Form II / SPECIMEN - "B"

SMALL SCALE INDUSTRIES
 Application Form for Credit Facilities of over Rs. 2 Lacs & Upto Rs. 15 Lacks)

8. Arrears in Statutory Payments (if any)

     a) Income Tax

     b) Sales Tax

     c) Provident Fund

     d) Employees State Insurance Corporation

     e) Other (Specify)

9. If the unit is an ancillary unit,
    the undertaking to which it is
    catering and its address

10. Name of the associate concern(s), if any, and

    10.1 Nature of association and amount invested

    10.2 Nature of activity

    10.3 Items traded/manufactured

    10.4 Turnover and Profit during the preceding
           three years.

11.           Employment                    Present                 Proposed

Executives

    

Supervisory

    

Administrative/
Office Staff

    

Skilled Labour

    

Unskilled Labour

    

TOTAL

________________

________________

12. TECHNICAL FEASIBILITY

    12.1 Name of the Products(s),
           Including bye-products &
           Its (their) use :

    12.2 Manufacturing Process, in brief.
           (Indicate to the extent possible.
           stage-wise capacity data, yield/
           conversion data, material flow, etc.)

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