Application ID: (For office use)

APPLICATION FORM FOR FINANCIAL ASSISTANCE UNDER PRIME MINISTERS

EMPLOYMENT GENERATION PROGRAMME (PMEGP)
12 Name of the project / business activity proposed :

13 Amount of loan required (in Rs.)

Capital Expenditure Loan
Working
Building Type Workshed Machinery/ Pre
Capital /
Building Equipment/ Operative
Cash Credit Total
etc. Furniture Cost
Limit
Rented 0 784670 176104 190774 1151548
Details of earlier or current Loan/Grant and subsidy availed from
14 Central/State Govt. Scheme/ or any other Similar Scheme.
Activity of the Project with Address Amount Year of Sanction

I certify that all information furnished by me is true; and that I and any of my dependent have not
borrowed any money under subsidy linked scheme from any Central / State Government or bank for
establishing any such project

Place:
Date: Signature of the Applicant

For Official Use only: (Rejected / to be placed before District Task force Committee)
Reason (if Rejected):

Place: Signature, Name & Designation of Officer

Date:
 NOTE

Own contribution must be invested 5% for SC/ST/OBC/PHC/woman/ Ex-serviceman/ North

East Reason/Hill Boarder Area and 10% for General
Total Project Cost should not exceed 25 lakhs for Manufacturing unit and 10 lakhs for
service unit.
Applicant will not be entitled for additional Margin Money(Subsidy) in case of Own
Contribution over and above the prescribed limit.
VIIIth pass for Manufacturing Unit above Rs.10 lakhs project cost and under Service Sector
above Rs.5 lakhs
Application should be submitted complete in all respect along with attested copies of the
following documents:
1. Certificate of qualification-academic and technical (if project cost above 5 lakhs under
service industry or above 10 lakhs under Manufacturing industry)
2. Relevant Certificate for SC/ST/OBC/Minority/Ex-Servicemen/PHC
3. if Entrepreneur Development programme(EDP) training undergone (at least for two weeks)
then submit photocopy of the certificate
 DATA INPUT SHEET

Preference for sponsoring agency of the project to Bank: (mark )

KVIC KVIB DIC RURAL URBAN
1.1 Name of the Applicant/Institution
SUSHILA SHYAM GHORPADE
1.2
SHYAM GHORPADE
2 Gender Male Female
3 Address of the Proposed location of Unit: Rural Urban
KHUBEPHAL SHENDRA

Taluk/Block: AURANGABAD
District: AURANGABAD Pin: 431001
State: MAHARASTRA
Email: Mobile: 7743893280

4 Qualification
Academic Technical
10th Pass

5 Whether the applicant belongs to (mark )

Ex- Hill
SC ST OBC PHC Service Minority Boarder General
man Area

Manu-
Whether the

Service
6 facturing
Unit
project (mark ) Unit
8 Name of the project / business activity proposed :
SUNNY MFG.JHADU AND CANE

Legal Status:

Land 1000 ###

BUILDING DETAILS
Particulars Area Rate/Sq.ft Amount in Rs.
0.00
0.00
0.00
0.00
0.00
0.00
0.00

MACHINERY DETAILS
Particulars Qty. Rate Amount in Rs.
AUTOMATIC MACHINEY JHADU 2 150000.00 300000.00
OTHERS MACHINEY WITH MOTOR 5 HP 1 100000.00 100000.00
ALL JHADU MATERILAS 20 18500.00 370000.00 Male
0.00
0.00
0.00 KVIC
0.00
0.00 DIC
0.00
0.00
0.00 Rura
0.00

Total 770000.00 No

d. Preliminary & Pre-operative Cost : 130000.00 SC

e. Furniture & Fixtures : 14670.00

f. Contingency/Others/Miscellaneous 46104.00

Working Capital : 190774.00

 Manu

Means of Financing ###

Own Contribution : 5%
Bank Finance : 95%
Margin Money (Govt. Subsidy) : 35%

DETAILS OF SALES Own

Rate/ Qantity Amount in Rs.
Particulars of Products
Unit
485.00 3500 1697500.00
0.00
0.00
0.00
0.00
0.00
0.00

Total 1697500.00

RAW MATERIALS
Particulars Unit Rate/Unit Reqd. Unit Amount In Rs.
2500.00 150 375000.00
2500.00 95 237500.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Total 612500.00

WAGES
No. of Wages Per Month Amount in Rs.
Particulars
Worker Total Month 12
4 7500.00 360000.00
0.00
0.00
0.00
0.00
0.00
0.00
Total 4 360000.00

SALARY DETAILS
No. of Wages Per Month Amount in Rs.
Particulars
Staff Total Month 12
0.00
0.00
0.00
0.00
0.00
Total 0 0.00

WORKING CAPITAL ESTIMATE

Element of Working Capital No. of Days

Stock in process 5

Finished goods 3

Receivable by 2

POWER ESTIMATE
Power Requirement 6 HP

Repair and Maintanance 3.00% Rs. 50925.00

Power and Fuel 1.00% Rs. 16975.00

Other Overhead Expenses 2.00% Rs. 33950.00

Telephone Expenses 1.00% Rs. 16975.00

Stationery & Postage 3.00% Rs. 50925.00

Advertisement & Publicity 1.00% Rs. 16975.00

Building Rent Rs. 10000.00

Other Miscelleneous Expenditure Rs. 0.00

Rate of Interest 12.50%

Depreciation
On Building
On Machinery

INTRODUCTION

ABOUT THE PROMOTER

 PROJECT AT A GLANCE - TOP SHEET
1 Name of the Entreprenuer SUSHILA SHYAM GHORPADE

2 Constitution (legal Status) Individual

3 Father's/Spouce's Name SHYAM GHORPADE

4 Unit Address : KHUBEPHAL SHENDRA

Taluk/Block: AURANGABAD
District : AURANGABAD
Pin: 431001 State: MAHARASTRA
E-Mail :
Mobile 7743893280
5 Product and By Product

6 Cost of Project : Rs. 10,00,000

Name of the project / business SUNNY MFG.JHADU AND CANE
activity proposed :
7 Means of Finance
Term Loan Rs. 9,50,000.00
KVIC Margin Money Rs. 3,50,000.00
Own Capital Rs. 50000.00

8 Debt Service :
Coverage Ratio

9 Pay Back Period : 5 Years

10 Project : 0 Months
Implementation
Period

11 Break Even Point :

12 Employment : 4

13 Power Requirement : 6 HP

14 Major Raw materials : ,,

15 Estimated Annual : Rs. 1697500.00

Sales Turnover

PMEGP Project Report Page 10

 DETAILED PROJECT REPORT
1 INTRODUCTION :

2 ABOUT THE PROMOTER :

3 COST OF PROJECT
A. Fixed Capital Investment
a. Land : 1000 Own

b. Workshed Area Sq.ft Rate in Rs. Amt. In Rs.

0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
Total 0.00
#REF!
C. Machinery Qty. Rate Amount in Rs.
ALL JHADU MATERILAS 2 150000.00 300000.00
OTHERS MACHINEY WITH MOTOR 5 HP 1 100000.00 100000.00
#REF! 20 18500.00 370000.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
Total 770000.00

PMEGP Project Report Page 11

 d. Preliminary & Pre-operative Cost : Rs. 130000.00

e. Furniture & Fixtures : Rs. 14670.00

f. Contingency/Others/Miscellaneous Rs. 46104.00

Total Capital Expenditure : Rs. 960774.00

Working Capital : Rs. 39226.00

Total Cost Project : Rs. 1000000.00

3.1 Means of Financing :

Own Contribution 5% Rs. 50000.00

Bank Finance : 95%

Term Loan Rs. 912735.00
Working Capital Rs. 37265.00

Total Rs. 950000.00

Margin Money (Govt. Subsidy) From KVIC 35% Rs. 350000.00

Margin Money Subsidy received From KVIC will be kept in term deposit as per norms of
PMEGP in the name of Beneficiary for three years in the financing branch.

3.2 STATEMENT SHOWING THE REPAYMENT OF TERM LOAN & WORKING CAPITAL :
TERM LOAN

Interest @
Year Opening Balance Installment Closing Balance
12.50%
1st 912735 0 912735 114092
2nd 912735 182547 730188 114092
3rd 730188 182547 547641 91274
4th 547641 182547 365094 68455
5th 365094 182547 182547 45637
6th 182547 182547 0 22818
7th 0 0 0 0
8th 0 0 0 0

WORKING CAPITAL

Interest @
Year Opening Balance Installment Closing Balance
12.50%
1st 37265 0 37265 4658
2nd 37265 7453 29812 4658
3rd 29812 7453 22359 3727
4th 22359 7453 14906 2795
5th 14906 7453 7453 1863
6th 7453 7453 0 932
7th 0 0 0 0
8th 0 0 0 0

PMEGP Project Report Page 12

3.3 STATEMENT SHOWING THE DEPRECIATION ON FIXED ASSETS:
WORKSHED @ 0.00%
Particulars 1st Year 2nd Year 3rd Year 4th Year 5th Year
Opening Balance 0 0 0 0 0
Depreciation 0 0 0 0 0
Closing Balance 0 0 0 0 0
MACHINERY @ 0.00%
Opening Balance 770000 770000 770000 770000 770000
Depreciation 0 0 0 0 0
Closing Balance 770000 770000 770000 770000 770000
TOTAL DEPRECIATION
Workshed 0 0 0 0 0
Machinery 0 0 0 0 0
Total 0 0 0 0 0

4 Schedule of Sales Realization :

4.1 Details of Sales
Rate/ No. of Amount in Rs.
Particulars of Product Pair/Unit Pair/Unit
0
0 485.00 3500 1697500.00
0 0.00 0 0.00
0 0.00 0 0.00
0 0.00 0 0.00
0 0.00 0 0.00
0 0.00 0 0.00
0 0.00 0 0.00
Total 1697500.00

4.2 Capacity Utilization of Sales

Particulars 1st Year 2nd Year 3rd Year 4th Year 5th Year

Capacity Utilization 70% 80% 90% 90% 90%

Sales / Receipts 1188250 1358000 1527750 1527750 1527750

5 Rawmaterials :
Particulars Unit Rate/unit Reqd.Unit Amount in Rs.
0 0 2500.00 150 375000.00
0 0 2500.00 95 237500.00
0 0 0.00 0 0.00
0 0 0.00 0 0.00
0 0 0.00 0 0.00
0 0 0.00 0 0.00
0 0 0.00 0 0.00
0 0 0.00 0 0.00
0 0 0.00 0 0.00
Total 612500.00
5.1 Wages :
No. of Wages Amount in Rs.
Particulars Worker Per Month (Per Annum)
0 4 7500.00 360000.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
Total 4 360000.00

PMEGP Project Report Page 13

5.2 Repairs and Maintenance : Rs. 50925.00

PMEGP Project Report Page 14

5.3 Power and Fuel : Rs. 16975.00

5.4 Other Overhead Expenses : Rs. 33950.00

6 Administrative Expenses :
6.1 Salary
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0.00 0.00
0 0.00 0.00
Total 0 0.00

6.2 Telephone Expenses 16975.00

6.4 Stationery & Postage 50925.00

6.5 Advertisement & Publicity 16975.00

6.6 Workshed Rent 120000.00

6.7 Other Miscellaneous Expenses 0.00

Total 204875.00
7 Capacity Utilization of Manufacturing & Administrative Expenses :
Particulars 1st Year 2nd Year 3rd Year 4th Year 5th Year
Capacity Utilization 70% 80% 90% 90% 90%
Manufacturing Expenses
Rawmaterials 428750 490000 551250 551250 551250
Wages 252000 288000 324000 324000 324000
Repairs & Maintenance 35648 40740 45833 45833 45833
Power & Fuel 11883 13580 15278 15278 15278
Other Overhead Expenses 23765 27160 30555 30555 30555
Administrative Expenses
Salary 0 0 0 0 0
Postage Telephone Expenses 11883 13580 15278 15278 15278
Stationery & Postage 35648 40740 45833 45833 45833
Advertisement & Publicity 11883 13580 15278 15278 15278
Workshed Rent 120000 120000 120000 120000 120000
Other Miscellaneous Expenses 0 0 0 0 0
Total: 931458 1047380 1163303 1163303 1163303
8 Assessment of Working Capital :
Particulars Amount in Rs.
Sale 1697500.00

Manufacturing Expenses
Raw Material 612500.00
Wages 360000.00
Repair & Maintenance 50925.00
Power & Fuel 16975.00
Other Overhead Expenses 33950.00

Production Cost 1074350.00

Administrative Cost 204875.00
Manufacturing Cost 1279225.00

PMEGP Project Report Page 15

 Working Capital Estimate :
Element of Working Capital No of Days Basis Amount in Rs.
0 0 Material Cost 0.00

Stock in process 5 Production Cost 17906.00

Finished goods 3 Manufacturing Cost 12792.00

Receivable by 2 Manufacturing Cost 8528.00

Total Working Capital Requirement Per Cycle 39226.00

9 Financial Analysis
9.1 Projected Profit & Loss Account :
Particulars 0 Year 1st Year 2nd Year 3rd Year 4th Year
Sales / Receipts 1188250 1358000 1527750 1527750
1188250 1358000 1527750 1527750
Manufacturing Expenses
Rawmaterials 428750 490000 551250 551250
Wages 252000 288000 324000 324000
Repairs & Maintenance 35648 40740 45833 45833
Power & Fuel 11883 13580 15278 15278
Other Overhead Expenses 23765 27160 30555 30555
Depreciation 0 0 0 0
Production Cost 752045 859480 966915 966915
Administrative Expenses
Salary 0 0 0 0
Postage Telephone Expenses 11883 13580 15278 15278
Stationery & Postage 35648 40740 45833 45833
Advertisement & Publicity 11883 13580 15278 15278
Workshed Rent 120000 120000 120000 120000
Other Miscellaneous Expenses 0 0 0 0
Administrative Cost 179413 187900 196388 196388
Interest on Bank credit @ 12.5%
Term Loan 114092 114092 91274 68455
Working Capital Loan 4658 4658 3727 2795
Cost of Sale 1050208 1166130 1258303 1234553
Net Profit Before Tax 138043 191870 269448 293198
Less Tax 0.00 0.00 0.00 0.00
Net Profit 138043 191870 269448 293198

9.2 CALCULATION OF DEBT SERVICE CREDIT RATIO (D.S.C.R) :

Particulars 0 Year 1st Year 2nd Year 3rd Year 4th Year
Net Profit 138043 191870 269448 293198
Add :
Depreciation 0 0 0 0
TOTAL - A 138043 191870 269448 293198
Payments :
On Term Loan :
Interest 114092 114092 91274 68455
Installment 0 182547 182547 182547
On Working Capital
Interest 4658 4658 3727 2795
TOTAL - B 118750 301297 277547 253797
D.S.C.R = A/B
1.16 0.64 0.97 1.16
Average D.S.C.R

PMEGP Project Report Page 16

9.3 PROJECTED BALANCE SHEET :
Particulars 0 Year 1st Year 2nd Year 3rd Year 4th Year
LIABILITIES :
Promoters Capital 50000 50000 50000 50000
Profit 138043 191870 269448 293198
Term Loan 912735 912735 730188 547641
Working Capital Loan 37265 37265 29812 22359
Current Liabilities 0 0 0 0
Sundry Creditors 0 0 0 0
1138043 1191870 1079448 913198
ASSETS :
Gross Fixed Assets : 784670 784670 784670 784670
Less : Depreciation 0 0 0 0
Net Fixed Assets 784670 784670 784670 784670
Preliminary & Pre-Op. Expenses 130000 97500 73125 54844
Current Assets 37265 37265 29812 22359
Cash in Bank/Hand 316108 369935 264966 106169
Total 1138043 1191870 1079448 913198

9.4 CASH FLOW STATEMENT :

Particulars 0 Year 1st Year 2nd Year 3rd Year 4th Year
Net Profit 138043 191870 269448 293198
Add : Depreciation 0 0 0 0
Term Loan 912735 912735 730188 547641
Working Capital Loan 37265 37265 29812 22359
Promoters Capital 50000 0 0 0
Total 1138043 1141870 1029448 863198

Total Fixed Capital Invested 960774

Repayment of Term Loan 0 182547 182547 182547

Repayment of WC Loan 0 7453 7453 7453
Current Assets 37265 37265 29812 22359
Total 37265 227265 219812 212359

Opening Balance 0 1100778 2015383 2825018

Surplus 1100778 914605 809636 650839
Closing Balance 1100778 2015383 2825018 3475857

9.5 BREAK EVEN POINT AND RATIO ANALYSIS :

Particulars 0 Year 1st Year 2nd Year 3rd Year 4th Year
Fixed Cost 293504 301992 287661 264843
Variable Cost 756703 864138 970642 969710
Total Cost 1050208 1166130 1258303 1234553

Sales 1188250 1358000 1527750 1527750

Contribution (Sales-VC) 431547 493862 557109 558040

B.E.P in % 68.01% 61.15% 51.63% 47.46%

Break Even Sales in Rs. 808155 830404 788848 725061

Break Even Units 1666 1712 1626 1495

Current Ratio 0.31 0.12 0.10 0.09

PMEGP Project Report Page 17

 Net Profit Ratio 11.62% 14.13% 17.64% 19.19%

PMEGP Project Report Page 18

 This Project Report has been prepared based on the data furnished by the entrepreneur whose details are
given in the application.
Place :
Date:
Prepared by :
Full Name : SUSHILA SHYAM GHORPADE

Signature of the Beneficiary

PMEGP Project Report Page 19

 PROJECT REPORT FOR

Affix latest
attested
Photograph

1 Name of the Entreprenuer SUSHILA SHYAM GHORPADE

1
2 Constitution (legal Status) Individual

3 Father's/Spouce's Name #REF!

5 Unit Address : KHUBEPHAL SHENDRA

0
Taluk/Block: AURANGABAD

District : AURANGABAD
Pin: 431001 State: #REF!
Phone #REF!
E-Mail #REF!

6 Background of the Proprietor/Partners/Directors : Furnished detailed information in the DPR

7 Name of Business House/Group if any :

8 Details Other Companies/Units in the group :

Other Companies / Units in the Group (Rs. in Lakhs)
Name & Address Business Equity Reserves Loans Turnover *P.B.T **P.A.T
of Company / Unit

* Profit Before Tax ** Profit After Tax

`

8.1 How the activity was financed so far : ( To be filled up in case of existining unit Only )
*Source of Funds Security Rate of Repayment per Present O/s Amount of Default
Interest Month ( Rs. in '000 ) (if any)

8.2 If the Unit is an ancillary one, undertaking to

which it is catering and its address :
8.3 Employment : Present Proposed
0 4
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
Total 4

9 Project Details for Proposed New Unit : Copy of detailed project report is enclosed.
a Expansion / Mordenisation :

b Setting up of New unit :

c Activity for proposed new unit :

d Product / Item proposed to undertake :

9.1 Capacity (Furnish the details of Installed capacity & production : (No. in Units/ Qty. in Kg./Volume in liter per annum)
Capacity is arrived at on the basis of Days working on shift basis
Product & Present Installed Maximum Prod. Proposed Installed Maximum Prod.
By-product if any Capacity Achieved Capacity of 1st Year envisaged
70.00% 752045

9.3 State the manufacturing process in brief :

9.4 Has the proposed process ever been tried in the
country or newly adopted? :

9.5 Technical Arrangements :

9.6 Describe arrangement for Key Official

for managing the proposed unit :
Technical Manpower

Administrative Manpower

Accounting personnel

9.7 Particulars of Land Existing Proposed

Location of the Land :
Area of Land
Status of the Land
Nature of Land
Availability of Water :

9.8 Particulars of Building Existing Proposed

(Enclose the plan & Estimation for the proposed Building) Area Value in Rs. Status Area Value Status
Factory Building :

Ancillary Building

Storage

Total 0.00 0.00

9.9 Plant and Machinery Existing (Value in Rs.) Proposed (Value in Rs.)
Indigenous 770000.00

Imported

(Enclose the plan layout of the existing plant and machinery )

9.10 Rawmaterials / Components
Req. of Raw material/Components/Chemicals Qty. in Nos./Kgs./Ton Rate/Nos./Kgs/Tons Value in Rs.

Total 0.00

9.11 Utilities (Furnish details on requirement, availability, adequacy, qualitative aspects etc..)
Particulars of Utilities Contracted Load Connected Load Further requirement
in HP/KW/W in HP/KW/W in HP/KW/W
Power

Water

Fuel

Others (Specify)
9.12 Environment Aspect of the Project :

9.13 Requirement of Manpower for the Project :

Particulars of Manpower Total Requirement Salary/Wages per month Cost per Annum
0 4 7500.00 360000.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
0 0 0.00 0.00
Total 4 360000.00

9.14 Schedule of Implementation : BAR CHART

Activities Date of Commencement Expected Date of Completion
a. Acquisition of Land
b. Development of Land
c. Civil Works for Factory / Building
Machinery / Foundation etc..
d. Plant & Machinery
Imported
Indigenous
e. Arrangement for power
f. Arrangement for water
g. Errection of equipment
h. Commissioning
I. Procurement of Raw materials/Chemicals
j. Trail Runs
k. Commercial Production
10 Cost of Project :
(Rs. in '000)
Sr.No. Particulars Already Incurred To be Incurred Total Cost
A Land including Development 0.00 0.00

B Building & Other Civil Works 0.00 0.00

C Plant and Machinery

1. Indigenous 770000.00 770000.00
2. Imported 0.00

D Furniture & Fixture 14670.00 14670.00

E Testing equipment 0.00

F Miscellaneous Fixed Assets 0.00

G Errection & Installation Charges 0.00

H Contingency 46104.00 46104.00

I Preliminary & Pre-Op. Cost 130000.00 130000.00

J Provision for
1. Buildings 0.00
2. Plant & Machinery 0.00
3. Other Fixed Assets 0.00

K Working Capital for one 39226.00 39226.00

Operating Cycle

L Total 0.00 1000000.00 1000000.00

 11 Means of Financing :
(Rs. in '000)
Sr.No. Particulars Amount already Amount Proposed Total
Raised to be Raised
A Equity / Promoters Contribution 50000.00 50000.00

B Reserves 0.00

C Term Loans 950000.00 950000.00

D Unsecured Loans and Deposits 0.00

(Indicate sources, roi, repayment etc)

E Deferred Payment 0.00

Arrangements including Suppliers credit

F Subsidy
Central Government 350000.00 350000.00
State Government 0.00

G Seed Capital 0.00

H Internal Cash Accruals 0.00

I Other Sources (Specify) 0.00

J Total 0.00 1000000.00 1000000.00

11.1 In case internal accruals are taken as

source of finance explain the basis of
estimation of internal accruals :

11.2 Indicate source from which expenditure

already incurred has been financed :

11.3 % of Promoters contribution of the :

total cost of project
 12 Marketing & Selling Arrangements of the Product :

13 Projected Profitability : Projected Profitability Statement given in the

Detailed Project Report.

14 Projected Cash flow Statement : Projected Cash flow Statement given in the
Detailed Project Report.

% of Cash Sales in Total Sales :

Period in which payment is received Days

in respect of Credit Sales

Average Credit Available on Purchase : Days

15 Working Capital Required for the : Rs. 39226.00

anticipated turnover

16 Repayment Programme : Detailed Repayment programme for Term loan and

Working capital loan have been given in the DPR.

17 Details of Securities to be Offered :

17.1 Primary ( Furnish details for term loan and : :

working capital loan separately )
17.2 Collateral, if any (Details) :

17.3 Details of Guarantor(s) :

1. Name
2. Residential Address :

3. Occupation :
4. Details of movable & immovable
properties owned by him /her/other
family members

5 Details of any other similar guarantees:

if any, given to other institutions

18 Government Consents :
(Give deatails of various licenses / consents required to be obtained from various authorities for the proposed project)

19 DECLARATION

I / We hereby declare that the information given herein before and the statements and other
papers enclosed are, to the best of our knowledge and belief, true and correct in all particulars

Date : 0 Signature of the Borrower

Place : 0 Name & Designation (In case of Regd. Inst.)
 Project Report on

Prepared By:
#REF!
Khadi & V.I. Commission
#REF!
#REF!
#REF! State: #REF!
e-Mail:
Ph. No.: Fax: