APPLICATION FOR SANCTION OF CAPITAL SUBSIDY FOR …

1 87 FORM-IAPPLICATION FOR SANCTION OF CAPITAL SUBSIDY FORMICRO, small AND medium ( manufacturing ) ENTERPRISESS pecify the name of the SUBSIDY applied for (Pl. mark) CAPITAL SUBSIDY for Thrust Sector Intensive CAPITAL SUBSIDY for Select Category of CAPITAL SUBSIDY for Promotion of Cleaner andEnvironment Friendly of of the of the Proprietor /Managing Partner /Managing of the :P I :P I Location of the Name of If located in Industrial Estate i.

2 Name of the Industrial Estate ii. Whether Co- Name of of Name of Contact Nos TelephoneOfficeFactoryCell Status of the enterprise : (Pl. mark) ConstitutionProprietaryPartnershipPvt. enterprise Whether New/ Expansion/ Social Status of the EntrepreneurWomenSC/STPhysically If Women/ SC, ST /Physically disabled / Transgender please indicate %Share of the Partner(s) / Director(s) in the equity:Name of Partners Details of Entrepreneurs Memorandum (Part II) (Part II) No: as specified in the Entrepreneurs Memorandum (Part II) Project Line of capacity /StatusItems ManufacturedTurnoverin unitsValue in Rs.

3 New /Existing Unit Expansion/ Diversification Project % of capacity increase proposed under Expansion / Diversification Fixed CAPITAL Investment(in Rs.)% of increaseExpansion/underNature of AssetsExisting UnitDiversificationTotalExpansion/Projec tDiversificationProjectLandBuildingPlant & Means of finance (in Rs.) from Promoters/ Details of Term loan sanctioned and availed:a. Name of the Bank/Financial Institution:b. Type of Loan:c. loan SANCTION No. and date:d. Term loan Sanctioned in Rs.

4 :e. Term loan released in Rs.:f. Rate of Interest %:8. Details of Power connection No. & Details:SanctionedConnectedLoadLoadPower Load Load Employment created / likely to be createdMenWomenTotal i)Managerial :ii)Supervisory / Technicaliii)Workersa)Skilledb)Semi-skil ledc)UnskilledTotal10. Details of Registration with Commercial Tax Department with Number and Registration Number and of commencementof commercial of first sale invoice raisedor date of first delivery Challan(in case of enterprises manufacturingon job work basis) Give Invoice/delivery Challan Number & of SUBSIDY claimed in Rs.

5 And Machinery SUBSIDY / Special CAPITAL SUBSIDY @ 15% ofPlant and Machinery (Maximum Rs. 30 lakhs) Intensive SUBSIDY @ 5% ofPlant and Machinery value (Maximum Rs. 5 lakhs) CAPITAL SUBSIDY for Select Category ofEntrepreneurs 5% (Maximum Rs. 2 lakhs) CAPITAL SUBSIDY on @ 25% on the vale ofPlant and Machinery installed to promote cleanerand environment friendly technologies(Maximum Rs. 3 lakhs)Total SUBSIDY claimed *Rs.(* This should not exceed Lakh per enterprise )DeclarationI / We hereby declare that all the information given above and the statementsand other documents enclosed are to the best of our knowledge and belief, trueand / We hereby agree that.

6 I / We shall forthwith repay the CAPITAL SUBSIDY / Special CAPITAL SUBSIDY for Thrust sector enterprises / Employment IntensiveSubsidy / Additional CAPITAL SUBSIDY for select category of entrepreneurs /Additional CAPITAL SUBSIDY for promotion of Cleaner and Environment friendlytechnologies disbursed to the unit, if the amount of SUBSIDY is found to have beendisbursed in excess of the amount actually admissible for whatever reason. Furtherwe also shall be liable to pay interest at such rate as prescribed by the Governmentfrom time to time on such amounts and such other changes / expenses whichmay be repayable by is further certified that I / we have not hitherto applied for or have receivedany amount by way of grant / SUBSIDY in respect of this enterprise fromGovernment / Financial :Authorized signatoryDate.

7 Designation with seal92 List of Documents to be submitted along with SUBSIDY of Entrepreneur Memorandum (Part I) and (Part II). of Partnership Deed, If Partnership Concern; in case Limited Companycopy of Memorandum and Articles of Association duly signed by the the enterprise is functioning in its own land, copy of land purchase deedduly signed by the the enterprise is functioning in a leased land/ building, copy of leaseagreement deed executed in stamp paper of , for a minimum periodof 5 years from the date of commencement of commercial production.

8 From Block Development Officer regarding the block/ area inwhich the enterprise is of Loan SANCTION letter from the Bank / Financial Institution in respectBank / Institutional financed of SANCTION order from for power supply with copy of of the invoices, cash bills and stamped receipt duly attested. In case ofnon-availability of receipts, the bank scroll which shows the payment, withthe details of the machinery supplier, should be furnished, in original, withthe attestation of the Bank of Chartered Accountant for fixed assets created as on date ofcommencement of commercial production in the prescribed form(Annexure-A) of commencement of commercial production duly signed byChartered Accountant.

9 Self fabricated Plant and Machinery Engineer s Certificate for the value of the plant and Accountant Certificate for the expenses incurred for thepurchase of Plant and machinery to be of the invoices, cash bills , job work bills and stamped receipt of the first sale invoice raised after commencement of CommercialProduction or copy of first delivery challan ,in case of enterprisesmanufacturing on job work documents for to be submitted in respect of enterprises applyingfor Employment Intensive SUBSIDY /Additional CAPITAL SUBSIDY for SelectCategory of Entrepreneurs & for Promotion of Cleaner and EnvironmentFriendly declaration for having employed more than 25 workers with copy ofreturns to Labour Department / Inspector of Factories Department etc.

10 , status Certificate from authorities concerned in respect ofselect category of entrepreneurs like SC/ST / Physically Handicapped /Transgender etc, from Tamil Nadu Pollution Control Board regarding promotion of Cleanerand Environment friendly technologies in the documents in respect of existing enterprises taking upexpansion / from Chartered Accountant on the of commencement of commercial production after production turnover for the last 3 years before the date ofcommencement commercial production under expansion/ of fixed assets before Expansion/diversification.