Format - Application Form For MCA

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Application for Assistance under Tamil Nadu Government Mezzanine Capital

Assistance scheme(TNGMCAS)
Date:25-03-2023

1 Name of the FPC Girivalam Farmer Producer Company Limited


2 Address of FPC No.51/E ,Kulathu Street, Su.Valavetti Village & Post,
Tiruvannamalai Taluk & District-606 806.
3 Registration Number& U01100TN2021PTC144670
PAN number AAJCG1305L
4 Date of Incorporation 12-07-2021
5 Email of FPC, Name of girivalamfpcl@gmail.com
the CEO, Contact M.Sabari
details +917339225441
6 Business activities of Aggregation, Oil Mill
FPC
7 Number of 640
shareholders
(List of shareholders
enclosed)
8 Number of small and Small Farmers – 130
Marginal farmers and Marginal Farmers – 468
Landless labourers Large Farmers – 22
Landless Tenant – 20
9 Paid up capital as per Rs.14,50,000/-

Rathinam Selvaraj(Director) Selvaraj Tamilselvi (Director) RangasamyJagadeesan


(Director)

Asaithambi Sumathi (Director) R.Ramalingam (Director) G.Ramu (Director)

S.Srinivasan (Director) M.Sabari (CEO)


latest ROC filing
10 Maximum number of 20
shares held by an
individual share holder
11 Share held by Nil
Institutional
shareholders and their
holding
12 Bank Account details A/C No : 7060611736
for operation Bank : Indian Bank
IFSC : IDIB000S306
Branch :Su.Valavetti Branch

13 Details of Board of Name of BoD DIN PAN


Directors along with Rathinam Selvaraj 09235370 BLVPS3212D
DIN and PAN numbers
Selvaraj Tamilselvi 09235371 AREPT4730H

RangasamyJagadeesan 09235372 AKZPJ9807D

Asaithambi Sumathi 09235664 LFLPS7289L

R.Ramalingam 09326599 BABPR9324J


G.Ramu 09326621 BQCPR8704F
S.Srinivasan 09326666 AZDPS7705A
14 Number of woman 2

Rathinam Selvaraj(Director) Selvaraj Tamilselvi (Director) RangasamyJagadeesan


(Director)

Asaithambi Sumathi (Director) R.Ramalingam (Director) G.Ramu (Director)

S.Srinivasan (Director) M.Sabari (CEO)


directors in the Board
15 Details of Managing Committee Name Name of the members
committee and other in each committee
committees of Board Marketing Rathinam Selvaraj
S.Srinivasan
M.Sabari
Purchase RangasamyJagadeesan
R.Ramalingam
G.Ramu
M.Sabari
Financial Selvaraj Tamilselvi
Asaithambi Sumathi
M.Sabari

16 Whether the consent of Yes


General Members
obtained for availing
MCA in case of
amendment of
MoA/AoA
17 Resolution passed by Yes
the Board for availing
MCA assistance (Copy
enclosed)

Rathinam Selvaraj(Director) Selvaraj Tamilselvi (Director) RangasamyJagadeesan


(Director)

Asaithambi Sumathi (Director) R.Ramalingam (Director) G.Ramu (Director)

S.Srinivasan (Director) M.Sabari (CEO)


18 Whether the Yes
auditedFinancial
statements for last 1/ 3
years attached?
19 Whether the certified Yes
copy of Bank statement
attached for a period of
last one year?
20 Whether approved Yes
business plan drawn up
for coming 5 years?
(attach a copy of the
same)

21 Enclose approved Enclosed


business plan for
coming 1 year/18
months

Rathinam Selvaraj(Director) Selvaraj Tamilselvi (Director) RangasamyJagadeesan


(Director)

Asaithambi Sumathi (Director) R.Ramalingam (Director) G.Ramu (Director)

S.Srinivasan (Director) M.Sabari (CEO)


Check List of Documents submitted with the application
i. Application duly signed by CEO and all Directors of the Board (as per ROC
records).
ii. List of shareholders with details of membership number, no. of shares held
and amount of capital contributed.
iii. Resolution passed by the Board of Directors for availing assistance under the
scheme.
iv. Copy of Memorandum of Association and Articles of Association.
v. Audited Balance Sheet and, Profit and Loss Account for last three years or
from the date of incorporation if less than three years.
vi. Certified statement of bank account for the last one year.
vii. Board approved Business plan for coming 5 years period.
viii. Affidavit on stamp paper signed by CEO and all Directors of the Board
ix. Copies of ID proof and address proof of CEO and all Directors of the Board
(self-attested).
x. 06 post-dated cheques towards five yearly interest payment and principal

Rathinam Selvaraj(Director) Selvaraj Tamilselvi (Director) RangasamyJagadeesan


(Director)

Asaithambi Sumathi (Director) R.Ramalingam (Director) G.Ramu (Director)

S.Srinivasan (Director) M.Sabari (CEO)

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