Sheet funding) Derivatives (after applying CCF) Any other (specify) Total Exposure Banking arrangement and sharing pattern: Financial Arrangement: Sole Banking/Consortium/Multiple Banking/ FB NFB Total % Share WC TL Bank 1 Bank 2 Banks(Total) Total Limit O/s Limit O/s Limit O/s Limit O/s Loans with Financial Institutions / NBFCs and overdues, if any: F. Details of Other Liabilities: (Amount in Lacs) Details of Statutory dues remaining Details of Unsecured Creditors. outstanding with State Government or Central Government (Furnish reason for incurring liability) G. Financials: (Amount in Lacs) Particulars Past Year-II (Actual) Past Year- I (Actual) Present Year Next Year-I (Projection) Next Year-II (Projection) Net Sales (including Operating Income) (%) growth in net sales over previous year Operating Profit (after interest) Operating Profit Margin (%) (Estimate)

Other Income Profit Before tax PAT Net Profit Margin (%) Paid-up Equity Capital/ Tangible Net Worth Adjusted TNW TOL/ Adjusted TNW Current Ratio Cash Accruals Debt Service Coverage Ratio H. In case of additional Working Capital: (Amount in Rs.) Actual Sales Projected FY- FY- Sales Working Cycle (in days) Inventory (in days) Debtors (in days) Creditors (in days) Promoter s Contribution I. For additional term loan facilities projections to be provided till the proposed year of repayment of loan.

J. (a) Details of Existing Security: (Amount in Lacs) Particulars of Primary Security Nature of charge Date of Valuation Value Particulars of Collateral Security SARFAESI Complaint (Yes or No) Nature of charge Date of Valuation Value (b) Details of Proposed Additional Security to be offered: (Amount in Lacs) Particulars of Primary Security Nature of charge Date of Valuation Value Particulars of Collateral Security SARFAESI Complaint (Yes or No) Nature of charge Date of Valuation Value K (a) Details of Existing Guarantors: Name and Age Occupation Annual addresses of the Income Guarantors (Amount in Lacs) Net Worth as Other dues as on.. Borrower / Guarantor (b) Details of Proposed Guarantors: Name and addresses of Age Occupation Annual the Guarantors Income (Amount in Lacs) Net Worth as on Other dues as Borrower / Guarantor

L. Details of stress faced by the Enterprise: Indicative List of Stress Details of stress faced by the Enterprise Outstanding balance in cash credit account remaining continuously at the maximum. Inability to maintain stipulated margin on continuous basis. Failed to make timely payment of instalments of principal and interest on term loans. Decline in production. Decline in sales and fall in profits. Increase in level of inventories. Failed to pay statutory liabilities. Delay in meeting commitments towards payments of installments due, crystallized liabilities under LC/BGs. M. Suggested Remedial Measures with the estimated time frame to justify the action plan: Indicative Remedial Measures Suggested remedial measures with the estimated time frame by the Enterprise with supporting details to justify the action plan /solution, duly supported/vetted by TEV as the case may be. Rectification: Restructuring: Reschedulement of Instalments. Capitalisation of interest. Fresh and/or additional WC / WCTL. Fresh term loan assistance for need based expansion.

Declaration: I/We hereby certify that all information furnished by me/us is true, correct and complete to the best of my/our knowledge and belief. I/We shall furnish all other information that may be required by Bank in connection with my/our application. The information may also be exchanged by you with any agency you may deem fit. You, your representatives or any other agency as authorised by you, may at any time, inspect/ verify my/our assets, books of accounts etc. in my/our factory/business premises. You may take appropriate safeguards/action for recovery of bank s dues. Signature of Borrowers Signature of Existing & Proposed Guarantors Date: Place: CHECK LIST: (The check list is only indicative and not exhaustive and depending upon the requirements of banks addition/deletion could be made as per necessity) 1. GST Registration Certificate. 2. Last two years audited balance sheets (wherever applicable as per IT Act) of the units along with income tax/sales tax return etc. 3. Projected balance sheets for two years in case of working capital limits and for the period of the loan in case of term loan. 4. Sales achieved during the current financial year up to the date of submission of application/provisional Balance sheet as at Previous Quarter End. 5. Asset & Liability statement of Proprietor/ Partners/ Directors. 6. If funds proposed to be infused by borrower, please specify Sources. 7. Detailed Particulars of securities primary/collateral proposed, if any. 8. Details of all liabilities of the enterprise, including the liabilities owed to the State or Central Government and unsecured creditors, if any. 9. Supporting details for the suggested remedial measures with the estimated time frame by the Enterprise to justify the action plan /solution.

Acknowledgement Office Copy: Received form Mr/Ms/M/s..... (Name & Address) an application dated.. for corrective action plan under revival & rehabilitation of MSMEs. Date Branch Manager Name: Name of the Bank --------------------------------------------------------------------------------------------------------------------- Customer copy: Received form Mr/Ms/M/s... (Name & Address) an application dated.. for corrective action plan under revival & rehabilitation of MSMEs. Date Branch Manager Name: Name of the Bank Please Note that: 1. This is only an acknowledgement for having received the application and this should not be construed as an indication of our acceptance of the proposal, a decision on which will be taken only after due consideration of the proposal on its merit and / or on fulfilment of conditions if any, that may be stipulated by the Bank. 2. The application will be taken up for consideration only after all the particulars / data / documents as may be required are received by the Bank. 3. The application will be disposed of within days from the date of receipt of all the details /papers/documents /clarifications sought by the Bank. 4. In case the proposal is rejected/not considered the reasons for the same will be intimated to the applicant.