APPLICATION FORM
Women Coops. towards activities/services coming under the
purview of NCDC funding
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Regional Office, 5th Floor, Co-Bank Towers , Palayam,
Trivandrum
Email -
RO.TVM@ncdc.in
1. a)
Name and address of the society (with PIN code:
And telephone no with STD code
b) Date of registration :
c)
No. of branches and purchase retail outlets :
with their locations.
2. Area
of operation of the society
a)
No. of villages covered
b)
Total population of the area
c) Women population in the area
4. Membership
and share capital (as on 31.03.2011) (Amount in lakhs)
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Type of members
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No. of Members
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Paid up share capital
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1. Individuals
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a) Scheduled Castes
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b) Scheduled Tribes
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c) Coop. Societies
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e) State Govt.
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f) Others( Pl. specify)
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Total
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5. Financial Position of the Society
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Sl No
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Particulars
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2008-2009
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2009-2010
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2010-2011
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1
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Profit/Loss
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2
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Reserves and other funds
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3
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Un-distributed profit, if any
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4
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Total owned funds (2+3)
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5
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Accumulated Loss, if any
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6
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Long term investments made from
owned funds, if any
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7
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Net worth ((4-5)
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Net disposable owned funds
(4-(5+6)
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Enclose a copy each of the balance
sheet, profit & loss and trading accounts for the last three years.
6. Management of the society
a) Whether present Board is elected
and if so,
when elected and for what period?
b) If the Board is not elected, the
date which the board
has been superseded and nominated Board/
Administrator/Person in charge appointed by State
Govt. and reasons for such action.
When is the
Elected Board likely to be restored?
c) Date of the last general body
meeting
7. Audit of the society
a) Period for which audit has been
completed and
the audit classification.
b) If the statutory audit is in
arrears, reasons for
such arrears may be indicated.
8. Infrastructural Facilites
a) Processing facilities with the
society
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Type of unit
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Capacity ( in tones)
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Qty. of raw material processed during
2010-11( in tones)
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Year of establishment of the unit
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1)
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2)
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9. Godowns with the society
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No. of godowns with location
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Capacity (in tones)
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1) Own
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2) Hired
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3)Under Construction
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10. Business Operations
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Activity
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Actual business undertaken during
last three years
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Realistic business target for next
two years
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Working capital required
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% of margin money required for raising w.c. from bank
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2008-09
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2009-10
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2010-11
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ST & MT credit
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Consumption credit
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Pledge Loan
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Others, if any
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Total
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11. Details of assistance received
earlier under
NCDC Schemes for Year
Amount
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a) Share Capital
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b) Godowns
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c) Processing units
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d) FSC Scheme
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e) Consumer Scheme
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f) Other, if any
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Total
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14. Requirement of Margin Money for
raising working capital
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Credit availed for non-credit
business
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Agr. Inputs and consumer articles
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Name of bank from which credit
availed
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% of margin prescribed by bank for
credit limit
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Credit limit sanctioned by bank
during the year 2010-11
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Maximum drawal against the
sanctioned amt during 2010-11
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Credit limit applied for 2011-12
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Additional non-credit business
proposed to be undertaken during the year 2011-12
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Working capital required for
undertaking additional non-credit business
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Margin money required for raising
w.c.
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15. Amount available from net owned
funds of the society
Towards margin money required for non-credit business
16. Additional share capital required
from State Govt. for
Meeting the margin money gap for the society’s non-credit
Business during the year 2011-12
Signature:
Secretary/Chief
Executive of the society
Signature
Designation: AR/DR
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