Pondicherry Industrial Promotion Development And

Pondicherry Industrial Promotion Development And Investment Corporation Ltd. Regd. Office : 60, ROMAIN ROLLAND STREET , PONDICHERRY-605001

APPLICATION FOR LOAN (TRANSPORT INDUSTRY)

LOAN FOR Rs.------

1. a) Full name of the Applicant :

b) Age :

c) Whether belongs to S.C / S.T (if so , caste certificate should be enclosed) :

d) Father’s / Husband’s Name :

e) Address :

f) Date of establishment / incorporation / Registered Office :

g) Constitution ( whether Private Limited / Public Limited Registered Co-operative Society / Sole Proprietorship / Joint Hindu Family / Partnership ) :

h) Registered Office : h i) Name(s) and address[es] of Proprietor / Partner / Directors :

J) Whether any one in (I) related to any of the Directors of PIPDIC :

2. Enclosed herewith are the following documents For your persual ; :

a) A copy of the Partnership Deed and a Copy of the Registration Certificate with The Registrar of Firms :

b) A copy of the Memorandum and Articles Of Association , Bye-laws of the society Together with a copy of certificate of Registration. :

c) Copies of audited Balance Sheet and Profit and loss Accounts of the concern for previous three years [ in the case of existing concern only]. : 3. a) Brief history of the concern [indicate the experience of the applicant in the business if no experience , whether he would associate employ experienced personnel. :

b) The name and address of other concern and their Bankers name , and address wherein the Proprietor / partners/Directors are interested [ enclose the Profit and Loss account and Balance Sheet for last 3 years) :

c) Following details in respect of Proprietor / Partner /Director (a Separate sheet may be enclosed) :

(i) Wealth and property :

(ii) Income :

(iii) Liability :

(iv) Amount of wealth tax and income tax paid for the last 3 years :

4. Purpose of the loan :

5. Particulars of vehicle(s) proposed to be acquired

a) Name of the manufacture , type and make : b) Specification , model , capacity , etc. : c) Cost of chasis (quotations should be produced in proof thereof : d) Others costs, i,e Body Building , one spare tyre , insurance, etc. : e) Initial working capital : f) Total cost : g) Place of Registration :

6. Mode of Finance : a) by way of capital Rs. b) by way of loan from PIPDIC Rs. i c) Others (specify source , rate of interest, j etc ) Rs. k Total Rs.

7. Proposed terms of repayment of loan (indicate the period within which the loan will be repaid and state by what instalments you propose to repay the principal amount) :

8. Security for loan (the loan will be secure by the hypothecation of vehicle(s) that is /are owned and that will be acquired from the loan from the Corporation) :

9. Details in respect of the property which can be given collateral security for the loan :

a) Location and details of the property : b) The present value of the property (original Title deed and encumbrance certificate for a period 30 years in respect of property should be enclosed) :

10. Particulars of guarantor , if any :

a) Name : b) Age : c) Father’s Name : l d) Profession or occupation ( Income certificate Should be enclosed) : e) Permanent address : f) Net means :

11. Whether permission and licences from the authorities concernced have been obtained to operate the vehicle(s) including routes , etc., if so please furnish the details. :

12. Please state if there is any pending ligitation either by or against the concern :

13. a) Banker’s opinion and A/C . No. Name of the Bank and address (Please authorise your bank to furnish information as per form given in Scheduled ‘C’ under a copy to the corporation) :

b) References from two persons ….Give their names , occupation and address. :

14. Earning capacity (Please complete the Schedule ‘D’) : Estimated Income Rs.

Operating Expenses Rs. ------Rs.

Add : Depreciation Rs.

Interest charges Rs.

Management Remuneration Rs. ------

Net profit before taxation Rs. ------

15 Please state if you made any application to or availed of any loan from any other institution and / or Government . If any such application was made and rejected , please state the reasons given , if any for such rejection :

16. In the case of existing concerns , details regarding existing vehicles and the area of operation (No. of routes ) may be furnished :

17. General :

A] Position regarding income-tax assessment ; [Please state the last year in respect of which income tax assessment has been completed and the amount of income-tax and Corporation taxes demanded and paid advance tax paid f or subsequent year , etc ) :

b] Position regarding necessary licenses from authorities to operate the vehicles :

c] Whether any of the existing vehicles owned have been hypothecated/ mortgaged or taken on hire purchase basis. If so , please give full particulars such as name of the institution , amount borrowed , rate of interest, present outstanding , margin period , nature of charge , etc., [Please furnish copies of Registration books , permits from R . T . O . etc. ] : d] Position regarding registration of vehicles as “Public Transport Carrier “ and registration of charge on the vehicle with the Regional Transport Authority. :

I/We hereby certify that the answers given above are in every respect true and correct and that we have not withheld any information likely to affect acceptance of this proposal and that the properties mentioned herein are our exclusive properties and will not in any way be transferred or alienated until the obligations arising out of the agreement are fulfilled.

Place: Signature

Date: Name of Applicant SCHEDULE “A” PARTICULARS OF VEHICLE(S) ALREADY IN POSSESSION ------Chassis No. Whether Make and name of Engine No Date of purchase Cost purchased Manufacture Registration Rs. new or No. and place second hand ------

Area of operation

------PARTICULARS OF INSURANCE ------Name of Amount Vehicle Risks Insurance insured Date of expiry covered company (in force) of policy ------

------SCHEDULED “B” PARTICULARS OF VEHICLE(S) TO BE PURCHASED ------Cost of Other costs e . g .Body Make and chassis building, one tyre , Total Cost Manufacturer Rs. insurance etc., Rs. Rs. ------Area of operation SCHEDULE “C” Place: Date:

The Manager /Agent

(Name and address of the Banker to be inserted here)

Dear Sir,

We hereby authorise you to furnish to The Pondicherry Industrial Promotion Development And Investment Corporation Limited to whom we are making an application for financial assistance , our affairs or any matter relating thereto and to disclose such information as they may require of you

Yours faithfully,

Signature of Applicant. SCHEDULE “D” PROFORMA OF INCOME AND EXPENDITURE

A. INCOME :

1. Expected running K . M . per day : 2. Number of plying days per annum : 3. Total plying distance per annum : 4. Rate of hire charges assumed Rs. 5. Total income expected per year Rs.

B. EXPENDITURE :

1. Operating expenditure :

2. Cost of Petrol / Diesel per litre Rs.

3. Total Petrol / Diesel required per annum @ K .M . per litre :

4. Cost of litres of Petrol or Diesel :

5. Cost of Engine oil per annum :

6. Services and Maintenance [ % on the cost of the vehicle ] :

7. Salaries and Batta to Driver and Cleaners Post No. Salary per Salary per

Month Annum

Registration Charges :

------Total “X” ------

C. OTHER EXPENSES

1. Insurance :

2. Interest :

3. Road taxes : m n 4. Depreciation @ 20% of the cost the o vehicle : p q r ------Total “Y”

------

Total Expenditure[ X + Y ] :

Operating Profit [A-B] :

LESS : Taxes : ------ADD ; Deprecation : ------Net Cash available : ------Pondicherry Industrial Promotion Development and Investment Corporation Limited, 60, Romain Rolland Street , P .B . No .190, Pondicherry-605 001.

Sir / Madam ,

With reference to your loan application filed with us for financial assistance for purchase one new Tourist Taxi / Auto Rickshaw / Lorry / Van / Stage Carrier , you are requested to kindly furnish the following particulars at an early date so as to enable us to process your loan application :-

1. Valid permit from Transport Department in respect of vehicle proposed to be purchased.

2. Quotation in respect of vehicle proposed.

3. Three quotations in respect of body building for the vehicle from standard body builders.

4. Three quotations in respect of Tarpaulin from standard suppliers.

5. Three quotations in respect of extra tyres.

6. Copy of the Birth , Nativity , Nationality Certificate and Ration Card.

7. Affidavits in respect of the permit , Nationality and clearance of finance institutions / income tax and wealth tax as per Enclosures –I,II ,III respectively.

8. Copy of the Driving Lincense , if any.

9. Bio-data of the promater , in detail ( age, father’s name , educational qualification , present occupation , experience , if any ,details of family members and property of self and family members).

10. Banker ‘s name , address and Account Number of self / partners.

11. The name and address of other concerns wherein the promoter / partners are interest . If so, Last three years balance sheet (audited) and bankers details with account Number.

12. Details of property being given as collateral security for the loan :- a) Location and details of the property. b) The present value of the property .(to be obtained from Revenue Department to be produced). c) Original titie deed and encumbrance certificate for the last 30 years and copy of antecedent document of the property. 13. Details of the other existing vehicles , if any on the promoters name and on the family members name (Model , Registration Number , are of operation , year of purchase and details of loan obtained from any institution / bank if any ). In addition to the above you are also requested to pay a sum of Rs.------(I . e.0.25% of the loan proposed ) towards investigation fee. Enclosure – 1 ( to be typed in Rs. 15.00 stamp paper) AFFIDAVIT

I,------residing at ------do solemly and Sincerely affirm and state on oath as follows:

I am given a permit No------dated------issued by state Transport Authority in respect of Lorry / Taxi ?auto (as applicable)

I have not produced any vehicle against the above permit and the permit valid up to ------I am not having any other public carrier or stage carrier permit in my name or in the concerns where I am interested as partner or Director.

Solemnly and sincerely affirmed at Pondicherry on this the date ------of the contents of this affidavit having been first truly and audibly read over and explained to deponent in tamil who is not well acquintained in english and admitted by him to be correct and signed in my presence.

Signature (Dependent) Signature Signed before me

NOTARY. ------Enclosure-II (to be typed on Rs. 5.00 stamp paper) AFFIDAVIT

I,------S/o. / W/o.------residing at ------be do hereby solemnly and sincerely affirm and state on oath as follows :

I do hereby declare that I am an Indian National and that I have not opted or intend to opt to any other nationality.

Solemnly and sincerely affirmed at Pondicherry on the ------contents of this affidavit having been first truly and audibly read over and explained to deponent in tamil who is not well acqintained in English and admitted by him to be correct and signed in my presence.

Signature (Dependent) Signature Signed before me NOTARY ------

Enclosure-II (to be typed on Rs. 5.00 stamp paper) AFFIDAVIT

I , ------S/o. aged about ------years proprietor / partner of ------residing at ------do hereby solemnly and sincerely affirm as follows :

I am not in default to any financial institutions / banks in payment of their dues. I am also not in default to Govt. in respect of statutory dues including income tax and wealth tax.

Solemnly and sincerely affirmed at Pondicherry on this day of ------the content of this affidavit having been first truly and audibly read over and explained to the deponent in Tamil who is not well acquintained in English and admitted by him to be correct and signed in my presence.

Signature (Desonent) Signature Signed before me

NOTARY PUBLIC ------