srijanapp tech

8/13/2019 Srijanapp Tech

1/5

To be submitted by Indian Enterprises

seeking financial assistance under

TIFAC-SIDBI Reoling fund for Tec!nology Innoation

(SRI"A#$ %Application Format $

&ART A ' Brief about t!e (nit

1.1

Particulars of the Enterprise

1. Name

2. Constitution

3. Type of enterprise (Proprietorship, Partnership firm,

Company, Micro / Small / Medium / Large

Enterprises etc.

4. !ear of incorporation / commencement of operations

5. "ddress of registered office and site of operations

6.Main Promoter(s names # contact details (tel. /email

1.2

Particulars of promoters

Name #"ge

Educational / professional$ualification

No of !ears ofprofessional

e%perience

No of !ears ofentrepreneurial

e%perience

&Sta'e in

1.3Present line of usiness and technology / product successfully de)eloped y the entity in the last * years+

1.4

Technology 'no-ho partner of the proposed proect, if any (name designation ith educational and

professional ac'ground affiliation address, telephone, fa%, e - mail etc.

&ART B' Tec!nical Information

2. Proect title+

2.1 ac'ground+

2.2Proect oecti)es +

2.3 Maor Targets to e achie)ed during the proect period+

2.4

Process / Products proposed to e scaled up / commerciali0ed under the proect along ith specifications

etc. +

2.5 1etailed technology description in product / process+


2/5

2.6

2hat is the specialty / no)elty / uni$ueness / inno)ation aout the proposed technology +

2.7

2or' already carried out for proof of concept / )alidation of technology # at hat scale +

2.8

2hether the technology has een already patented. 3f yes, pro)ide the details +

2.9

Process flo - charts / schematic diagram etc. +

2.10

4a materials and their a)ailaility +

2.11

Comparati)e ad)antages/disad)antages of proposed technology o)er the con)entional / emerging

technologies and rief comments on competitions / challenges

2.12 Techno-economics, cost enefit analysis and demand statistics in ne%t 5/6 years (please pro)ide list

of potential customers along ith proof of documents

2.13 En)ironmental Clearance 4e$uired, if any +

2.14 Total Proect 1uration (in months +

2.15 2or' Plan indicating important acti)ities / milestones # duration, time scheduling (ar-chart +

2.16 1eli)erales of the proect # proposed capacity for scale up+

2.17 List of e%isting facilities already a)ailale for the proposed proect (land, uilding, machinery,

softare, manpoer, utilities etc.


3/5

&ART C' Financial Re)uirement

3.1Total &ro*ect Cost'

Proect head "rea / 7ty ./

specifications / Capacity

Company / 8irm

Contriution

(4s. la'h

Contriution

from 8und

(4s. la'h

Total Cost

(4s. la'h

Cost of construction / augmentation

of factory shed for the proect

Technology 9no-ho fee / patent /

licensing

E$uipment / machinery / :tilities

Consumales / 4a Materials

E$uipment for Testing #

E)aluation / 7uality Control

Manpoer SalariesMar'eting related e%penses

2or'ing Capital Margin

;thers (pl specify

Contingency

Total

3.2 +eans of Finance '

+eans of finance Amount %Rs, lak!$

"dditional Share capital

:nsecured loans from


4/5


5/5

3.6 Financial performance'

3n case of e%isting entity, rief usiness highlights gi)en elo (Pl, enclose last FY audited accounts with

auditors report)

(Rs, lak!$

&articular Fy, Fy, &articular Fy, Fy,

4e)enue Share Capital (promotersE13T"

Share capital (others@Profit "fter Ta% (P"T Net orth / "ccumulated

losses

3nital / product de) e%penses not

ritten off

an' term loans

Net profit Margin (& :nsec loans - promoters

1et E$uity 4atio (1E4 :nsec loans - others

an' orroings - 2C

* Please provide details

3.7

Credit / an'ing facilities from S313 / other an's / 8ls / PE or AC or "ngel 3n)estors in respect of

customer (4s. la'h

PE / AC / "ngel in) / an', ranch 8acility Sanc amt ;utstanding

3.7.1 2hether any o)erdues in any an'ing credit facilities y the applicant enterprise / associate

concerns in past 5 !ears.

3.7.2 hether any of the accounts of the enterprise / associate concern classified as NP" / any

restructuring done during past 6 !ears or any ;TSdone e)er.

3.7.32hether any defaultin promotersB personal / consumer loans / credit card payments, etc.

3.8Tentati)e usiness proections (4s. la'h

Particular 8irst!ear Second!ear Third!ear 8ourth!ear

> >5 > >5 > >5 > >5SalesP"T

4. 9ey strengths and ris' factors

5."ny other rele)ant information

DEC.ARATI/#

3 / 2e certify that all information furnished y me / us ao)e and in the appendi% / anne%ure / statements

and other papers enclosed is trueD 3 / e ha)e no orroing arrangements for the unit ith any an' / 83

e%cept as indicated in the applicationD that there are no o)er dues/statutory dues/go)ernment

en$uiry / proceedings / prosecution against the unit / associate concerns / promoters/directors e%cept asindicated in the preliminary informationD that no legal action has een/is eing ta'en against the

unit / associate concerns / promoters/directors+ that 3 / e shall furnish all other information that may e

re$uired y S313 in connection ith my / our application and 3 / 2e ha)e no oection to your furnishing

the information sumitted y me / us to any agency as you may deem fit in connection ith consideration

of the assistance. 2e ha)e no oection to S313 / its representati)es ma'ing suitale en$uires hile

considering the application.Signature'

#ame0 Designation 1it! Seal

&lace '

Date '

srijanapp tech

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