IREDA
APPLICATION FOR LOAN ASSISTANCE
FOR
ESTABLISHMENT OF ENERGY CENTRES
INDIAN RENEWABLE ENERGY DEVELOPMENT
AGENCY LIMITED
(A Govt. of India Enterprise)
Core 4-A, East Court, India Habitat Centre Complex,
1st Floor, Lodhi Road, New Delhi – 110 003.
Tel : 24682214- – 24682202
E-mail: mdireda@rediffmail.com
IREDA
APPLICATION FOR LOAN ASSISTANCE
For
Establishment of Energy Centres
Notes : 1. All communications to be addressed to the Managing Director, IREDA.
2. Application to be submitted in the proforma provided by IREDA only.
Application and DPR shall conform to IREDA’s Guidelines for Financial
Assistance (latest issue).
3. Two signed copies of the application form are to be submitted
alongwith one floppy copy compatible to Microsoft Word.
4. Demand Draft for Rs.10,000, drawn in favour of Indian Renewable
Energy Development Agency Ltd., payable at New Delhi, to be enclosed
as application registration fee towards processing and documentation
charges.
5. Application should confirm to IREDA’s “Guidelines for Financial
Assistance” latest issue.
6. If any of the points given below is not applicable, please specify so.
Enclose additional notes/ sheets wherever necessary.
7. The application shall be signed by an authorised signatory.
8. All the necessary documents and forms as listed under Item No.4 should
be completed and enclosed.
9. Incomplete and/ or ineligible applications shall not be registered by
IREDA.
10. Mere submission/ registration of loan application does not entail
automatic loan sanction.
Any
11. IREDA accepts application forms filled in English and Hindi only.
document in any other language to be submitted along with attested
translated copy.
***
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Details of the Scheme:
Functions of Energy Centres
Display/Marketing/Selling of Renewable Energy and Energy Efficiency Products and
Services.
Energy Centre can also provide retail financing or micro-lending to the customers for
procuring the energy products and IREDA can sanction a line of credit for this purpose.
To make the Energy Centre more viable, the Centre can also market or sell other Energy
Products (in addition to renewable energy and energy efficiency products/services)
Eligible Expenditure:
Display items (renewable energy and energy efficiency products/ equipment/ systems)
Office equipment including furniture, telephone, fax, computer etc. and other sales
promotion equipment like TV, VCR etc.
Instrumentation and Tool kits for servicing of sold systems/ products
Training of Manpower employed at Centre (not exceeding 1% of the total project cost)
Lease Rental upto one year and also any advance paid towards lease, security deposit etc.
Margin Money for Working Capital towards stock of goods (not exceeding 2 months stock),
payment of salary (not exceeding one month salary), sales promotion expenses (not
exceeding one month expenses)
Interior decoration expenses (not exceeding 10% of the total project cost)
Terms of IREDA’s Scheme:
Location of the Energy Interest Rate Repayment period Ceiling of Term
Centre (p.a.) (%) [Yr.] including Loan by IREDA
Moratorium (Max.)
A1 and A Cities 12.50 7 Upto Rs. 50
Lakhs
B1 and B2 Cities 12.00 7 Upto Rs. 30
Lakhs
Other cities and 11.50 7 Upto Rs. 20
district/Block/ Mandal/ Lakhs
Tehsil Headquarters
Minimum Promoters’ Contribution – 30% of the Project Cost
Maximum Moratorium – 2 Years
0.5% p.a. rebate in interest for timely repayment of IREDA’s dues
Minimum Loan Amount – Rs. 5.00 Lakhs
Front End Fee -@1.00% of the loan amount (payable after loan sanction)
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Date of loan application: -- -- ----
1.0 PROJECT TITLE (In block letters) :
2.0 PARTICULARS OF APPLICANT :
2.1 Name (In block letters) :
2.2 Address (with pin code) :
(Regd. Office & Admn. Office/
Head Office Separately)
2.3 Telephone :
2.4 Fax :
2.5 Email ID :
2.6 Website address :
2.7 Date/Place of Incorporation :
2.8 Date of commencement of business :
2.9 Name of the Group, the company belongs to:
2.10 Name & Designation of the Chief Executive :
(Also give the names and attach Bio-data of Key Executives of the Company )
2.11 a) Share Holding pattern of the company (current as well as proposed):
S.No. Name of Share Holder No. of Shares Value of % of Share
Share
b) Share Holding of the Promoters/Directors/their relatives, friends & associates in the
applicant company:
S.No. Name of Promoter/ Promoter No. of Shares Value of % of Share
Company/ Promoter Directors/ Share
NRI etc.
c) Details of investment by applicant company in the share capital of other Body Corporates:
S.No. Name of Company where No. of Shares Value of % of Share
investment has been made Share
2.12 List of Associated/ Sister/Group Companies
2.13 Name & Designation of
Authorised Dealing Officer :
(Enclose authorisation documents and attested signature, if applicable)
2.14 Constitution :
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(Please specify whether Public/Pvt.
Ltd. Co., Co-operative Society/
NGO/Trust/Society)
a) Kindly enclose copies of Memorandum & Articles of Association/ Certificate of
Commencement of Business/By-laws/Registration Certificate/Certificate of
Incorporation etc. as applicable to the applicant.
b) Indicate Clause No. of Memorandum & Articles of Association/ Bye-laws to
Undertake the Project and to borrow the loan.
c) Enclose Published audited Balance Sheet and Profit and loss account for the past
three years of the Applicant/Borrower company/ firm.
d) Board’s resolution to undertake the Project, if applicable.
e) Certificate by a Chartered Accountant indicating the net worth and borrowing
capacity.
2.15 Rebates/Concessions sought for (refer to IREDA’s Financing guidelines for details)
a) Due to Category of Borrower (specify):
b) Due to Location of the project (specify):
2.16 CRISIL/ICRA/CARE Credit rating, or any other rating, if available:
2.17 Sector :
(Please specify whether Public/
Joint/Private/Co-operative)
2.18 Size :
(Small scale/Medium scale/
Large scale / others)
2.19 Date/Place of Incorporation/ Registration:
2.20 Date of Commencement of Business:
2.21 Current Activity/Business :
(Please provide a small write up along with details of products, Licensed capacity,
existing installed capacity, utilisation etc. for the last three years. Also enclose the
Outlook/Forecast for the sector/ industry from any independent agency, if available)
2.22 Whether listed on stock exchanges :
(give the name of exchange, current quote and 52 weeks high/low for the stock)
2.23 Management Structure : Give the names of Directors and their Bio-data
covering followings parameters:
Name:
Date of Birth:
Father’s Name:
Present Address:
Permanent Address:
Telephone No.:
E-mail ID:
PAN No.:
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Educational Qualification:
Experience Details (under headings Period, Company, Designation, Nature of
Work)
Directorship in boards of other companies:
Special Awards/Achievements:
Membership of other organisations/ institutions:
2.24 Promoters’ Details : Give the details of Promoters/ Promoter-Directors/ Promoter
Companies covering followings parameters:
Name of Promoter:
Net Worth (Rs. In Lakhs):
Available Liquid Cash (Rs. In Lakhs):
Equity Shares (both face and market value) (Rs. In Lakhs):
Unsecured Loans given (Rs. In Lakhs):
Total Taxable Income (Rs. In Lakhs):
2.25 Financial Performance :
A) For Existing Applicant Companies: Kindly provide following details (Enclose
Audited Balance Sheets and Profit & Loss Account of the applicant company for
last three years and provisional accounts for the current year upto last quarter)
Item Audited Results Provisional
Year 1 Year 2 Year 3 Current
year
Paid-up Capital
Reserves and Surplus (excluding revaluation reserve)
Revaluation reserve
Net Worth
Term Loans
Working Capital Loans
Other Loans
Total Capital Employed
Fixed Assets
Total Assets
Debt equity Ratio (Current)
Debt equity Ratio (After Proposed Loan from IREDA)
Debt Service Coverage Ratio (DSCR) of the Company
Current Ratio
Turnover
Capacity utilisation
Profit before Depreciation and Taxes (PBDT)
Tax Paid
Net Profit
Earnings per share
Dividend
% Net Profit to Total Equity
% Net Profit to Total Capital Employed
Contingent Liabilities (as per the annual report)
Disputed Income Tax Demand
Disputed Sales Tax Demand
Disputed Custom/Excise Duty Demand
Guarantee issued and outstanding
Other contingent liabilities
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In addition to the applicant company, above details are also to be provided for the
sister/group concerns of the applicant company.
B) For New Applicant Companies: Kindly provide following details for each of
the promoter/sister/group companies (Enclose Audited Balance Sheets and Profit
& Loss Account of the promoter companies for last three years and provisional
accounts for the current year upto last quarter)
Item Audited Results Provisional
Year 1 Year 2 Year 3 Current
year
Paid-up Capital
Reserves and Surplus (excluding revaluation reserve)
Revaluation reserve
Net Worth
Term Loans
Working Capital Loans
Other Loans
Total Capital Employed
Fixed Assets
Total Assets
Debt equity Ratio (Current)
Debt equity Ratio (After Proposed Loan from IREDA)
Debt Service Coverage Ratio (DSCR) of the Company
Current Ratio
Turnover
Capacity utilisation
Profit before Depreciation and Taxes (PBDT)
Tax Paid
Net Profit
Earnings per share
Dividend
Return on Equity (ROE)
Return on Investment(ROI)
Contingent Liabilities (as per the annual report)
Disputed Income Tax Demand
Disputed Sales Tax Demand
Disputed Custom/Excise Duty Demand
Guarantee issued and outstanding
Other contingent liabilities
(Also provide following details for each of individual promoter/ promoter companies)
Income Tax Assessment Wealth Tax Assessment Sales Tax Assessment
Assessed Income Tax Wealth Wealth Tax Sales Tax Sales Tax
Taxable Paid Assessed Paid Paid Paid
Income
Also submit IT Returns and CA Certificate for Net Worth for Promoters/Promoter
Companies.
2.26 Have you given any corporate guarantee for any other loan/purpose:
(If yes, please provide complete details)
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2.27 Convictions/Pending Litigation (against the Applicant/Group Companies and/or Main
Promoters of the Applicant Company) under any criminal/ economic offence or under
national security laws: (Please provide complete details)
2.28 Whether Existing Borrower of IREDA (Yes/No)
If yes, please give following details:
a) Name of the Project for which loan applied/sanctioned:
b) Project No./Date of issue of Sanction Letter by IREDA:
c) Date of signing of Loan Agreement:
d) Amount Sanctioned (Rs.Lakhs):
e) Amount Disbursed (Rs.Lakhs):
f) Amount Repaid (Rs.Lakhs):
g) Amount over due (Rs.Lakhs):
2.29 Whether any of your group company is existing borrower of IREDA (Yes/No)
If yes, please give following details:
a) Name of Company
b) Name of the Project for which loan applied/sanctioned:
c) Project No./Date of issue of Sanction Letter by IREDA:
d) Date of signing of Loan Agreement:
e) Amount Sanctioned (Rs.Lakhs):
f) Amount Disbursed (Rs.Lakhs):
g) Amount Repaid (Rs.Lakhs):
h) Amount over due (Rs.Lakhs):
2.30 Kindly provide details of each of the loans availed by your company from
other financial institutions/banks:
a) Name of the financial institutions/banks:
b) Name of the Project for which loan applied/sanctioned:
c) Project No./Date of issue of Sanction Letter:
d) Date of signing of Loan Agreement:
e) Amount Sanctioned (Rs.Lakhs):
f) Amount Disbursed (Rs.Lakhs):
g) Amount Repaid (Rs.Lakhs):
h) Interest Rate (%)
i) Moratorium:
j) Repayment Period:
k) Security given for loan:
l) Reschedulement/ Restructuring availed, if any (give details):
m) One Time Settlement availed, if any (give details):
2.31 Do you figure in RBI Defaulters List? :
2.32 Previous Experience of the Applicant in Energy Related Area: Yes/No
If yes, indicate no. of years of experience
2.33 Previous Experience of the Applicant in Renewable Energy/ Energy Efficiency
Related Area: Yes/No
If yes, indicate no. of years of experience
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3.0 PARTICULARS OF THE PROJECT :
3.1 Project Highlights: (Kindly submit the business plan indicating the business
potential, marketing strategies, presence of competitors, after-sales service
arrangements, distribution arrangements etc. Give details of business plan for
current year and also for next three years both physical as well as financial terms.
Enclose support documents such as future corporate plan or other published
material, if any)
3.1.1 Location/Address of the Energy Centre:
3.1.2 Class of the City where the Energy Centre is located: A1/A/B1/B2/Others
(enclose supporting document if available)
3.1.3 Products/Services Proposed to be Sold at Centre:
3.1.4 Proposed Source of Products/Services Proposed to be Sold at Centre (if not
a manufacturer):
3.1.5 Implementation Schedule for Energy Centre :
Invitation of Tenders (date) :
Commencement of
Construction (date) :
Commissioning of
Project (date) :
(Give details on Implementation planning, PERT chart etc.)
Employment Generation :
No. of people for operation :
(in this project)
3.1.6 Location Classification :
(Please indicated whether Tribal Area/Backward area/Hilly area/Coastal
area/Island/ Estuary or other)
3.1.7. Arrangement of Space for Energy Centre (Owned/Leased/Rented)
(enclose supporting documents for ownership of land/lease agreement etc.)
3.1.8. Total Carpet Area of the proposed Energy Centre Premises (sq.ft.)
3.1.9. Area proposed to sub-let to IREDA for IREDA Showcase in Energy Centre (to
showcase and distribute IREDA’s Literature/Brochures; Exhibit IREDA’s Video
Films; and Promote IREDA’s services. Limited to 10% of total area of the
centre. IREDA shall pay rental for the space occupied at market rate.)
3.1.10 Accessibility of proposed site of the Energy Centre: Kindly indicate
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Whether the proposed site for Energy Centre is situated in well
established market place
Whether the site is well connected by motorable road
What types of shops are located in nearby areas
Distance of nearest railway station
3.2 Commercial Features :
3.2.1 Cost of the Project : (Please provide break-up in the following
headings, also provide justifications for cost estimates, quotations etc.)
Item Per Unit No. of Unit Total Copy of
Rate Required Amount Quotation/
(Rs.) Details
enclosed at
Display Items (renewable energy
products/systems and energy
efficient equipment/systems)
Office equipment including
furniture, telephone, fax, computer
etc. and other sales promotion
equipment like T.V. VCR etc.
Instrumentation and Tool kits for
servicing of above systems
Lease rentals upto one year and
also any advance paid for the
establishments towards lease,
security deposit etc.
Margin money for the working
capital
Interior decoration expenses
Training of Manpower
Others (specify)
3.2.2 Proposed Means of Finance : Source Amount %
Promoter’s Contribution :
(Please give break-up of sources like Equity, Internal Accruals etc.)
Subsidy (if any) :
Term Loan :
(Please give details of sources & status)
Others :
________ ________ ______
Total :
________ __ ______
3.2.3 Loan Assistance Sought from IREDA:
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3.2.4 Security Offered : Tickmark on appropriate set of securities
OPTION PROJECT FINANCING
SET 1 Bank Guarantee/Pledge of FDR from a Scheduled Commercial Bank
SET 2 State Government Guarantee
SET 3 Unconditional and irrevocable guarantee of All India Public Financial
Institution with “AAA” or equivalent rating.
SET 4 Equitable Mortgage (Mortgage by deposit of title deeds) of all
immovable properties
Hypothecation of movable assets, both existing and future,
subject to prior charge of Banks on specified current assets
Guarantees by promoters/ promoter directors and promoter
companies
Deposit of post dated cheques in accordance with repayment
schedule of principal loan amount and interest.
Note:
1) All loans (where mortgage of immovable properties either on exclusive or pari-
passu or second charge basis is not stipulated) will have to be secured by
additional security in the form of equitable mortgage of immovable non-
agricultural properties located either in urban or rural areas (excluding
waste/barren lands) belonging to promoters/directors of the borrower company
and/or close relatives and friends of the promoters having market value
equivalent to at least 33% of IREDA’s Loan. The valuation of the property shall
be arranged from any of the approved and registered valuers/architects at the
cost of the borrowers to the satisfaction of IREDA and the borrower shall
establish the title of such property to the satisfaction of IREDA. Alternatively,
Bank Guarantee from a scheduled bank or pledge of Fixed Deposit Receipt
(FDR) can be submitted.
2) In case the Borrower is loss making/having accumulated losses or individual/
partnership concerns, security of only Bank Guarantee for the amount of loan
shall be accepted.
3) In case of Set 4, also provide the names, address, net worth (in Format
attached at Annexure V) and percentage shareholding of promoter directors/
promoters companies whose personal/ corporate guarantees are proposed to be
offered by the applicant (In case of government companies, the securities of
personal/corporate guarantees are not applicable).
4) Kindly note that above set of securities are only minimum and IREDA can
stipulate additional securities on case to case basis taking into account the risk
perception, nature of the industry and background of applicant.
3.2.5 Moratorium (Years) :
3.2.6 Loan repayment (Years) :
3.2.7 Name of Bankers who will provide Working Capital Loan:
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3.3 Performance Indicators : (enclose detailed calculations)
3.3.1 DSCR :
3.3.2 IRR (Financial) - of the Project – Before Tax/After Tax:
3.3.3 IRR (Financial) - of the Applicant Company – Before Tax/After Tax:
3.3.3 Pay Back Period :
3.4 Licenses/Permissions :
(Enclose copies of the clearances mentioned below)
3.4.1 Licence to operate the Energy Centre from Local/State Govt.
3.4.2 Any Other Clearance as applicable for the project:
3.4.3 Name and Address of Your Bank(s) and at least one organisation/ individual
of repute (other than relative) with whom enquiries may be made: (This
authorises IREDA to make enquiries from referees).
4.0 ENCLOSURES (Essential for Registration the Application)
Document to be Submitted Yes/No/ Annexure Reasons for non-
N.A. / Page No. submission/
expected date of
submission
General:
4.1 Demand Draft as applicable drawn in favour of
Indian Renewable Energy Development Agency
Ltd. Payable at New Delhi (as processing and
documentation charges)
4.2 Copies of Application Form (both hard and
computer copies)
4.3 Filled up Form-I, II, III, IV & V (enclosed)
4.4 Executive summary of the project proposal and
Business Plan for the Project
4.5 PERT chart and Organisation charts
Legal Documents:
4.6 Copy of By-laws/Registration Certificate/
Certificate of Incorporation/ memorandum &
Articles of Association etc. as applicable.
4.7 Board’s Resolution to undertake the project
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4.8 Authorisation for the dealing/Liaisoning officer.
4.9 Letter authorising your bankers to provide any
information to IREDA.
Information on Promoters/ Directors/
Management:
4.10 Bio-Data of Promoters
4.11 Bio-Data of Directors of the Company
4.12 Share holding details of promoter directors in the
company
4.13 Name/Qualification/Experience of Key Top
Management
4.14 Net worth certificates for promoter directors, who
will be giving personal guarantee
Financial Statements
4.15 Printed/Audited Balance Sheets, Profit and Loss
Account and Annual Report for the last three
years of the applicant company and promoter/
associated companies
4.16 Statement of Asset & Liability of the Principal
Promoter(s)
4.17 CA’s Certificate of net worth and borrowing
capacity of the applicant (in case of existing
companies)
4.18 Copy of IT & Wealth Tax assessment of the
applicant (in case of new companies)
4.19 Credit Rating Certificate, if available
Certificate/ Clearances/ Approvals
4.20 Approval of Local Body for opening of Centre
Equipments/Suppliers
4.21 Copy of Tender Floated/Enquiries made
regarding Equipments proposed to be installed at
the centre
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4.22 Report outlining reasons for selection of any
particular supplier
4.23 Copy of Order/ Agreement already entered into
for installation
4.24 Note on Procurement Arrangements for display
items (Renewable Energy/Energy Efficiency
items)
Land, Site and Civil Works
4.25 Copy of Lease Deed of Energy Centre Premises
4.26 If centre premises is self-owned, document in
support of ownership
4.27 Any other document (please specify)
5.0 DECLARATION
I/We certify that:
5.1 All information furnished is true to the best of my/our knowledge.
5.2 No borrowing arrangements except as indicated are made.
5.3 No legal action is being taken against me/us.
5.4 I/We shall furnish all other information that may be required by you in connection
with the application.
5.5 The information pertaining to us may be exchanged by IREDA with any agency you
may deem fit.
5.6 IREDA or its nominees or any agency authorised by IREDA may, at any time
inspect/verify our assets, books of accounts, etc. in my/our factory & business premises.
5.7 Any change in the data/information given will be informed to IREDA immediately by
Registered Post.
Place:
Date:
Name & Designation: (Authorised Signatory & Seal)
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FORM-I
(Authorisation Letter to the Banker of the applicant concern)
Date:
Name of the Banker
and Address
Dear Sir,
We hereby authorise you to discuss/ disclose our affairs or any other matters
relating thereto with the Indian Renewable Energy Development Agency Ltd., First
Floor, East Court, Core 4A, India Habitat Centre Complex, Lodhi Road, New Delhi –
110 003, to whom we are making an application for financial assistance.
Yours faithfully,
(Name & Designation of
the authorised person)
(Note : The letter should be written on printed letterhead and signed by a person
or persons authorised to operate the account with the Banker).
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FORM-II
CERTIFICATE TO BE GIVEN ON THE LETTER HEAD OF
THE STATUTORY AUDITORS OF THE APPLICANT
I/We ………………………………………………., Auditor(s)/Chartered Accountant(s)
of the applicant company, hereby CERTIFY that,
Items Yes/No/N.A.
1. Whether the Applicant is having accumulated losses (without
taking into account effect of re-valuation of assets, if any) as
per audited Annual Accounts of the immediate preceding
financial year?
2. Whether the Applicant (in case of Company/Co-operative) is
Loss making as per Audited Annual Accounts of the
immediate last year of operation?
3. Is there erosion of paid up equity share capital of the
Applicant as per the latest Annual Report?
4. Whether the Applicant’s existing Debt Equity Ratio (total
borrowings (other than unsecured loans and working capital
loans) to net worth) exceeds 3:1 after taking into account
the proposed borrowings from IREDA?
5. Whether the Applicant (in case of non-profit Trust/Societies)
has accumulated revenue deficit or revenue deficit
immediately during the past year?
6. Whether the Applicant is in default in payment of dues to
Financial Institutions, Banks, NBFCs at the time of submission
of application?
7. Whether the Applicant and/or Group Companies and/or main
promoters of the applicant company are in default in
payment of IREDA dues at the time of submission of
application?
8. Whether the Applicant/Group Company is classified as willful
defaulter by RBI/ any other Financial Institution?
9. Whether The present loan is for Refinancing of financial
assistance availed of from other financing institutions, Banks,
NBFCs etc.
10. Whether Applicant is forming part of the Group, of which any
company had availed One Time Settlement (OTS) from
IREDA.
Date: (Signature & Seal)
15
FORM-III
Declaration to be furnished by the applicant
I/We …………………………….., the applicant for the loan hereby DECLARE that:
Yes/No/N.A.
Eligibility Conditions
1. Whether the present proposal of loan is for cost overrun
financing?
2. Whether the present proposal of loan is for procurement of any
Second-hand equipment and machinery?
3. Whether the Applicant and/or Group Companies and/or main
promoters of the Applicant Company have been convicted for
criminal/economic offences or under national security laws.
4. Whether the project under consideration is already
commissioned?
Date: (Signature & Seal)
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FORM-IV
CERTIFICATE TO BE GIVEN ON THE LETTER HEAD OF
THE STATUTORY AUDITORS OF THE APPLICANT
Dated the....................
The Managing Director,
Indian Renewable Energy Development Agency Limited,
Lodhi Road,
New Delhi
Sub: Request for Loan from IREDA made by (Name of the Applicant to be
mentioned here) for Setting up ............................
Dear Sir,
We note that above named company proposes to apply to IREDA for financial
assistance for setting up this project of .......................... at ........................
2. We have gone through the books and records of the company including the share-
holding held by promoters, their friends & associates and others in the company as also the
composition of the Board of the company and the involvement of the Directors in other body
Corporates as Promoters/ Directors. We have had discussions with the promoters/ executives
of the company. Based on the examination of the books of the company and discussions with
the Promoters and others, we hereby certify that the above company belongs to group
known as .................. , OR the said company does not belong to any group going by the
principle of commonality of management and effective control by other companies; corporate
bodies/ does not belong to known large industrial house/ groups in the country.
3. We note that above certificate is being furnished as requested by the Company to
enable IREDA to consider the Company’s request for financial assistance on merit.
Yours faithfully,
(Signature & Seal)
___________________________________________________________________
Note:
1) Delete whatever is not applicable.
2) Additional Enclosures to be submitted alongwith Loan Application:
1. In case, any of the directors of Applicant Company is common director in any other company,
give the name of director/company.
2. Give share Holding of the Promoters/Directors/their relatives, friends & associates in the
Shareholding of the company.
3. Give details of investment by Applicant Company in the share capital of other Body Corporates
17
FORM-V
REPORT ON NETWORTH OF INDIVIDUAL GUARANTORS
A. DETAILS OF THE GUARANTOR
1. Name of the assisted concern
2. Name of the guarantor/address
3. Members of his family
4. Capacity of the guarantor in the assisted concern
B. DETAILS OF ASSETS (RS. IN MILLION) VALUE_______(AS ON ____________)
B.1. Details of immovable property:-
i) Land
Particulars
Location
Ancestral or self-acquired
Share in the total property
If encumbered, to what extent
Total market value
ii) Buildings
Particulars
Whether residential or commercial
Location
Ancestral or self-acquired
Share in the total property
If encumbered, to what extent
Total market value
iii) Others (specify)
TOTAL IMMOVABLE ASSETS (B1)
B.2. Details of movable properties
i) Cash/Bank balances
ii) Marketable investments (cost price)
iii) Realisable book debts
iv) Life policies (surrender value)
v) Others (give details)
TOTAL MOVABLE ASSETS (B2)
TOTAL ASSETS (B1+B2)
C. DETAILS OF LIABILITITES
i) Borrowings
- Sources
- Security
- Value of Security
- Amount
ii) Other liabilities, if any
TOTAL LIABILITIES (B)
D. NET ASSETS (B1+B2-C)
I hereby declare that the above is a true and correct statement of my assets and liabilities and that
the lands/building and any other properties, mentioned above, are held in my name.
Signature of the guarantor
Name of the guarantor
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