APPLICATION FOR W CAPITAL /MARGIN MONEY NCDC

NATIONAL COOPERATIVE DEVELOPMENT CORPORATION

(M&I DIVISION)

Application for availing Working Capital Assistance/Margin money

A. GENERAL PARTICULARS

1.(i)Name of the Society & Address:
(ii)Telephone/Fax No.
2. Date of Registration:
3. Year of commencement of operation:
4. Area of operation:
5. Activities undertaken:
B. Financial Position
1. Membership & Share capital (as on 31.3.-------) (Rs. in lakhs)
____________________________________________________________________
Type of Members*                             Number                                    Paid up capital
____________________________________________________________________








___________________________________________________________________
Total:
____________________________________________________________________
* SC/ST/women members may be specified separately
2. Other Funds (as on 31.3. -------)
i) Reserves (excluding depreciation) :
ii) Undisbursed Profit :
iii) Others if any :
____________________________________________________________________
Total
____________________________________________________________________
3. Total Own funds (Item 1+2):
Page 1 of 13
4. Term Loans (as on 31.3.---- ) (Excluding cash credit limit etc).
____________________________________________________________________
Source         Amount    Purpose   Amount                Amount of                       Amount of
                    raised                       outstan-                overdue                            instalment
                                                       ding                    installment                       due during
                                                     as on                     if any                              current year
                                                      31.3.----
                                                      ______________________________________
                                                      Prin.         Int.           Prin.            Int.            Prin.          Int.
____________________________________________________________________
     (i)                (ii)             (iii)         (iv)          (v)            (vi)             (vii)              (viii)          (ix)
____________________________________________________________________
i. State Govt.
ii. Coop. Banks
iii. Commercial Banks
iv. Other, if any (Pl. specify)
__________________________________________________________________
Total:
__________________________________________________________________
5. Total Funds employed:
(as on 31.3.---- ) 3+4 (iv)
6. Investment in fixed assets, securities, share etc. (as on 31.3.----)
____________________________________________________________________
Type of investment                                                                                             Amount
          1                                                                                                                     2
____________________________________________________________________
i. Fixed assets, eg. land, building, furniture, plant and
achinery, transport vehicle(s).
ii. Investments in debentures, bonds, Govt. securities, etc.
of a long term nature.
iii. Investments in shares of other institutions.
iv. Any other investment of long term nature (Specify)
_______________________________________________________________
Total:
_______________________________________________________________


                                                                                                                                               Page 2 of 13
7. Accumulated losses, if any (As on 31.3.----)
8. Amount blocked in bad/                                                  Name of the                                  Amount
sticky accounts,if any:                                                              debtors
(Details may be given                                                             ______________________
in proforma enclosed at                                                                  1.
Page 8)                                                                                          2.
                                                                                                      3.
                                                                                                      4.
                                                                                                      5.
                                                                                                      6.
                                                                                                         ______________________
                                                                                                      Total:
                                                                                                         ______________________


Note: A detailed note on above accounts considered bad/sticky may be furnished indicating complete details like since when blocked, reasons, steps taken for recovery etc. (as per appendix-I)
9. Funds available for current business operations 5 - (6+7+8)
10. Working Results for past 3 years:                    * Please specify the year also.
____________________________________________________________________
1st year*                                    2nd year                                                     * 3rd year *
____________________________________________________________________
Gross        Cash      Net           Gross           Cash               Net             Gross          Cash            Net
Profit         Profit     Profit          Profit            profit             Profit           profit           profit           Profit
____________________________________________________________________






____________________________________________________________________

Note: Certified copies of Balance sheet, trading account & profit & loss account for past 3 years may be furnished along with Analysis of the Balance sheet in the enclosed format (Appendix-II)


C. AUDIT & MANAGEMENT
1. Indicate the year upto which statutory audit has been completed :
and audit report issued. If the audit is in arrears, reasons may be
indicated. A copy of the last audit report alongwith compliance
report may also be furnished.
2. Audit classification (Year-wise) for the Preceding 3 years.
3. Details of Board of Directors & tenure of the existing Board. :
4. Whether elected or nominated


                                                                                                                                     Page 3 of 13


5. If nominated, reasons for the same:
6. Date of Election/nomination:
7. No. of Directors:
8. Whether general body meeting is being held regularly?
If so, date of last 3 meetings:
9. Whether Chief Executive is on deputation or own employee?
10. Since when the present incumbent is in position?
D. Business operations and working capital.

1. LEVEL OF BUSINESS OPERATIONS:

                                                                                                                                   (Rs. in lakhs)
____________________________________________________________________
Type of business       Business Achievement             Business programme                 Likely rotation in
                                during last three years*             during next 2 years*                 each commodity
  ____________________________________________________________________                                  
                               1st year   2nd year    3rd year      1st year       2nd year
____________________________________________________________________
             1                    2            3                4                  5                 6                                       7
____________________________________________________________________


MARKETING
a)Commercial/own
i. Wheat
ii. Paddy
iii. Other foodgrains
iv. (including pulses)
v. Cotton
vi. Jute
vii. Other crops
viii. (Pl.specify)
b)PSS/MIS operations
i.
ii.
iii.
c)Consignment/Jt. Venture/commission basis
i.
ii.
iii.
DISTRIBUTION OF INPUTS
i. Fertilisers
ii. Seeds
iii. Pesticides/Insecticides
iv. Agril. implements



                                                                                                                                           Page 4 of 13
v. Other inputs (Cement, Iron
and Steel, Gunny bag etc.)
*Please specify the year also
DISTRIBUTION OF CONSUMERS GOODS
i. Levy sugar
ii. Non-levy sugar
iii. Controlled cloth
iv. Coal
v. Kerosene
vi. Other consumer goods
----------------------------------------------------------------------------------------------------------------
Sub Total:
----------------------------------------------------------------------------------------------------------------
INCOME FROM OTHER SOURCES (PL. SPECIFY)
i.
ii.
iii.
____________________________________________________________________________
Total:
____________________________________________________________________________
Note: In case of low achievement in business during last year, as against previous years, reason(s) for the same may be mentioned.


                                                                                                                                       Page 5 of 13


2. Anticipated month-wise stock position during next 2 years. *Please specify year also.
                   1st year*                                                                                                (Rs. in lakhs)
____________________________________________________________________________
Sl.           Commodity          April  May  June  July  Aug.  Sept. Oct.  Nov.  Dec . Jan.  Feb . March
No.
____________________________________________________________________________








___________________________________________________________________________
_

Total:
____________________________________________________________________________
                  2nd year*                                                                                        (Rs. in lakhs)
____________________________________________________________________________
Sl.            Commodity   April  May   June   July   Aug.  Sept.  Oct.  Nov.  Dec.  Jan.  Feb.  March
No.
____________________________________________________________________________







____________________________________________________________________________
Total:
____________________________________________________________________________




                                                                                                                                            Page 6 of 13


3. Working capital loan position (as on …………….)

_________________________________________________________________________________
S.No   .Source     Purpose          CC limit             Rate            CC       Margin stipulated              Amt. Out
                                                   sanctioned          of               limit            by                                standing
                                                                           interest        availed   Banks & n ature of
                                                                                                           security
      _________________________________________________________________________________                                                                   
  _________________________________________________________________________________                                   
  _________________________________________________________________________________
_________________________________________________________________________________   
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________



Note: Copies of the sanction letters from the Banks regarding cash credit limit approved may be enclosed.



4. Working Capital requirement as indicated in D(2)
5. Requrement of margin money (To be furnished in
case the proposal is for m.m. assistance)
                                                                                                                                     (Rs. in lakhs)
_________________________________________________________________________________
Sl.No.       Commodity               Peak level stock as                 Margin of                        Requirement of
                                                  indicated in D(2)                    security                            margin money
                                                                                                reqd. by
                                                                                                Banks
 _________________________________________________________________________________
1
2
3
4
5
6                                                    
_________________________________________________________________________________


6. Funds available for meeting the working capital requirement:
a) Funds available from within (as indicated at B(9) }
b) Funds available from outside sources
(as indicated at D(3) }
c) Additional share capital proposed to be raised }
7. Net requirement (4-6) of working capital
8. Net requirement of margin money (5-6)-(To be furnished in case proposal is for m.m.)
9. Assistance Proposed to be availed: for working capital / margin money



                                                                                                                                            Page 7 of 13



10. Whether proposed assistance approved by Board of Directors. If yes

i) Date of meeting:

ii) Resolution No.

(A copy of resolution may be enclosed)
11. Only in the case of direct funding proposal,
a) “No overdue certificate” is to be furnished as
Per proforma at Appendix-III.
b) Nature of securities proposed to be offered.
( Please specify clearly)
c) In case assets are proposed to be offered
As security, the details may be furnished in
Appendix-III.



   Date :                                                                                                            (Name and Signature of
   Place:                                                                                                               authorized signatory






                                                                                                                             (Seal of Socoety)



                                                                                                                                            Page 8 of 13

                                Appendix-I

Proforma for details of funds blocked as shown in col. B-8 of the application.


                                                                                                                                         (Rs. in lakhs)
_________________________________________________________________________________


S.NoParty/Item Amount Blocked Period uptoAction takenWhether re-In caseofbadComments of Remarks,
 if any

                                         since  which a/c       including      viewed by debts, whether S/Govt. reg
                                        when reconciled       statutory     competent action taken    settlement of
                                        (date/yr.) with the   for recovery  authority    for writing      dues pending                                                                                              

                                                      parties                         to declare  off such debts  with various                                                
                                                (PCMS etc.)                     it doubtful/  especially        deptts. of
                                                                                           bad        which are over  S/Govt.,if
                                                                                                         3 years               any.
   _________________________________________________________________________________
  1.         2.            3.         4.              5.                6.            7.                 8.                     9.             10.  
  _________________________________________________________________________________













                                                                                                                                            Page 9 of 13

                                                  Appendix-II

Analysis of the Balance Sheet

_________________________________________________________________________________

1. Summarized Profit & Loss Accounts of last 3 years. *Please specify the year also.
_________________________________________________________________________________

1.Business Turnover (Sales and
   other income)
_________________________________________________________________________________
2.Gross Profit before Intt
   Depreciation and tax.
_________________________________________________________________________________
3.Interest
_________________________________________________________________________________
4.Cash Profit(2-3)
_________________________________________________________________________________
5.Depreciation
_________________________________________________________________________________
6.Profit before tax (4-5)
_________________________________________________________________________________
7.Income Tax
_________________________________________________________________________________
8.Net Profit (6-7)
_________________________________________________________________________________
2. Summarized Balance Sheet of last 3 years. *Please specify the year also.
_________________________________________________________________________________

_________________________________________________________________________________
1.Gross Block
_________________________________________________________________________________
2.Depreciation
_________________________________________________________________________________
3.Net Block(1-2)
_________________________________________________________________________________
4.Work in Progress
_________________________________________________________________________________
5.Investments
_________________________________________________________________________________
6.Total Fixed assets
   (3+4+5)
_________________________________________________________________________________
7.Current Assets

i) Cash, Bank balance & deposits
ii) Inventory
Sundry debtors
iii) Loans, advances and
prepaid expenses
iv) Others, if any
_________________________________________________________________________________
8.Current Liabilities

1. Working capital loan
2. Sundry creditors
3. Interest payable
4. Short term loans
5. Other provisions and liabilities
_________________________________________________________________________________
9.Net Working Capital(7-8)
_________________________________________________________________________________
10.Long term loans & deposits
_________________________________________________________________________________
11.Paid up share capital
_________________________________________________________________________________
12.Reserves (excluding depreciation)
_________________________________________________________________________________
13.Un-distributed profits (+)/Accumulated Losses(-)
_________________________________________________________________________________
14.Net worth (11+12+13) or (6+9-10)
_________________________________________________________________________________
15.Net disposable resources
     (10+11+8+13-6)
    (For margin money calculations
_________________________________________________________________________________

          Page 10 of 13

2. Ratios

_________________________________________________________________________________
1.Debt Equity Ratio
   (10/(11+8+13)
_________________________________________________________________________________
2.Current Ratio (7/8)
_________________________________________________________________________________
3.Cash profit to Turnover Ratio(4/1)
_________________________________________________________________________________
4.Net Profit to Turnover Ratio (8/1)


_________________________________________________________________________________

   Enclosures to be appended:

- Copies of Audited Trading Accounts, P&L A/Cs. & Balance sheet for the last three years* (Tentative if not finalized) along with necessary schedules

- Detail of deposits, if any specifying the nature of deposit i.e. whether refundable, non-fundable, convertible. Rate of interest payable on these deposits.

- Details of reserve funds indicating depreciation reserves, reserved for doubtful debts etc.

- Details of long term loan, short-term loan, medium term loan indicating the name of lending agency and
whether these loans are secured or un-secured, the rate of interest on the loans.

+++++

Page 11 of 13

Appendix –III

Certificate regarding overdues of the society to NCDC and other institutions

1. This is to certify that___________________________(name of the society), as on date, is not in default in repayment of loans and payment of interest to NCDC and any financial institution/bank OR

        Position of default in repayment of dues by the society to NCDC and other institutions as on date is as follows:
_________________________________________________________________________________
Name of the     | Loan received  Principal   |                  Outstanding dues
Lending           |                           Paid       |
                        _____________________________________________________________________                          
Institution/Bank|  Date |    Amount              |       Principal                 |              Intt.           |            Total
____________|_____________________________________________________________________                                                                 
                        |                                        |  Overdue   |  Not yet due  |
____________|_____________________________________________________________________

_________________________________________________________________________________
_________________________________________________________________________________
  _________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________




2. It is also certified that other cooperatives on which Directors of our Board are Directors or associated with are not in default in repayment of loans and payment of interest to NCDC and any Financial Institution/Bank as on date. OR

Position of default in repayment of dues by the Cooperatives on which Directors of our Board are Directors or associated with is as follows:

Name of the Director
Name of defaulting Coop. Society
Nature of association of the Director with the defaulting society
Name of Financial Institution/
Bank
Amount of default
Reasons and period of default
(Chief Executive of the Society)
Place:
Date:
Note: Strike out which is not applicable.
Page 12 of 13
Page 13 of 13
Appendix-IV
4. Details of assets to be mortgaged (applicable in case of direct funding)
Description
Of Assets
Yr. Of
Acquisi-tion
Cost of
Acquisi-
tion
Deprecia-
tion
Book Value
Market
Value
Whether
Charged/mort-
gaged/free from
encumbrances
To Whom Mortgage
Against what
Amount of loan
i.
ii.
iii.
Total:

NATIONAL COOPERATIVE DEVELOPMENT CORPORATION
MARKETING SECTION
Application form for Availing Financial Assistance for
Strengthening Share Capital Base of PAMS / Providing Long Term Loan for Development of / Revitalisation of Business Activities
GENERAL
1) Name & Address of the Society	:
2) Date of Registration	:
3) Year of Commencement of Business	:
4) Area of Operation	:
5) Activities Undertaken	:
MEMBERSHIP & PAID-UP SHARE CAPITAL (last 2 yrs)						(Rs in lakhs)
Type of Membership		No. of Members		Paid-up S-capital
		2009-10	2010-11	2009-10	2010-11
i.    PACS		.
ii.   Other Coops:(Please specify)
v.   Individuals
vi.  State Govt.
vii.  Others
Total
MANAGEMENT OF SOCIETY
i.  Full time Manger	:	Yes /  No
ii. Manager	:	Trained/Untrained
iii. Own Employee/ Deputationist	:	Own  / Deputation
Board of Management	:	Elected / Nominated
Annual General Meeting Last Held on	:
BUSINESS OPERATIONS							(Rs in lakhs)
Particulars		ACTUAL BUSINESS			Target for 2 years		Till date achievement in 2011-12
		2008-09	2009-10	2010-11	2011-12	2011-12
i.  Marketing of Agriculture Produce
a. As Agent of Farmers
b. Under Price Support Operation
c. Outright Purchase
Sub-Total (i)
ii. Distribution of Agriculture Inputs
a. Fertilizer
b. Others Inputs
Sub-Total (ii)
ii. Distribution of Consumer Goods
a. PDS
b. Non-PDS
Sub-Total (iii)
Grand Total (i)+(ii)+(iii)
Main Crops of the Area, Quantities Handled by the Society during last year
Name of the Crop	Total Qty. produced in the area		Market Value	Crop Handled by the Society
				Quantity		Value
i. __________________________
ii. ______________________
iii. _________________________
iv.
Total
FINANCIAL PERFORMANCE / POSITION
Amount of Assistance received earlier from NCDC for
a. Marketing		Year	Amt. (Rs in lakhs)
b. Processing
c. Storage
d. Consumer Distribution
e. Others, if any
Total
					(Rs in lakhs)
i) Reserve & Other Funds           (as on 31-3-2011)
ii) Out of Reserve & Other Funds, how much available for business
Net Profit (+) / Loss(-) during             (Rs in lakhs)		2008-09	2009-10	2010-11
Accumulated Profit (+) / Loss (-) as on 31.3.2011
Audit Completed Up-to	:			Classification:
Amount of Assistance Proposed
				Signature
				MD / Secretary of the Society
				Dated:
		Certified that the information furnished in the proforma is correct
				AR /Jt. RCS
Please enclose: Copies of latest audited trading P&L A/C Balance Sheet and the tentative Account for the Years 2008-09 & 2009-10 & 2010-11
Name of the Society : (Rs in lakhs) SN PARTICULARS Years                    (Rs in lakhs)          2008-09 2009-10 2010-11 I. Summary of Balance Sheet Summary of P&L Account   1 Business Turnover       2 Profit before intt., depre. & Tax        3 Interest       4 Cash Profit (2-3)       5 Depreciation       6 Profit before tax (4-5)       7 Income Tax       8 Net Profit       II. Summary of Balance Sheet         1 Gross Block       2 Depreciation       3 Net Block (1-2)       4 Work-in-progress       5 Investments       6 Total Fixed Assets(3+4+5)       7 Current Assests       a) Cash, Bank balance, deposit       b) Inventory       c) Sundry Debtors       d) Loans/Advances/Pre-paid Exp.       e) Interest Receivable       f) Others       Total Current Assets       8 Current Liability       a) Working Capital Loan/Deposit       b) Sundry Creditors       c) Interest Payable       d) Short term loans       e) Other provisions/liablities       Total Current Liabilities       9 Net Working Capital(7-8)       10 Long term loan & deposits       11 Paid up Share Capital       12 Reserves(excluding depreciation)       13 Undistributed Profit/Acc. Loss       14 Networth(11+12+13) or (6+9-10)       15 N.D.R (10+11+12+13-6)(for M-M)