Year A Share Capital a. Preference b.

Equity Total Reserve Free Reserve Net Worth (Equity Share Capital + Free Reserve) Net Fixed Assets Incl.Cap.W.I.P excl. Depreciation Current Assets & Loans & Advances a. Current Liabilities & Provisions b. C.C & O.D Availed on Date c. Other Long/Short Term Loans Maturing within One Year TOTAL CURRENT LIABILITIES = a+b+c NET CURRENT ASSETS = F-G Total Debts a. Secured Debts b. Unsecured Debts Debts Secured Against Fixed Assets Funded Debts Not Maturing Within One Year Debts To Be Serviced By One Year a. Term Loans b. Unsecured Fixed Deposits Intercorporate Deposits Institutional Short-Term Loans Others c. Interest Accured & Other Companies TOTAL SERVICABLE DEBTS IN ONE YEAR TURNOVER a. Sales b. Other Income Operating Costs PROFIT BEFORE INTEREST, DEPRECIATION & TAX Interest a. On Fixed Loans b. On Total Borrowings PROFIT BEFORE DEPRECIATION & TAX Depreciation For The Year PROFIT BEFORE TAX Tax/Provision For Taxation PROFIT AFTER TAX Dividend In Percentage (Interim+Final) Retained Profit - Ploughing Back To Reserve

Year

Year

B C D E F G

H I

J K L

N O Q

R S T U V W Y

FINANCIAL INFORMATION :

Nam e

Addres s

Communicat ion

Management Details

Group Particulars

Nature Of Business

Any Special Features

KEY RATIOS & DATA

1 2 3 4 5 6 7 8 9 1 0 Debt Equity Ratio Asset Cover Ratio Debt Service Coverage Ratio Interest Cover Ratio Current Ratio Return On Capital Employed Earning Per Share Networth Per Share Share Prices K/D E/J P/[Q(b)+L] P/Q(b) F/G V/D V/No.Share D/No.Share High Low

FINANCIAL PROJECTION / ESTIMATION ENCLOSED

YEAR_______TO_______

Financial Assistance Sought__________________________________________________________ Respective Phases__________________________________________________________________ NOTES: