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. 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.

2 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.: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.

3 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, 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.

4 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: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.

5 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 . 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.

6 , 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 , on Expansion /diversification and after Expansion / diversification % increase of fixedassets due to Expansion / capacity / Turnover (both in terms of units and value in Rs.) before expansion/ diversification, after expansion / diversificationand % increase of production capacity / Turnover due to expansion :All Original documents should be produced for verification and return atthe time of inspection.

7 If the originals are in the bank, the copies shouldbe duly attested by the Branch Manager of the bank which financed ACCOUNTANT CERTIFICATEThis to certify that madethe following fixed CAPITAL investment for their new enterprise / expansion /Diversification Project of their existing enterprise and commenced of commercialproduction of their new enterprise / expansion/ Diversification Project of theirexisting enterprise onExpansion/Nature of AssetsExisting UnitDiversificationTotal(or) New UnitProjectin Land2. Building3. Plant & Machinery*4. OthersTotal* Details to be enclosed separately in the Annexure to this hereby confirm that I/We have examined the prescribed registers,books of account and the bank statement in respect of the above fully understand that any submission made in this certificate if provedincorrect or false, will render me/us liable to face any penal action or otherconsequences as may be prescribed in the law or otherwise & Stamp/seal of the Signatory_____Name_____Membership address_____Name and address of the Institution where :Place:Signature of ApplicantSignature of Chartered Accountant95 ANNEXURE-BLIST PLANT AND MACHINERY INCLUDING INSTALLATIONS DETAILSAS ON THE DATE OF COMMENCEMENT OF COMMERICAL ofsuppBill ofDate ofthelier s&costportcost ofpaymenterecmachinerynameDateincluerecm achistampedtionandsivetionnery asreceiptcommismachineof & ofNo.

8 (5 & 6)themachinery123456789 Signature of ApplicantSignature of Chartered Accountant96 FORM-II AAPPLICATION FORM FOR ISSUE OF ELIGIBILITY CERTIFICATE FORLOW TENSION POWER TARIFF SUBSIDY TOMICRO, small AND medium manufacturing Details of of the of the Proprietor /Managing Partner /Managing of the Office :P I Location :P I Contact Nos. TelephoneOfficeFactoryCell Status Constitution of the Organisation (Pl. mark)ProprietaryPartnershipPvt. enterprise Status (Pl. mark) Details of Entrepreneurs (Part I) No. with dateNo.:Date: (Part I) No. with dateNo.:Date:Activity:6. Details of Power connection No. & Details:SanctionedConnectedLoadLoadPower Load Load of commencementof commercial productionDeclarationI / We declare that the particulars furnished are correct to the best of myknowledge. I / We agree to refund the SUBSIDY amount, if found inadmissible forany reasons at a later signatoryDate:Designation with sealList of enclosures of Entrepreneur Memorandum(s).

9 Of load SANCTION order from with copy of Meter BGOVERNMENT OF TAMIL NADUDEPARTMENT OF INDUSTRIES AND COMMERCEELIGIBILITY CERTIFICATE FOR LOW TENSION POWER TARIFF SUBSIDYTO micro , small AND medium manufacturing ENTERPRISESO ffice of the General Manager, District Industries Centre,Eligibility Certificate is to certify that a micro / small / medium manufacturing enterprise engaged in the activityof ..and is eligible for the grant of SUBSIDY on Low Tension Power of their Entrepreneurs (Part I) No.: (Part I) No.:Date:2. Details of Power connection No. & Details:SanctionedConnectedLoadLoadPower Load Load of commencementof commercial of receipt of LTPT SUBSIDY applicationwith Entrepreneur Memorandum (Part II) Eligibility at 20%FromToOffice Seal with DateGENERAL MANAGER(See Terms and Conditions over leaf)Terms and first claim for Power SUBSIDY should be submitted in Form C within 30days ( )

10 From the date of issue of this Eligibility Power SUBSIDY claims for the period from January to Juneshould be submitted on or before 31st August and that for the period fromJuly to December should be submitted on or before 28 th /29th February claims would not be SUBSIDY is restricted to the actual energy charges inclusive of surcharge,tax other charges but exclusive of above Eligibility Certificate is issued subject to the condition of availabilityof funds and policy change or order issued by the Government / IndustriesCommissioner and Director of Industries and Commerce from time to of SUBSIDY shall be subject to confirming the existence,functioning of the Enterprises at the time of disbursement and without anychange made in the constitution / management of the enterprise madeduring the eligibility Eligibility Certificate does not confer any right whatsoever and it issubject to the availability of funds allotted for the financial CAPPLICATION FOR GRANT OF POWER TARIFF SUBSIDY TO Details of of the of the Proprietor /Managing Partner /Managing Director of the :P I Location :P I SUBSIDY Eligibility Certificate No.