Section A

Personal Information

Type of applicant

Name of the main applicant

First name
Middle name
Last name

The term “main applicant” refers to the applicant who has the largest proposed shareholding, or is the majority partner / managing director in the proposed company.

Name of the co-applicant 1

First name
Middle name
Last name

Name of the co-applicant 2

First name
Middle name
Last name

Name of the co-applicant 3

First name
Middle name
Last name

Name of the co-applicant 4

First name
Middle name
Last name

Highest degree of education

Education and professional qualifications of applicant(s) & other proposed partner / directors
Name Relationship with
main applicant		 Age
(Yrs)		 Highest degree
of eduction		 Institution Year passed
Main applicant
co-applicant 1
co-applicant 2
co-applicant 3
co-applicant 4

Contact number (Mobile)*

Primary
Alternate
Land-line

Address

Address line 1 *
Address line 2 *
State *
City *
Pin Code
Email address *
Website
Address for the correspondence

Other information

Are you resident of the city applied for
Company information

Do you have a registered company*

Company background

Information of company held by applicant
Name of the company City Nature of business
(Agriculture, automotive, real estate, if other please mention)		 Current CEO
(self, professional, relative)
Company 1
Company 2
Company 3
Company 4
Company 5

Details of companies held by applicant*

Name of the company Company details Shareholders's name Designation & role % of share
Type of company
Year started
(MM/YYYY)
Total manpower employed
No. of executives /managers
Type of company
Year started
(MM/YYYY)
Total manpower employed
No. of executives /managers
Type of company
Year started
(MM/YYYY)
Total manpower employed
No. of executives /managers
Type of company
Year started
(MM/YYYY)
Total manpower employed
No. of executives /managers
Type of company
Year started
(MM/YYYY)
Total manpower employed
No. of executives /managers
Total years of experience in business*
Nature of business

If 'others' please specify

Business information

Existing business finanacial details*

(All figures to be mentioned in lakhs)
Name of the company Loans Turn over Profit before tax (PBT)
Term Working Capital Total 2015-16 2016-17 2017-18 2015-16 2016-17 2017-18
Total
Name of the company Net worth Reserves & surplus Share capital
2015-16 2016-17 2017-18 2015-16 2016-17 2017-18 2015-16 2016-17 2017-18
Total

Total assests owned by the applicants*

Current and non - current assests (Rs. in Lacs)
Type of assest 2013-14 2014-15 2015-16 2016-17 2017-18 Total
Cash in bank
(saving A/C)
Fixed deposits
Shares
(Listed in stock exchange)
Bonds
LLIC / ULIP
(surrender value)
Any other security
(NSC, Kisan vikash patra etc.)
Gold / jewellary
(valuation report available)
Total current assets
Real estate
Capital invested in business
Total non-current assets
Total assets
(current + non-current)

Real estate details

Sr. No Description Owned by Current market value (Rs lacs) Mortgaged (Yes/No)
1
2
3
4
5
Total

Product profile & business experience details

Are you already a manufacturing*
If the above (a) is Yes, please select the sector/product
Do you have experience in Retailing *
Do you have own or leased storage / warehouse facilities*

Other information

Have you ever been convicted of a criminal offence*
If the above (1) is Yes, please provide details*
Have you ever been convicted of a sales / income tax / GST violation*
If the above (3) is Yes, please provide details*

Section B

Proposed Business
Name of the proposed company
Nature of the proposed company
Date of incorporation

Shareholding pattern

Shareholders's name Relationship with main applicant Proposed shareholding (%) Responsibilities in proposed business
1
2
3
4
5

Details of person (s) who will be managing the business on day to day basis

Name Relationship with main applicant Designation Experience details Current business/occupation Proposed role in business
1
2
3
4
5

Break up of investment*

Head Own funds Loans Total Source of own funds
Head Cash Fd's Shares / Bonds LIC / ULIP Property liquidation Others Total
Land
Fixed investment
(Infrastructure/equipments etc.)
Working capital
TOTAL

If the proposed investment will require liquidation of assests, please provide the details below:

Asset details Current selling price
(Rs in Lacs)		 No of days required for liquidation Mode of liquidation (How will be the asset liquidated)
1
2
3
4
5
TOTAL

Site details   (please select from appropriate dropdown menu)

Detail Site 1 Site 2 Site 3 Site 4 Site 5
Address
Proposed for storage
Type built-up/green field
Ownership status
(owned/leased)
Acquisition status:
acquired/to be acquired
Land usage
(agricultural, commercial, residential, industrial )
Plot area (sqft)

Banker information

Please provide the details for banks with which applicants are/have been dealing in last five years
Name of the bank Branch location Duration of relationship Type of facility
(inventory funding / term loan / credit limit)		 Current limit
(Rs. Lacs)
Can you arrange for a LC of Rs 50Cr to start with and later increase this to Rs 200 cr in 2 years?*

Attachments

Checklist for attachments

Identity

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Financials

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Others

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Declaration
Name
City
Date
Instructions

1.All sections should be completely filled. Only fully completed applications will be accepted

2.MEE reserves the right to reject the application if the mandatory questions are not filled

3.All figures should be mentioned in Indian rupees (lakhs)

4.The application forms will be accepted until the deadline mentioned in the advertisement

5.The selection of application is purely at the discretion of MEE management

6.MEE shall not give any reasons or explanation for selection or rejection of particular applicant

7.Shortlisted applicants will be invited for further discussions

8.MEE shall take reasonable steps to keep the information submitted by the applicant confidential

9.A candidate needs to pay Rs.5000/- (Rupees two thousand only) per district per state [+ taxes @ 18 % (Rs. 900) = Total Rs. 5900/-]

10.A candidate can apply for multiple districts. For each additional district he/she needs to pay Rs.5000/- (Rupees two thousand only) per district per state [+ taxes @ 18 % (Rs. 900) = Total Rs. 5900/-]

Checklist for attachments

1.Financials

a)Balance sheet - last 3 years

b)Profit & loss account statement - last 3 years

c)Bankers letter in the desired format (see section B, point 11)

d)Income tax & wealth tax returns

2.Others

a)Photographs of site

b)Family tree of applicants

c)Current organization structure

d)Occupation and experience details of directors

NOTE:

Please attach a certificate from your main banker in support of your financial strength and investment capability.

This document should certify the following :

1.The number of years you have been banking with that bank.

2.Facilities being extended by the bank - inventory finance.

3.Indicate if any collateral is held by bank for the loans.

4.Bank’s rating for all the firms.

5.Turnover of your current account.

6.Credit limit from bank.

7.The average monthly balance in your account

FAQs:

1.For any help in the form, please call our call centre 998 377 4445.

2.For any clarifications regarding the product, please write to enquiry@myecoenergy.in. MEE will get back to you within 5 working days.

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