Application Form for Seeking Credit Guarantee Cover Under CGF

1.Bank Details

Bank Name*

Address*

Pin-code*

Phone No.*

Fax No.

E-mail Id*

Details of the authorised person of the Bank submitting the Claim :

Name*

Designation*

Mobile No.*

E-Mail ID*

2. Borrower FPC Details

Name*

Constitution*

Producer Company

Registered Office Address Details

Address*

Pin-Code*

Phone No*

Fax No.

E-mail Id*

Business Office Address Details(if any)

Address

Pin-Code *

Phone No

Fax No.

E-mail Id

Name of CEO*

Mobile No.*

Credit Facility for which guarantee cover sought*

Give details of components

Inputs

Processing

Marketing

Total Investment

3.Banking Facilities Sanctioned by sanctioning authority(Rs. in Lakhs)

Term-loan

Date of Sanction

Amount Outstanding

IRAC Status

Cash Credit

Date of Sanction

Amount Outstanding

IRAC Status

Sanctioning Office

Branch

ZO/RO

Designation of Sanctioning Authority

Sanctioning Authority approval vide

Sanction/Appraisal Note No

Date

Agenda No./Minutes conveying sanction

4. Controlling Office Details

Office Name

Address

Pin-Code *

Authority Name

Mobile No.

E-mail Id

5.Present status of FPC Activity:(Give component wise details)

6. Status of Accounts

Term-Loan

Amount of Disbursement till date

Outstanding as on date

First instalment due on (date)

Last instalment due on (date)

Cash Credit

Limit

Drawing Power

Outstanding

Comments on Irregularity(if any)

Any adverse comments on the unit by inspecting official in last inspection report

A.Cost of project(as accepted by sanctioning authority)(In Rs. Lakhs)

B.Means of Finance(as accepted by Sanctioning Authority)(In Rs. Lakhs)

Give component wise details

Term loan of Bank

Promoter Equity

Unsecured Loan

Other if any

Total

A.Forward Linkages

b.Backward Linkages with small/Marginal farmers

No. of members

Details of Primary and Collateral Securities taken by bank(if any)

a.Primary Securities

b. Collateral Securities

(Please enclose details separarely

9.Name od the Consortium(if any) associated with Credit Facility with complete address contact details and email

Name

Address

Pin-code *

Phone No.

E-mail id

Request of Branch Head for Credit Guarantee:-
In view of the above information, we request Credit Guarantee Cover against Credit Facility of Rs (in Rupess ) to FPC (copy of sanction letter along with appraisal/process note competent authority is enclosed for your and record).
Further we Confirm that:

The KYC norms in respect of the Promoters have complied by us
Techno-feasibility and economic viability aspect of the project has been takrn care of by sanctioning authority and the branch.
On Quarterly basis, bank will apprise the SFAC about progress of unit, Recovery of banks's dues present status of account to SFAC
We Undertake to abide by the Terms & Conditions of the Scheme

10.Checklist

S.No	Checklist*	Note: 1)All checklist file must be in pdf/image/zip file. 2)Each file size must be less than 2 MB
1	Application is as per the prescribed format and bear signature with seal of bank.
2	Recommendations with amount of CGC sought on Bank’s letter head with date and dispatch number duly signed by the Branch Manager on each page
3	Sanction letter of Sanctioning authority addressed to the recommending branch.
4	Bank’s approved appraisal/process note bearing signature of sanctioning authority.
5	Potential impact –Social, Environmental, risk analysis report.
6	Promoter’s request letter addressed to the Bank Manager on original letter head of FPC.
7	Implementation schedule confirmed by the Bank.
8	Up to date statement of a/c of TL/CC if already sanctioned.
9	Equity/CA Certificate./ RCS Certificate
10	Form-2, Form-5 and Form-23 filed with RoC for Company / RCS
11	Affidavit of promoters that they have not availed CGC from any other institution for sanctioned Credit Facility.
12	Field inspection report of Bank Official as on recent date.

Note: Hard copies along with enclosure to be submitted separately to SFAC registered office NCUI Auditorium Building, 5th Floor, 3, Siri Institutional Area, August Kranti Marg, Hauz Khas, New Delhi - 110016. (T) +91-11- 26966017, 26966037, 26862365 (F) +91-11- 26862367
Checklist