28 April 2025

In continuation to our Circular No.181/DoR-31/2024 dated 11 September 2024, we forward herewith format of Annexure XX (declaration form) to be submitted by banks for claiming subsidy for integrated projects for which term loan is sanctioned on or after 01.10.2024.

2. You may please accordingly advise your Controlling Offices/District Central Cooperative Banks (in case of State Cooperative Banks) and branches under your jurisdiction.

Yours faithfully,

-sd-

(Chinchu Khan)

General Manager

Annexure-XX

A. Integrated Projects (Advance Subsidy) – Declaration by FI

CONSOLIDATED CLAIM FORM FROM THE FINANCING BRANCH OF THE BANK THROUGH ITS CONTROLLING OFFICE FOR RELEASE OF ADVANCE SUBSIDY IN RESPECT OF AGRICULTURAL MARKETING INFRASTRUCTURE (AMI) SUB-SCHEME OF ISAM

NAME OF THE PROJECT:

NAME OF THE PROMOTER:

NAME OF THE FINANCING BANK & BRANCH:

Project Details
1.	ENSURE URN (Unique Reference Number) *
2	Project’s Complete Address* including Block
3	Type of project (activity)*	Integrated
4	Type of project (Sub activity- Storage) *	Rural Godown
5	Type of project (Sub activity- Other than Storage) *	Functional Infrastructure, Other infrastructure (Please specify)
6	Whether Godown is part of the project?	Yes
7	Whether Hilly area (Hilly area is a place at an altitude of more than 1000 meters above sea level) *	Yes/No
8	Whether Tribal area*	Yes/No
9	Land on which unit is established (Own/Leased) *	Own/Leased
10	Lessor Type*	Urban Development Authorities (UDA)/ Industrial Development & Infrastructure Corporations of State Govt or UTs (IDIC)/ Food Parks sanctioned by MoFPI/ Other govt or Quasi govt agency/Others
11	Tenure/Duration of leased land in years (from the date of sanction of term loan of project) *
12	Market Value/Purchase price (owned land) *	Rs.
13	Lease premium/One time cost (UDA/IDIC/Food Parks) *	Rs.
14	Whether the project is outside Municipal Corporation area
15	Number of farmers to be benefited from the project

Promoter Details
1.	Beneficiary type*	Individual/State Govt Dept/Village Panchayat/PACS/SCARDB/State Coop Bank/DCCB/State owned corporation/Urban Coop Bank/Other local and quasi govt/Public Sector Bank/RRB/Warehousing Corporation/Producers Organization or Coop/Milk Union/Milk Federation/SHG/SHG Federation/Other registered federations/Private Bank/Public or Private Ltd Company/Partnership Firm/Society
2	Whether Registered FPOs/Panchayats/Cooperatives of Women, SC or ST/SHGs (SC/ST Cooperatives to be certified by concerned officer of State Government) *?	Yes/No
3	Gender (in case even 1 member in a partnership firm/co-borrower is male, select male) *	Male/Female
4	Category	GEN/SC/ST/NER-GEN/NER-SC/NER-ST

Calendar of Events
1.	Date of sanction of term loan by financial institution*
2	Date of disbursement of first instalment of loan*
3	Minimum lock-in period*
4	Date of last installment of payment by beneficiary*

Godown Dimensions
	Rectangle/Square Godown - Ground Floor	Chamber Roof type	Average height more than 4.5 meters			Average height less than 4.5 meters
			Length (in Meter)	Breadth (in Meter)	Capacity in MT	Height (in Meter)	Volume (Cubic Metre)	Capacity in MT
1	Chamber 1*	RCC/Other
2	Chamber 2	RCC/Other
	Total	RCC/Other	No total here	No total here

4. Plinth Height (in Feet):

5. Plinth Projection (in Feet):

Project Finance Details- Other than Storage Infrastructure
		As per project report (Rs.)	As approved by FI (Rs.)
1	Description of Components
a	Plant & Machinery
b	Other infrastructure (Please specify)
	i)
	ii)
2	Civil Structure
	Total

Means of Finance/Subsidy Details
1.	TFO as per FI	Rs.
2	Promotor’s Contribution before sanction of Term Loan	Rs.
3	Promotor’s Contribution after sanction of Term Loan	Rs.
4	Total Promoter’s contribution	Rs.
5	Term loan	Rs.
6	Loan Sanction letter	To be uploaded
7	TFO Net of margin before sanction of Term Loan	Rs.
8	Total subsidy calculated	Rs.
8	Advance subsidy calculated	Rs.
10	Notarised Affidavit as per Annexure XVIII	To be uploaded

1. We undertake having complied with all the instructions contained in Operational Guidelines 2018 of AMI sub-scheme of ISAM and subsequent clarifications issued under it.

2. We request you to release an amount of Rs.................../- (Rupees........................................................................ .......................................................................) as Advance Subsidy in respect of the above Project

3. We solemnly declare that all information provided in this document is true and accurate to the best of my knowledge and belief.

Place:

Date:

Branch Manger

Seal and Signature

Controlling Officer

Seal and Signature

B. Integrated Project (Final Subsidy) – Declaration by FI

CONSOLIDATED CLAIM FORM FROM THE FINANCING BRANCH OF THE BANK THROUGH ITS CONTROLLING OFFICE FOR RELEASE OF FINAL SUBSIDY IN RESPECT OF AGRICULTURAL MARKETING INFRASTRUCTURE (AMI) SUB-SCHEME OF ISAM

NAME OF THE PROJECT:

NAME OF THE PROMOTER:

NAME OF THE FINANCING BANK & BRANCH:

Project Details
1.	ENSURE URN (Unique Reference Number) *
2	Project’s Complete Address* including Block
3	Type of project (activity)*	Integrated
4	Type of project (Sub activity- Storage) *	Rural Godown
5	Type of project (Sub activity- Other than Storage) *	Functional Infrastructure, Other infrastructure (Please specify)
6	Whether Godown is part of the project?	Yes
7	Whether Hilly area (Hilly area is a place at an altitude of more than 1000 meters above sea level) *	Yes/No
8	Whether Tribal area*	Yes/No
9	Land on which unit is established (Own/Leased) *	Own/Leased
10	Lessor Type*	Urban Development Authorities (UDA)/ Industrial Development & Infrastructure Corporations of State Govt or UTs (IDIC)/ Food Parks sanctioned by MoFPI/ Other govt or Quasi govt agency/Others
11	Tenure/Duration of leased land in years (from the date of sanction of term loan of project) *
12	Market Value/Purchase price (owned land) *	Rs.
13	Lease premium/One time cost (UDA/IDIC/Food Parks) *	Rs.

Promoter Details
1.	Beneficiary type*	Individual/State Govt Dept/Village Panchayat/PACS/SCARDB/State Coop Bank/DCCB/State owned corporation/Urban Coop Bank/Other local and quasi govt/Public Sector Bank/RRB/Warehousing Corporation/Producers Organization or Coop/Milk Union/Milk Federation/SHG/SHG Federation/Other registered federations/Private Bank/Public or Private Ltd Company/Partnership Firm/Society
2	Whether Registered FPOs/Panchayats/Cooperatives of Women, SC or ST/SHGs (SC/ST Cooperatives to be certified by concerned officer of State Government) *?	Yes/No
3	Gender (in case even 1 member in a partnership firm/co-borrower is male, select male) *	Male/Female
4	Category	GEN/SC/ST/NER-GEN/NER-SC/NER-ST

Calendar of Events
1.	Date of sanction of term loan by financial institution*
2	Date of disbursement of first instalment of loan*
3	Minimum lock-in period*
4	Date of last installment of payment by beneficiary*
5	Date of submission of completion project
6	Date of submission of item-wise actual expenditure certificate
7	Date of completion of project (later of 5 & 6)
8	Date of inspection by bank
9	Inspection Report of Manager of FI	To be uploaded
10	Actual Expenditure Certificate	To be uploaded

Godown Dimensions
	Rectangle/Square Godown - Ground Floor	Chamber Roof type	Average height more than 4.5 meters			Average height less than 4.5 meters
			Length (in Meter)	Breadth (in Meter)	Capacity in MT	Height (in Meter)	Volume (Cubic Metre)	Capacity in MT
1	Chamber 1*	RCC/Other
2	Chamber 2	RCC/Other
	Total	RCC/Other	No total here	No total here	No total here

4. Plinth Height (in Feet):

5. Plinth Projection (in Feet):

6. WDRA registration for godowns above 1000 MT to be uploaded

Project Finance Details-Functional Other than Storage Infrastructure
		As per project report (Rs.)	As approved by FI (Rs.)
1	Description of Components
a	Plant & Machinery
b	Other infrastructure (Please specify)
	i)
	ii)
2	Civil Structure
	Total

Means of Finance/Subsidy Details
1.	TFO as per FI	Rs.
2	Promotors Contribution before sanction of Term Loan	Rs.
3	Promotors Contribution after sanction of Term Loan	Rs.
4	Total Promoter’s contribution	Rs.
5	Term loan	Rs.
6	TFO Net of margin before sanction of Term Loan	Rs
7	Total subsidy calculated	Rs.
8	9 Advance subsidy sanctioned by NABARD	Rs.
9	Penalty, if any	Rs.
10	Final subsidy to be released	Rs

1. We undertake having complied with all the instructions contained in Operational Guidelines 2018 of AMI sub-scheme of ISAM and subsequent clarifications issued under it.

2. Certified that the project has been commenced only after sanction of term loan

3. We request you to release an amount of Rs .................../- (Rupees ........................................................................ .......................................................................) as Final Subsidy in respect of the above Project

4. We solemnly declare that all information provided in this document is true and accurate to the best of knowledge and belief.

5. It is certified that the project complies to the guidelines and conforms to the technical specifications and financial parameters of the scheme and if not found as above at any later date, the subsidy shall be refunded forthwith and the same has been acknowledged by the promoter.

Place:

Date:

Branch Manger

Seal and Signature

Controlling Officer

Seal and Signature