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)