Application Form for Seeking Equity Grant Under 10000 FPO Scheme
Name of the FPC :
*
State :
--Select State--
Andaman and Nicobar
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chhatisgarh
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu & Kashmir
Jharkhand
Karnataka
Kerala
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Mysore
Nagaland
Odisha
Punjab
Rajasthan
Sikkim
Srinagar
Tamil Nadu
Telangana
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
*
District :
--Select District--
*
Correspondence Address :
*
Contact No. :
Mobile No. :
*
Email ID :
*
Registration No. :
*
Registration Date/ Incorporation of FPC(
dd/mm/yyyy
) :
Business of FPC :
*
No. of Shareholder Members :
*
No. of Small,Marginal and Landless Shareholder Members :
*
Authorised Capital (in INR) :
*
Paid Up Capital (in INR) :
*
Amount. of Equity Grant Sought (in INR) :
*
Maximum Shareholding of an Individual Shareholder Member:
*
Maximum Shareholding of an Institutional Member :
*
Bank Name in which account is maintained :
--Select Bank Name--
Abu Dhabi Commercial Bank Ltd.
Adilabad District Central Co-operative Bank Limited
Adilabad District Cooperative Central Bank Limited
Allahabad Bank
Allahabad Up Gramin Bank
Almora Zila Sahkari Bank Ltd.
American Express Bank Ltd.
Andhra Pradesh State Co- operative Bank Ltd.
Andhra Bank
Andhra Pradesh Grameena Vikas Bank
Andhra Pragathi Grameena Bank
Andhra Pragathi Grameena Bank
Antwerp Diamond Bank N.V.
Arab Bangladesh Bank Limited
Arunachal Pradesh Rural Bank
Assam Gramin Vikash Bank
AU SMALL FINANCE BANK
Axis Bank
Banaskantha District Co-op Bank
Bandhan Bank
Bangiya Gramin Vikash Bank
Bank Internasional Indonesia
Bank of America N.A.
Bank of Bahrain & Kuwait BSC
Bank of Baroda
Bank of Ceylon
Bank of India
Bank of Maharashtra
Barclays Bank Plc
Baroda Gujarat Gramin Bank
Baroda Rajasthan Kshetriya Gramin Bank
Baroda U.P Bank
baroda Uttar Pradesh Gramin Bank
Bihar Gramin Bank
Birbhum District Central Co-Operative Bank Limited
BNP PARIBAS
Buldhana Urban Co Op Credit Society Ltd
Calyon Bank
Canara Bank
Capital Small Finance Bank
Catholic Syrian Bank Ltd.
Cauvery Grameena Bank
Central Bank of India
Central Madhya Pradesh Gramin Bank
Chaitanya Godavari Grameena Bank
Chhattisgarh Rajya Gramin Bank
Chinatrust Commercial Bank Ltd.
Cho Hung Bank
Citibank N.A.
City Union Bank Ltd.
Coastal Local Area Bank Ltd.
Corporation Bank
Cuttack Central Co-operative
Dakshin Bihar Gramin Bank
Dena Bank
Dena Gujarat Gramin Bank
Deutsche Bank AG
Development Credit Bank Ltd.
Ellaquai Dehati Bank
Federal Bank
Gramin Bank Of Aryavart
HDCC
HDFC
Himachal Pradesh Gramin Bank
Hooghly Dist Central Coop Bank Ltd.
ICICI Bank
IDBI Bank Limited
IDFC First Bank
Indian Bank
Indian Overseas Bank
IndusInd Bank Limited
Industrial Development Bank of India
ING Vysya Bank
J P Morgan Chase Bank, National Association
J&K Grameen Bank
Jammu and Kashmir Bank Limited
Jharkhand Gramin Bank
Jharkhand Rajya Gramin Bank
Kangra Central Cooperative Bank
Karnataka Bank
Karnataka Gramin Bank
Karnataka Vikas Grameena Bank
Karur Vysya Bank Limited.
Kashi Gomti Samyut Gramin Bank
kaveri Grameen Bank
Kerala Gramin Bank
Kotak Mahindra Bank Limited
Krung Thai Bank Public Company Limited
Langpi Dehangi Rural Bank
Lord Krishna Bank Ltd.
Madhya Bihar Gramin Bank
Madhya Pradesh Gramin Bank
Madhyanchal Gramin Bank
Maharashtra Gramin Bank
Malwa Gramin Bank
Manipur Rural Bank
Mashreqbank psc
Meghalaya Rural Bank
Mizoram Rural Bank
Mizuho Corporate Bank Ltd.
Murshidabad District Central Co-op Bank Ltd.
Nagaland Rural Bank
Nagrik Sahkari Bank
Nainital District Co-operative Bank Limited
Narmada Jhabua Gramin Bank
Odisha Gramya Bank
Oman International Bank S A O G
Oriental Bank of Commerce
Pallavan Grama Bank
Pallvan Grama Bank
Pandyan Grama Bank
Paschim Banga Gramin Bank
Poornawadi Nagarik Sahakari Bank Ltd.
Pragathi Gramin Bank
Pragathi Krishna Gramin Bank
Prathama Bank
Prathama UP Gramin Bank
Puduvai Bharthiar Grama Bank
Punjab & Sind Bank
Punjab Gramin Bank
Punjab National Bank
Purvanchal Bank
Rajasthan Marudhara Gramin Bank
Regional Rural Banks(RRB)
Saptagiri Grameena Bank
Sarva Haryana Gramin Bank
Sarva Up Gramin Bank
Saurashtra Gramin Bank
SBI Commercial and International Bank Ltd.
Societe Generale
Sonali Bank
South Indian Bank Ltd.
Standard Chartered Bank
State Bank of Bikaner and Jaipur
State Bank of Hyderabad
State Bank of India
State Bank of Mauritius Ltd.
State Bank of Mysore
State Bank of Patiala
State Bank of Travancore
Sutlej Gramin Bank
Syndicate Bank
Tamil Nadu Grama Bank
Tamilnad Mercantile Bank Ltd.
Tamluk Ghatal Central Co-Op Bank Ltd.
Telangana Grameena Bank
The Akola Urban Cooperative Bank
The Assam Co-op Apex Bank Ltd.
The Aurangabad District Central Co-Operative Bank Ltd.
The Bank of Nova Scotia
The Bank of Tokyo-Mitsubishi, Ltd.
The Chaitanya Godavari Grameena Bank
The Chandarpur district central co-operative bank Ltd.
The Development Bank of Singapore Ltd. (DBS Bank Ltd.)
The Dhanalakshmi Bank Limited.
The District Co-operative Central Bank Ltd
The Federal Bank Ltd.
The Hassan District co-operative central bank ltd.
The HDFC Bank Ltd.
The Hongkong & Shanghai Banking Corporation Ltd.
The Jammu & Kashmir Bank Ltd.
The Jharkhand State Co-op Bank Ltd
The Lakshmi Vilas Bank Ltd
The Nainital Bank Ltd.
The Nanded Dist. Central Co-op. Bank Limited
The Ratnakar Bank Ltd.
The Ropar Central Cooperative Bank Limited
The Royal Bank of Scotland N.V.
The Sangli Bank Ltd.
The South Indian Bank Ltd.
Tripura Gramin Bank
UCO Bank
Union Bank of India
United Bank Of India
Utkal Grameen Bank
Uttar Banga Kshetriya Gramin Bank
Uttar Bihar Gramin Bank
Uttarakhand Gramin Bank
Vananchal Gramin Bank
Vidharbha Konkan Gramin Bank
Vijaya Bank
Warangal DCC Bank Ltd.
Yes Bank
Zila Sarkari Bank Limited
*
Branch Name :
*
Branch Address :
*
Bank Email ID :
IFSC Code :
*
Account No. :
*
No. of Directors :
*
No. of Women Directors :
*
Dates of Board Meetings held in the last year(
dd/mm/yyyy
) :
*
No. of Functional Committees of the FPC :
(Mention the major activities of each committee)
*
Roles & Responsibilities of Board of Directors :
*
Details of Board of Directors:
#
Name of BoD Members
Designation/Role in FPC
DIN No.
Qualification
Tenure(in Yrs.)
Contact No./Address
Land Holding (in Acres)
1
2
3
4
5
6
7
Details of CBBOs:
Name
Contact No
Address
Email ID
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 on prescribed form duly signed by two Board Members/Authorised Representative of FPC on each page.
2
Category wise allotment pattern of shares of FPC and proposed computation of allotment of shares out of Equity Grant may be submitted on the lines of Annexure-I.
3
Resolution of the FPC Board/Governing Council to seek Equity Grant, issue of shares to the shareholders against Equity Grant and transfer of shares (issued against Equity Grant) in case of exit of any shareholder from FPC may be submitted on the lines of Annexure -II.
4
The Resolution will be ratified in the next AGM of the FPC may be submitted on the lines of Annexure -III.
5
Resolution for appointment of Chief Executive officer of Company.
6
Audited Financial Statements for last financial year.
7
Photocopy of Bank Account Statement for last six months duly authenticated by the Branch Manager of the Bank.
8
KYC documents of only those Representatives/Directors authorised by the Board of FPC for executing and signing documents with SFAC.
9
Certificate of incorporation/commencement of business, Memorandum of Association/Articles of Association.
10
Business plan for 18 months.
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
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