1.

Details of the Applicant :

i. Name of Applicant *
ii. Legal status of applicant*
iii. Communication Details
iv. Registration No. of Applicant/CIN/NGO Unique ID
v. PAN No. of Applicant*
vi. GSTIN
vii. Aadhar/ Udyog Aadhar No.
viii. Is the applicant registered with
SFAC/NABARD/NDDB/other Government Agency *
ix. Project Location State.
x. Project Location Zone.

2. Details of the Promoter(s)/Partner(s):

i. Name of Promoter(s)/Partner(s)*
ii. Communication Details
iii. Aadhar No.
iv. PAN No.*
v. Any Other Details
vi. Category*
vii. Proposed Shareholding in the
Firm(In %age)*

3. Experience of the lead Promoter(s)/Partner(s)/ Applicant Entity in Food Processing

(and/or) /Cold Chain (and/or) / Agri-produce logistics
(Pl. enclose documentary evidence regarding experience and turnover) :
i. Name of lead Promoter(s)/Partner(s)/Applicant Entity*
ii. Details of Experience
iii. Details of Turnover(year-wise for last three years)

4. Details of Project,Sector,Type of Operating Model, Land Location,Proposed Facilities:

i. Components Under the Scheme as applicable to the project :
Linkages* : Type of :
Components*
Facility Name* : Numbers :
Proposed*
Capacity* : Unit* :
No of Day of operation :
of each facility in a year*
Sector Of Project* :
Type of Operating Model* : --Select-- Area Category*

ii. Proposed location of land

Address Line 1* : Address Line 2 :
Address Line 3 : Village :
State* : --Select-- District* :

Pin Code* :

iii. Area of Land(In Sqm)* :

iv. Status of possession(**)* :
v. Status of Land Use Conversion(CLU)* :
vi. Proof of water Connection* :
vii. Proof of power Connection* :
viii. Availability of Approach Road* :
ix. Connectivity Details
National Highway Name : Distance(in :
kms)
State Highway Name : Distance(in :
kms)
Freight corridor Name : Distance(in :
kms)
GoldenQuadrilateral Name : Distance(in :
kms)

x. Coordinate Details
Longitude* : Latitude* :
xi. Catchment Area Name* : Distance(in kms)* :

xii. Name of Authentic source of data for

Raw Material Production like(NHB,MIDH,DAHDF,State Govt. etc.)*
xiii. Product Mix*
xiv. Ref. Pg. no. in DPR(*)*
*DPR should have a detailed chapter on proposed land, raw material
production and supply statics for the catchment area.
** In case of leased land, period of lease should be not less than 15 years.
6. In case modernization/ upgradation of technology/ plant & machinery of existing
facilities is proposed :
i. Whether covered under Backward Linkages or Forward Linkages*
ii. Details of Existing Facilities
Capacity*
Unit*
iii. Details of facilities proposed to be modernized/upgraded
iv. Location of the Facility*

7. Details of Catchment Area of the Project:

i. Catchment Area* :
ii. Location of Catchment Area
Pin Code* :
iii. Commodities to be Sourced* :

Quantities to be sourced* : Unit*

Ref. Pg. no. in DPR(*)* :

8. Details of the Forward /Market Linkage :

i. Details of Linkage*
ii. MoU*
iii. Contract documents*
iv. Undertaking*
v. LoA*
vi. Target consumption centres*
vii. Key domestic markets*
viii. Export targets/plans, if any
ix. Details of volume* :

Proposed Project Financials

9. Estimated Project Cost Details(In Rs.):

Item Amount(In Rs.)

i. Land (Including FLIs /
CCs / value added centre /
distribution centre)*
ii. Site Development*
iii. Technical Civil Work
(TCW)*
iv. Other Civil Works*
v. Plant & Machinery
(P&M)*
vi. Common Utilities like
Water/ETP/ STP, etc.*
vii. Pre-operative
Expenses*
viii. Interest During
Construction *
ix. Margin Money for
Working Capital*
x. Contingencies*
xi. Add other items not
listed above*

10. Proposed Means of Finance(In Rs.):

Source Amount(In Rs.)

i. Promoter's contribution / equity*
ii. Bank Term Loan*
iii. Eligible Grant*
iv. Unsecured loan*
v. Others*
Total Means of Finance 0

ii. Term Loan :

IFSC Code *
i. Name of Bank *
ii. IFSC Code *
iii. Branch Name *
iv. Term Loan Amount (In Rs.) * :
v. Date of Final Sanction * :
vi. Date of Bank Appraisal * :
iii. Basic Revenue Projections of Bank Appraisal (In Rs):

Item Year 1 Year 2 Year 3 Year 4 Year 5

i.Turnover *

ii. Cost of Operations *

iii. Gross Profit *

iv. Earning Before Interest, Tax,
Depreciation and
Amortization(EBITDA) *
v. Profit before taxation *

vi. Profit after taxation *

iv. Financial Parameters(as per Bank Appraisal Note) :

Details as per Ref Page No.

Particulars Bank Appraisal Bank Appraisal
Report Report
i. Internal Rate of Return(IRR In %) [(a) With grant] *

ii. Internal Rate of Return(IRR In %) [(b) without grant] *

iii. Avg. debt Service Coverage Ratio(DSCR) *

iv. Break Even Point (BEP In %) *

v. Debt-Equity Ratio(DER) *

11. Raw Material / Processing and value addition Details:

* i. Availability of Raw Material in the Catchment Area - provide

details such as Adequate Volume, Wider Mix of Raw Materials,
Days of Operation in a Year along with supporting data along with
authentic source.
* ii.Product Mix

* iii.Project proposing processing and value addition

ii. Employment Generation Projections :

 i. Direct Employment (In No): * :
ii. Indirect Employment (In No): * :
iii. Contractual Employment with No. of Days (In No): * :
iv. No. of farmers expected to be benefitted : * :

12. Document to be Uploaded(Each Pdf file upto 10 MB):

Note :- Applicant is required to submit all the documents in support of information filled in the application form, in case any of
the supporting documents is not uploaded then eligibility/scoring against that criterion/a will not be considered.
SNo. Document Name

1 Detailed Project Report (DPR) in the prescribed template as at

Appendix-II. *

2 CA/Statutory Auditor certificate as per Appendix-III. *

3 CE (Civil) certificate [Appendix-IV]. *

4 CE (Mech.) certificate [Appendix-V]. *

5 Final term loan sanction from the Bank/ Financial Institution for
availing term loan for an amount not less than 20% of the project
cost. *

6 A detailed appraisal note from the Bank / Financial Institution. *

7 Certificate of incorporation/ registration of the applicant firm,

Memorandum and Articles of Association in case of Company/ Bye
laws of the Society, Co- operative, Self Help Group/ Registered
partnership deed, etc. *

8 Bio-data/background/ experience of the project promoter(s). *

9 Annual reports and Audited Financial Statement of Accounts of

the applicant firm/company/cooperative/ Partnership/ Co-
operatives, Farmer Producer Organizations (FPOs), Farmer
Producer Companies (FPCs), Self Help Groups (SHGs), etc. for last
two years. *

10 Self-attested English/ Hindi version of land documents for the

project in support of land title in the name of the applicant or land
lease, duly registered with the competent authority for not less
than the period of 15years. *
11 Change in Land Use (CLU) permission for the project for the said
land from the competent authority. *

12 Certificate from lending Bank/ FI that the facility has not

commenced commercial operations as on the date of issue of EOI
or the date of bank certificate, whichever is later. *

13 An undertaking to be furnished by the applicant as per Appendix-

VI. *

14 MoU/ Agreement for Backward Linkages and Forward Linkages

duly authenticated by concerned District Authority pertaining to
respective sectors. *

15 Annual Reports and Audited Statement of Accounts of last three

years, in case modernization/ upgradation of technology and plant
& machinery is proposed. This will not be applicable for new
entrepreneur. *

16 Proof of submission of requisite fee ( refundable fees of Rs.

50000/-) - ( Photo copy of Demand Draft ). [Please note that the
Demand draft must reach the Ministry within 10 days of
submission of the online application ] *

17 Proof of submission of requisite fee (Non- refundable fees of Rs.

5000/-) - ( Photo copy of Demand Draft ). [Please note that the
Demand draft must reach the Ministry within 10 days of
submission of the online application ] *

18 Mandate form as per Annexure-I in respect of the applicant firm. *

19 Self attested copy of a PAN card of applicant firm. *

20 PFMS (CGA) Registration – Controller General of Accounts (CGA)

registration on pfms.nic.in of firm under agency type “private
sector companies” and under the scheme name “National Mission
on Food Processing (SAMPDA) CS (9535)”.

21 List of Manufacturers/ Suppliers of P&M (enclose quotations)

22 Availability of Raw Material in the Catchment Area - provide

details such as Adequate Volume, Wider Mix of Raw Materials,
Days of Operation in a Year along with supporting data along with
authentic source. (supporting document if any viz State Govt./
NHB / etc )
 23 Upload documentary evidence regarding the existing registration /
association with any Government agency like DIC/ MCA/ DGFT/
GST/ etc.

24 Document pertaining to details of export targets/ plans , if any. In

case of export, details of volume to be exported / export
destination/ statutory norms of export destination should be
provided in DPR.

25 MoUs/ Contract documents/ Undertaking/ LoA.

26 Supporting Documents for Experience of the lead

Promoter(s)/Partner(s)/ Applicant Entity in Food Processing
(and/or) / Cold Chain (and/or) / Agri-produce logistics .

27 Copy of Board resolution/certificate from Board of

Directors/promoters (as applicable) authorizing one of the
directors/partners as authorized signatory to sign documents
pertaining to the application.

Note :- SC/ST Certificate, as the case may be, from concerned Government Authority, if applicable.