APPLICATION FORM
Cooperatives
under Consumer Scheme
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Regional Office, 5th Floor, Co-Bank Towers , Palayam,
Trivandrum
Email -
RO.TVM@ncdc.in
Annexe- 1(A)
PROFORMA APPLICATION
Application form for availing NCDC’s financial assistance by societies for undertaking Marketing of
Consumer Goods under NCDC Sponsored Consumer Scheme
General Information
1. Name
of the Society
2. Postal
address with PIN code and Telephone No with STD Code
3. Area
of operation (in terms of number of villages/Taluk/Block/District
4. Total
population in the area of operation
5. Membership
& share capital (as on 31st March, )
-------------------------------------------------------------------------------------------------------------------------------
S.No. Type of Member Number Paid-up Share capital (Rs.)
--------------------------------------------------------------------------------------------------------------------------------i) Individual
a)
SC
b)
ST
c)
Women
d)
Other
ii) Cooperative Societies
iii) State Government
iv) Other (pl. specify)
Total
6.
(a) Whether Society is already dealing in
distribution of consumer articles in area ?
Yes/No
If yes, since when _________________
(b)
What are the other activities of the society (please specify)
7. Business operations in consumer
distribution
(Rs. in lakhs)
-------------------------------------------------------------------------------------------------------------------------------
Year Total
Retail
Wholesale
Business Business Business
-------------------------------------------------------------
PDS Non-PDS PDS Non-PDS
----------------------------------------------------------------------------------------------------------------------------------
I . Actuals
2008-09
2009-10
2010-11
II. Target (for next two years)
2011-12
2012-13
8 (a)
Indicate type of consumer articles dealt by society with percentage
share of
Major items in the total business during the last year.
(b) New items proposed to be added.
9.
Indicate amount of assistance received under NCDC Rural Consumer Scheme
(Rs.
in lakhs)
-------------------------------------------------------------------------------------------------------------------------------
Year Activity for which date Amount
of Assistance
repaid
Assistance availed assistance (loan) (upto ------)
-----------------------------------------------
Share Loan Subsidy
Capital
----------------------------------------------------------------------------------------------------------------------------------
i)
Margin money
ii)
F&F
iii)
Transport Vehicles
10. Credit limits sanctioned /Availed/Applied
during last two years & applied during current year
i.e. year of application (for Consumer
business only).
-----------------------------------------------------------------------------------------------------------------------------------
Sl.No. Name of Bank Year Credit limit Credit limit
Sanctioned
availed
-----------------------------------------------------------------------------------------------------------------------------------
11. Profit (+)/loss (-) position for last
three years (Rs.
in lakhs)
Year Profit(+)/Loss(-)
Cumulative position at the
During
the year in
end of year
-----------------------------------------
PDS Non-PDS Total
------------------
---------------------------------------- -------------------------------------------
( If society is in loss
indicate reasons for losses.)
12. a)
Own funds as on 31-3- (indicate latest
position)
i)
Share capital
ii)
Reserve & other funds
iii)
Undistributed profits, if any
iv)
(-) Accumulated losses, if any
----------------
Total
----------------
b)
i) Fixed assets
ii)
Long term investments
a)
Investment in shares of other coop.
b)
Fixed deposits
c)
Dead stock
d)
Govt. securities
e)
Others (Pl. specify)
-------------------------
Total
------------------------
c)
Details of the funds block, reason for the same and steps taken to
recover them:
13. Indicate year upto which audit completed
and audit classification
(Enclose last Audited balance sheet and
Audit Report and last year audited/Tentative balance sheet)
14. Whether the society has received any
assistance for distribution of consumer articles under ICDP
Scheme of NCDC ? If yes, please indicate assistance received
and date of completion of ICDP.
15. Whether the society has ever declared
dividend ?
If yes, indicate the details for
last three years
---------------------------------------------------------------------------------------------------------------------------------------
Year Percentage of Dividend Amount given as Amount given as
Declared
dividend to State Govt.
dividend to members
---------------------------------------------------------------------------------------------------------------------------------------
-
-
16. Amount of share capital refunded to State
Government during last three years
Year
Amount
refunded (Rs.)
-----------------
-------------------------------------
17. Board of Management :
i) Elected
_____________________
Election held on
_______________________
ii) Nominated
___________________
Nominated on
_________________________
iii) Date of last Annual General Body Meeting
held on ____________________________
Iv) Number of Board meetings
held during last year ______________________________
v)
Number of women in the Board of Management ___________________________
N.B. i)
For availing financial assistance under the scheme general information
should be filled-up by the society and then as per the requirement of the
financial assistance relevant information be furnished in the enclosed
proforma.
ii) The certificate and all enclosures as
indicated at the page 4 of the proforma should be
enclosed with proposal.
NCDC CONSUMER
SCHEME
Certified by the
Society/AR/DR of District to be enclosed with the proposal
Signature
Manager of the
Society
Seal of the Society
Certified
that the proforma has been scrutinized and is found to be correct.
Signature
of the Assistant/Dy. District Registrar of
Cooperative Societies of the concerned District
Seal
List of
enclosure(s) to be enclosed with the proposal:
1.
By-laws
of the Society
2.
Copy of resolution passed by Board of Directors
of the society regarding assistance
Proposed to be availed from NCDC.
3.
State
Government recommendation on the proposal of the society
4.
Latest Annual Report of the Society
5.
Copies of the Audited/Certified Balance Sheet of
last five years and Audited/Certified copies of the Trading Account and Profit
loss account for past three years.
6.
Copy of sanction of the credit limit from the
Bank.
Annex-I (B)
B. ASSISTANCE
FOR MARGIN MONEY (Rs. In lakhs)
I.
Total working
capital needed to achieve the target of consumer business:
II.
Already working
capital available from its own resources:
III.
Addition
working capital needed to achieve the target business:
IV.
Rotations
proposed (turnover):
V.
Margin money
needed for the purpose:
VI.
Indicate name of the financial institutions in
the area of operation agreed to provide working capital (credit) for consumer
activity and margin of security required :
(Please enclose Bank’s letter)
VII.
Margin money
assistance applied
____________________________
ANALYSIS OF THE BALANCE SHEET
I. Summarised Profit & Loss Accounts
of last 3 years
1.
Business
Turnover
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)
II. Summarised Balance Sheets of last 3
years
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
iii)
Sundry debtors
iv)
Loans, advance
and prepaid expenses.
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 loan
and deposits
11.
Paid up share
capital
12.
Reserve
(excluding depreciation)
13.
Un-distributed
profits (+)/Accumulated losses(-)
14.
Net worth (11 +
12 + 13) or (6 + 9 + 10)
15.
Net disposable
resources (10+11+12+13-6)
(for margin money)
III. Ratios :
1.
Debt-equity ratio (10)/(11+12+13)
2. Current ratio (7/8)
3.
Cash profit to turnover Ratio (4/1)
4.
Net profit to
turnover Ratio (8/1)
IV. Comment on financial statements, audit report
and status of audit.
Annex –
I (C)
C.
ASSISTANCE FOR FURNITURE AND FIXTURES
In case
society proposes to avail assistance towards purchase of furniture and
fixtures for retail outlets, the following information may be furnished.
1.No.
of retail outlets run by society (enclose list with Address)
2.Furnish information for the last three
years, business done by cash retail outlet separately alongwith profit(+)/loss(-) position and
also indicate projections for next two years as follows:
(Rs. In lakhs)
---------------------------------------------------------------------------------------------------
Name of the Consumer business
undertaken Profit(+)/
Retail outlet
-------------------------------------------------------------- loss(-)
Year PDS Non-PDS Total during the
Year
________________________________________________________________________
*
Actual
(year)
Projections
(Year)
*
For the last here year from the year of making loan application
3.
Whether society
proposes to open new branches, if yes, furnish following information
Business target
-------------------------------------------------------
Branch Distance
Population 1st
year 2nd year
Name from HO in the (Pl. specify) (pl. specify)
Area
-------------------------------------------------------
PDS Non-PDS Total
PDS Non-PDS Total
----------------------------------------------------------------------------------------------
4.
Furnish the
following details for the retail outlets to be furnished
---------------------------------------------------------------------------------------------
Branch Distance Population Shop to be Estimated Remarks
Name from in the constructed expenditure
H.O. area on own land for purchase
or taken on of F & F
rent (itemwise)
i)
Existing
----------
----------
ii) New
------------
-------------
5.
(a) Total assistance required for
furniture & fixtures
NB : Out
of the above cost 75% will be made available to society as loan, so society
should ensure that it is in position to repay the same alongwith interest by
generating enough surplus from its increase volume of sales of consumer goods
before applying assistance under this head.
* Minimum three quotation to be obtained from
supplier/manufacturer
D. ASSISTANCE
FOR TRANSPORT VEHICLES
If the society proposes to avail
assistance for purchase of vehicles, the following information may be furnished
:-
1. Whether society is already having any
transport vehicles, if so, following
details may be furnished:-
i)
Details of vehicles :-
---------------------------------------------------------------------------------------------------
Type of vehicle No Date of purchase Please indicate
and cost source of
finance
a. Operations of (own) vehicles :
---------------------------------------------------------------------------------------------------
Year No. of vehicles No. of days in operation Type of goods
In operation -------------------------------------- transported
Socy’s own Given on hiring
Use to others
2008-09
2009-10
2010-11
2.
Whether vehicle owned by society need replacement ? If need
replacement give reasons and indicate maintenance cost/other
expense
incurred during last three years.
3.
If additional transport vehicles are used on hire basis please indicate
the
Transport (hire) charges paid by the
society during last 3 years.
Year Distance covered Rate of hire Hire charges paid
(Kms.) charges (Per km.) (Rs.)
2008-09
2009-10
2010-11
4. Details of vehicle(s)/proposed to be
purchased :
No. & Type Capacity of Estimate total Expected
delivery
of vehicle vehicle cost of the vehicle time from booking
on road (cost of
chasis and body
building)
---------------------------------------------------------------------------------------------------
5.
Please give justification for vehicle and its
viability viz-a-viz hired
transport in the enclosed format “0”
6.
Total cost of the vehicle(s) on
road
(Enclose quotation from the authorised dealer)
NB : Out
of the above cost 75% will be made available to society as loan, so society
should ensure that it will be in a position to repay the same alongwith
interest by generating enough surplus from its business operation before
applying the assistance under this head.
FORMAT FOR WORKING OUT ECONOMIS OF TRANSPORT
VEHICLES
1. Name of the Society
i)
Capacity of vehicle :
ii) Cost
of vehicle :
iii) Cost
of body building :
iv)
Cost of vehicle on road :
v) Make
of vehicle :
vi)
Distance to be covered during :
the year (average
Kms. X No.
of days
vii) Rupees tonne/per Km. average :
charges for hiring pvt.
Vehicle in
the area of operation of the
society
for consumer goods transportation
A
Expenditure to be incurred on vehicle
i) Fuel
charges :
ii) Depreciation on vehicle @
10% :
of total cost
iii) Repairs and
maintenance :
iv) Road Tax :
v) Salary of driver and cleaner and
insurance 1% of the total cost of
:
the
vehicle
vi) Interest on loan :
B. Savings
i) Charges for hiring vehicle :
C.
Estimated Profit (B-A)
(Savings –
Expenditure) :
ASSISTANCE FOR OPENING/RENOVATION/CONSTRUCTION OF
SHOWROOMS/GODOWNS/SHOWROOM-CUM/GODOWN –
If society proposes to avail
assistance under this head the following
information may be furnished:-
(Rs.
In lakhs)
-------------------------------------------------------------------------------------------------------
1. a) Existing
godown No Capacity Size
Location Capacity
Capacity utilization utilization
of the godown
(last year)
b)
Existing retail outlets
No Location Size
(Sale
Year Year
Year
(I) (II) (III)
c)
Existing No Location Godown
Showroom Godown Showroom
godown-
capacity size capacity sales during
cum-
utilisat- last 3 years
showrooms ion
last (Rs.in lakhs)
year
-------------------
Year Year Year
(I) (II)
(III)
2. Capacity
of show- Location Capacity Size
rooms/Central
Godown/showroom-
cum-godown now
proposed
(length &
breadth)
(New/
Renovation)
-------------------------------------------------------------------------------------------------------
3. Cost of
showroom- Appx. Cost Appx. Cost of Appx. Cost of Total
Cum-Godown (New/ of show- GDN any other
Renovation)
room component component.
Component
4. Assistance required
I Year
II Year III Year
IV Year V Year
------------------------------------------------------------------
5.
a) Anticipated sales
after renovation/
completion of the
showroom/godown
b) Anticipated gross income
c) Anticipated expenditure
d) Anticipated net income
e) Expected profit
* (Please enclose drawings & estimations
and indicate whether the proposal is for opening/renovation or construction of
showroom/godown etc.).
NB : 1. For availing financial assistance under this
head society is advised to have a detail project report prepared all details
about performance of the society,
activities proposed to be taken with justification, viability of the such
activities, drawing, estimates etc. The
project report may be got prepared from experienced consultancy
agency/consultant of the field and should be enclosed with the proposal.
2. Out of the total cost approved 75% will
be made available to society as loan so society should ensure that it will be
in position to repay the same alongwith interest by generating enough surplus
from its business operation before applying assistance under this head.
F. ASSISTANCE FOR
COMPUTERISATION
If
society propose to avail assistance for computerization the following
information may be furnished :
1. Activities of the societies in brief
2.
Proposed area of Computerisation
3. *Project cost for Computeristion
a) Cost of Hardware
b) Site preparation cost
c) System and application software
cost
----------------------- Total
------------------------------------
* Assistance by way of 100%
of the cost will be made available as loan so society should ensure that
it is in position to repay the same alongwith interest from its own resources.
G. If the proposal of the society is to avail
assistance for revitalization/rehabilitation, the following information should
be furnished.
1. Report for losses in ________________
explain how to re-coup the loss
2. Financial restructuring proposed for
improving equity : debt ratio so as
to
make the society eligible for bank
finance
3. Sundry debtors, how these are proposed
to be liquidated and by what time;
i) Total stocks ……………….. (value)
ii) Of which saleable …………… (value)
4. Projections (Business Development Plan)
Year Year Year
----------------------
----------------------- --------------------
a)
Sale
three year (Please give item-wise
details) in value terms i.e.
(Rs. Lakhs)
b)
Profitability for next three years
(Rs. In value)
5.
Role of Apex. Cons. Federation
Providing supply of goods and
Other benefits etc.
6. Improvement in management proposed
7. Any
other action proposed for
rehabilitation/revitalization
NB : 1. For the rehabilitation proposed detail
project report prepared by an experienced consultancy agency/consultant of the field and approved
by State Government be enclosed with the proposal.
2. The steps taken for implementation of
the project report or action taken so far be enclosed.
Annexure to letter No. NCDC:1-3/94-RC dated 13.5.2003
GUIDELINES FOR FILLING UP THE APPLICATION FORM FOR
AVAILING
FINANCIAL ASSISTANCE BY THE SOCIETY UNDER NCDC
SPONSORED SCHEME
1. For availing financial assistance
by the society under the scheme first
General information performa Annexure-I(A) should be filled up and then as per
the recruitment of the financial assistance relevant performa should be
filled-up i.e. Annex-I(B) to Annex-I(G) depending upon the financial assistance
required.
2. For illustration following examples
may be seen :-
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Component for which financial assistance to be availed
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Forms to be filled-up
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a. Margin Money
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Form
Annex.I(A( and Form Annex.I(B)
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b. Margin Money and Furniture &
fixtures
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Form
Annex.I(A), Form Annex.I(B) & Form Annex.I(C)
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c. Transport vehicle
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Form
Annex.I(A), Form Annex-I(D) and Format (Q)
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d. Margin Money, Furniture & Fixtures and
Transport vehicles
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Form
Annex-I(A), Form Annex-I(B), Form Annex-I(C), Form Annex-I(D) and Format (Q)
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