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| 1 Name
of the Organisation: |
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| 2 Legal
Status: |
| Pvt. Ltd Public
Ltd Partnership Form Proprietary
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| 3 Year of
incorporation: |
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| 4 Year of
commencement of commerical: |
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| 5 Category
applied for(select out of 10 industry categories) |
| Auto, Ancillaries and
Engineering Pharma
and Chemicals FMCG,
Food and Agri-business Gems
& Jewellery
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| Textile
& Apparel
ICE
& ITeS
Infrastructure
Travel
& Tourism
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| Retail
Trade
Non-retail
Traders and Others
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| 6 Industry
sub-segment: |
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| 7 Key
Products manufactured: |
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| 8 Key
Promoters name: |
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| Address: |
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| Telephone: Fax: Email: |
| Gender:
Age: |
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| 9 Experience
of Key promoters(in years): Total |
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| 10 Financing
from banks and financial institution (Rs cr): |
| 1) Funded: Sanctioned
limit Rs. Cr
Outstanding Rs. Cr. |
| 2) non-Funded: Sanctioned
limit Rs. Cr
Outstanding Rs. Cr. |
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| 11 Name of
the top three banks/financial institutions from whom facilities availed(Based
in sactioned amount) |
1)
2)
3)
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| 12 Average
interest rate currently charged on funded limit(based on sanctioned amount)
from banks and financial institutions %
p.a. |
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| 13 Was any
interest/principal repayment overdue for more than 3 months in the last 3
years? Yes
No
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15 Are you an ICICI Bank account holder Yes
No ( If
Yes, please tick any of the following )
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| Savings
account
Current
account
or any other, please specify
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| If you are not an ICICI
Bank account holder, do you wish to avail any of the following services from
ICICI Bank? (Please tick)
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| Savings
account
Current
account
Loan
for self
|
| Loan
for business
Investment solution
|
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| 16 The
Communication/IT spend |
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| 17 The Number
of Employess |
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| 18 The Number
of Computers |
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| 19 The
Number of existing telephone lines |
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| 20 The type
of internet access |
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| 21 The number
of Branches/Offices |
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| 21 Please
provide the following information |
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| Particulars |
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| 1 Sales/Turnover *
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| 2 Interest
|
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| 3 Depreciation
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| 4 Profit Before Tax
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| 5 Profit After Tax
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| 6 Networth #
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| 7 Total Debt
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| 8 Total Assets
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*
Sales / Turnover: (Net Sales - Excise Duty) + Other recurring income incidental
to main business
# Networth: Paid up share Capital + Reserves - Revaluation Reserves -
Intangible assets (patents, goodwill, prelim. expenses, bad / doubtful expenses
not provided for, etc.)
Eligibility criteria for SMEs: If you are a small and medium enterprise, you can
register for the awards.
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