COMMON LOAN APPLICATION

NATIONAL COOPERATIVE DEVELOPMENT CORPORATION (NCDC)

4, SIRI INSTITUTIONAL AREA, HAUZ KHAS, NEW DELHI-110016
 PART- A
General information of the Borrowing Cooperatives

(Rs. in lakh and Numbers in actual)

1 Name of the
cooperative society
2 Address with
pincode
3 Contact Details Phone No. Fax No. Email Website, if any

4 Details of Board Elected/Nominated

Date of Election
Tenure of Board
5 No. of Directors in Type Gen SC ST OBC Total
Board Men
Women
Transgender
Total
6 No. of Board
meetings held
during last financial
year
7 Last AGM held Date
No. of participating members
8 Chief Executive of Name
the Society Designation
Mobile No.
Email
PAN
Aadhaar No.
9 No. of Employees Category Regular Contractual Seasonal Total
Men
Women
Transgender
10 Details of society Multi state / State
Regd. No & date
GSTIN No.
PAN
Area of operation
11 Statutory audit
completed upto
12 Audit Classification Year
for last 3 years Classification
13 Brief of present
Activities
14 Membership as on Type Gen SC ST OBC Total
31/03/_____ (i) Individual members
a. Men
b. Women
c. Transgender
Subtotal (i)
(ii) Societies
(iii) State Govt.
(iv) Others
Total (i) to (iv)

2
15 Authorised Share
Capital
16 Paid up share Capital Individuals Societies State Govt. Others Total
as on 31/03/_______
17 Net worth of the Share Reserves excluding Accumula Total
society Capital (depreciation + ted Profit
revaluation reserve + (+) / Loss
bad debts) (-)

18 Whether assisted by If yes, please provide details (Purpose, NCDC release

NCDC earlier (Yes/No) particulars & repayment status in separate sheet)
19 Analysis of financial As per prescribed format at Annexure - I.
statements For cooperative banks - Annexure- II & III may be used.
20 No overdues
Certificate (only in
As per prescribed format at Annexure - IV
case of direct
funding)
21 Activities under
proposed project
22 Proposed total project
cost
23 Financial assistance Loan :
sought from NCDC Subsidy (if applicable) :
24 Types of security
proposed to be
provided for NCDC
financial assistance
(only in case of
direct funding)
25 Details of assets to be mortgaged (applicable only in case of direct funding)
Description of Land Building Plant & Other Total
Assets machinery fixed assets
Year/s of
Acquisition
Cost of
acquisition
Depreciation
Book Value
as on ________
Distress sale
Not Not Not
value by SBI/Govt.
applicable applicable applicable
approved valuer
State Government
guidance value/ Not Not Not
circle rate/Jantri rate applicable applicable applicable
Whether above assets
are charged (or)
mortgaged (or) free
from encumbrances
If mortgaged, to whom
and outstanding
balance as on _____

3
 Net value of assets to be mortgaged = Value of land as agreed by NCDC + book value of
other assets + proposed fixed assets being created using NCDC assistance

Note: In case of security other than the above, please provide details separately.

26. Status of term loan already availed from financing institutions including NCDC

(Rs. in lakh)
Loan sanctioned Loan
NCDC/Bank/FI/State Outstanding
amount Repayments
Govt./Central Month & as on
Amount availed so made so far
Govt./any others Year ______
far

27. Out of the above term loans, defaults to financial institutions including NCDC/
Banks / State Govt., if any

NCDC/Bank/FI/State Overdue amount (Rs. In lakh)

Period of
Govt./Central
Principal Interest Others Total default
Govt./any others

Note: In case, the space is insufficient, details may be given in a separate sheet.

Place: (Chief Executive of the Society)

Date: Society Seal

Note: Strike out whichever is not applicable

Documents/information to be enclosed with PART A as a part of DPR

 Copy of bye-laws along with its amendments, if any

 Hindi/ English translation of byelaws in respect of objective, area of operation, membership
details, authorised share capital, borrowing limit etc in case of other regional languages.
 Audited Financial Statements along with all schedules for last 3 years with audit reports
 Annual reports for last 3 years
 Brief bio-data of board of directors
 If board is nominated/superceded/administered, please specify reason
 If land is proposed as security, land valuation report by SBI/Govt. approved valuer
 Resolution of Board of Directors for availing financial assistance from NCDC
 Disbursement terms & repayment of schedule of all outstanding loans

4
 Annexure – I

A. Summarised Profit & Loss accounts of last 3 years (₹ in lakh)

S.No. Particulars
1 Business turnover
2 Trading profit
3 Add : Interest receipt
4 Add: Other receipts
5 Total Income (2+3+4)
6 Establishment & other expenses
7 Profit before interest, depreciation & Taxes (5-6)
8 Less : Interest paid
9 Cash Profit (7-8)
10 Depreciation
11 Profit before Tax (9-10)
12 Income Tax
13 Net profit (11-12)
B. Summarised Balance Sheets as on 31st March of last 3 years
S.No. Particulars
14 Gross Block
15 Depreciation
16 Net Block (14-15)
17 Work in progress
18 Investments
19 Total Fixed Assets (16+17+18)
20 Current Assets
(i) Cash, bank balance & deposits
(ii) Inventory
(iii) Sundry debtors
(iv) Others if any
Total :
21 Current Liabilities
(i) Short term loan
(ii) Sundry creditors
(iii) Interest payable
(iv) Other liabilities
Total :
22 Net Working capital (20-21)
23 Long term loans & deposits
24 Paid up share capital
Reserves (excluding depreciation, revaluation
25
reserve & bad debts)
26 Undistributed profits (+)/Accumulated loss (-)
27 Net worth (24+25+26)

5
 Annexure – II

Analysis of Profit and Loss Account of Cooperative Banks for last 3 years

(₹ in lakh)
S.No. Particulars Year 1 Year 2 Year 3
A Income
(i) Interest Income
(ii) Other Income
Total Income
(iii) Less: Interest Expenditure
Net Income
B Expenditure
(i) Salary and allowances
(ii) Other expenditure
(iii) Depreciation
(iv) Other Provisions
(v) Income Tax
Total (B)
C Net profit (A-B)
D Cash profit [C+ B(iii)]

Key Indicators

(₹ in lakh)
S. No. Particulars Year 1 Year 2 Year 3
1 Deposits raised
2 Borrowings
3 Total of deposits and borrowings
4 Loans & advances
5 Investments
6 Total of advances and investments
7 Gross NPA
8 Less NPA Provision
9 Net NPA
10 Net NPA % (Net NPA / Advances)
11 Capital Adequacy Ratio
12 Demand
13 Collection
14 Recovery %
15 No. of Employees
16 Dividend Paid
17 Audit Position

6
 Annexure – III

Analysis of Balance Sheet of Cooperative Banks for last 3 years

(₹ in lakh)
S.No Particulars Year 1 Year 2 Year 3
A Sources
i Paid up share capital
ii Reserves and Other funds
iii Undistributed Profits (+) / Accumulated losses (-)
Net Worth (i+ii+iii)
iv Overdue Interest Reserve
v Provision for Bad & doubtful debts +NPA
vi Provision for depreciation in investments
vii Interest Payable
viii Deposits & Other Accounts
a Fixed
b Current
c Savings
d Others
Subtotal (viii)
ix Borrowings
x Other Liabilities & Provisions
Total Source of funds (A)
B Applications
i Cash on hand & balance with banks
ii Investments and FD's
iii Advances
iv Interest receivables
v Fixed Assets
vi Other Assets
Total application of funds (B)

7
 Annexure – IV

NO OVERDUES CERTIFICATE (Only in case of Direct Funding)

1. This is to certify that _____________________ (name of the cooperative society), as

on date, is not in default in repayment of loans and payment of interest to NCDC and any
other Financial Institution / Bank.
OR
Position of default in repayment of dues by the cooperative society to NCDC and any other
financial institution/bank as on date is as follows:

Name of Loan received Outstanding dues

Lending Principal Principal
Institution/ Date Amount repaid Not yet Interest Total
Bank Overdue
due

2. It is also certified that other cooperatives on which Directors of our Board are Directors
or associated with, are not in default in repayment of loans and payment of interest to NCDC
and any other Financial Institution / Bank as on date.
OR
Position of default in repayment of dues by the Cooperatives on which Directors of our Board
are Directors or associated with, is as follows:

Name of Name of Nature of Name of Amount of Reasons and

Director defaulting association of lending default period of
cooperative the Director Institution/ default
society with the Bank
defaulting
society

(Chief Executive of the Society)

Society Seal
Place:
Date:

Note: Strike out whichever is not applicable