Step 1 of 714%Section I – General Details1. Basic InformationYear of Establishment:Registration Number:Legal Status of the FPO:Year of Establishment:Name of the Promoting Institution (PoPI/RI/CBBO):Section II - Governance and Management2. Number of board members:3. % of women in Board of Directors:4. Number of board meetings conducted in a year:2. Number of board Member - Score3. % of women in Board of Directors: - Score4. Number of board meetings conducted in a year: - Score5. Is there documentation of meeting minutes: YES NO6. Are the circulated or read in the next meeting: YES NO7. Please specify the date of last Annual General Meeting (DD/MM/YYYY): DD slash MM slash YYYY 5. Is there documentation of meeting minutes:- Score6. Are the circulated or read in the next meeting:- Score7. Annual General Meeting - ScorePlease enter a number from 0 to 3.8. Details of the CEO –a. Name:b. Gender Male Femalec. Highest Education Qualification: PG + MBA PG | PGD Graduate 12thd. Year of experience of CEO at FPO:e. Total Experience of CEO:> 5 Year3 - 5 Year1 - 3 Year< 1 Year8. Highest Education Qualification: - Score9. Total Experience of CEO: - Scoref. CEO’s short bio (Maximum of 100 words):9. Which of the following policy manuals are available?1. Financial & Compliance Management Yes No2. Human Resource Management Yes No3. Procurement Policy Yes No4. Operations Management Yes NoThis field is hidden when viewing the form10a. Financial & Compliance Management : - ScoreThis field is hidden when viewing the form10b. Human Resource Management: - ScoreThis field is hidden when viewing the form10c. Procurement Policy: - ScoreThis field is hidden when viewing the form10d. Operations Management: - ScoreThis field is hidden when viewing the form10. Policy manuals are available: - Score10. Total Policy manuals are available: - Score5. Any other (provide details)10. Does the FPO have a Business Plan? Yes No11. Who reviews the Business Plan?Board + CEOBoardCEONot Reviewed12. How frequently is the Business Plan reviewed ?MonthlyQuarterlyNot Reviewed11. The FPO have a Business Plan : - Score12. Who reviews the Business Plan : - Score13. How frequently is the Business Plan reviewed : - Score13. Details of FPO Employees (CEO, Accountant, Marketing Personnel, etc.)Employee DesignationFull Time/ContractNumber of Years in Service at the FPOPaid by FPO/Promoting Institution/Funding Organization Add Remove14. What trainings were provided to staff (staff and board members only) in last FY? Governance FPO Management Market Finance MISThis field is hidden when viewing the form14a. What trainings were provided to staff (staff and board members only) in last FY? : - Score14. What trainings were provided to staff (staff and board members only) in last FY? : - Score14. What trainings were provided to staff (staff and board members only) in last FY?Name of the TrainingObjective/Agenda of the TrainingNumber of Persons Trained Add RemoveSection III – Financial Management15. Who is the approving authority for making payments?Financial Limit : Up to INR 50,000Approving AuthorityFinancial Limit : INR 50,000 to INR 100,000Approving AuthorityFinancial Limit : Above INR 100,001Approving Authority16. Who are the authorized signatories for the FPO?Sr. NoNameDesignation Add Remove15. Who are the authorized signatories for the FPO :- Score:Please enter a number from 0 to 3.Director + Director + CEO / Director - Value = 3 | CEO / Director + Director - Value = 2 | Not Listed - Value = 017. What is the accounting system used to maintain the data? Manual Excel TALLY VOLAC Any other18. Does the FPO prepare its annual budget? Yes No16. If Yes : FPO prepare its annual budget :- Score19. If yes, how frequently the annual budgets are reviewed?20. Who reviews the annual budget?BoardCEOPromoting InstitutionBudget Not Prepared17. Who reviews the annual budget? :- Score21. Are the statutory audits completed timely? Yes No22. Please share the date of audits for the last three financial years: Date of Audit (DD-MM-YY)2024-252023-242022-2318. The date of audits for the last three financial years:- ScorePlease enter a number from 0 to 3.Date Range : 01-04 to 30-6 - Value = 3 | Date Range : 01-07 to 30-09 - Value = 2 | Date Range : Later Then 30-09 - Value = 1 | No Audit - Value = 023. Has the FPO received any credit in the last 3 years? [FY 2022-23, FY 2023-24, FY 2024-25]: Yes No24. If yes, please provide the details:Sr. NoYearSourceAmount Received INRInterest RateTenureRepayment (on time / delayed)Purpose (working capital, infrastructure, etc.) Add RemoveSection IV – Business25. What was the turnover and profit/loss in the last three FYs?1. Year : 2024-25Revenue INRProfit/Loss (in INR)2. Year : 2023-24Revenue INRProfit/Loss (in INR)3. Year : 2022-23Revenue INRProfit/Loss (in INR)26. List the type of licenses obtained by the FPO [trade, pesticide, seed, fertilizer, etc.]: Add Remove19. List the type of licenses obtained by the FPO [trade, pesticide, seed, fertilizer, etc.]:- ScorePlease enter a number from 0 to 3.List >4 - Value = 3 | List 2-3 - Value = 2 | List 1 - Value = 1 | No List - Value = 027. Please provide details of the business lines of the FPO:Output MarketingRetail Marketing of ProduceValue (last FY, INR)% of Total RevenueInstitutional Agreements/Linkages for MarketingValue (last FY, INR)% of Total RevenueOnline MarketingValue (last FY, INR)% of Total RevenueAny OtherValue (last FY, INR)% of Total RevenueInput MarketingSeedsValue (last FY, INR)% of Total RevenueFertilizer/PesticideValue (last FY, INR)% of Total RevenueValue AdditionGradingValue (last FY, INR)% of Total RevenueProcessingValue (last FY, INR)% of Total RevenueOther ServicesCustom Hiring CentreValue (last FY, INR)% of Total RevenueFinancial Loaning/ On Lending (please provide details of the loan disbursed during the last FY)Value (last FY, INR)% of Total RevenueSeed ProductionValue (last FY, INR)% of Total RevenueAny otherValue (last FY, INR)% of Total Revenue20. Details of the business lines of the FPO : - ScorePlease enter a number from 0 to 3.List >3 - Value = 3 | List 3 - Value = 2 | List 2 - Value = 1 | List 1 - Value = 028. What commodities does the FPO trade in?PerishableRevenueProductSemi-perishableRevenueProductCerealsRevenueProduct29. Does the FPO carry out any value addition activity? Yes No30. If yes, please describe and provide details of the process and product:Sr. NoValue AdditionDetails Add Remove31. Name and describe a brand that the FPO has created, if any:NameDescribe a brand that the FPO has created32. Attach a picture of the brand that the FPO has created: Drop files here or Select filesMax. file size: 200 MB.33. Please provide a list of business partnerships for output sale and marketing:Sr. NoBusiness PartnerDetails of, Output Sale / Marketing of Product Add Remove21. list of business partnerships for output sale and marketing: - ScorePlease enter a number from 0 to 3.List >6 - Value = 3 | List (3-6) - Value = 2 | List (1-3) - Value = 1 | NO List - Value = 0Section V - Innovation34. Please Indicate any innovation incorporated in the FPO. Elaborate on the innovation and its application in; technology, operations, production, service delivery, business generation, management practices, etc.:*Please limit your response to 200 words.Section VI - Sustainable Agriculture Practices35. List the Sustainable agricultural practices of the FPO along with the number of farmers associated:Sr. NoSustainable Agricultural Practice(s)Number of Members Add RemoveSection VII - Member Centrality and Impact36. Number of shareholder members: > 750 501 - 750 201 - 500 < 20036a. Enter Number of shareholder members:37. Shareholding capital, INR (as of 31st March 2025): > 10 Lac 5 - 10 Lac 2 - 5 Lac < 2 Lac37a. Enter Shareholding capital, INR (as of 31st March 2025):22. Number of shareholder members:- Score23. Shareholding capital, INR (as of 31st March 2025):- Score38. Total number of farmers doing business directly through FPOs:Type : Member - Number of FarmersType : Non-member - Number of Farmers39. Please specify the number of numbers involved in different lines of business:1. Line of Business : Input SupplyNumber of Members2. Line of Business : Output MarketingNumber of Members3. Line of Business : Value Addition and ProcessingNumber of Members4. Line of Business : Custom Hiring CentreNumber of Members5. Line of Business : Loan DisbursementNumber of MembersSection VIII - Impact40. What infrastructure support has been developed by the FPOs for the members?*Tick the ones that apply1 Aggregation Point Yes No2. Warehouse Yes No3. Weighing and Grading Zone Yes No4. Processing Plant Yes No5. Packaging Plant Yes No6. CHC Yes No7. Input Shop Yes No41. Attach pictures of the infrastructure support: Drop files here or Select filesMax. file size: 200 MB, Max. files: 5.42. Any incremental benefit for the members in terms of profit, network, finance, etc.:Section IX – Supporting Docs and Contact43. Please make a single PDF containing the following documents:a. FPO Registration CertificateMax. file size: 200 MB.b. MOAMax. file size: 200 MB.c. PANMax. file size: 200 MB.d. GST CertificateMax. file size: 200 MB.e. Business Licenses Procured by the FPOMax. file size: 200 MB.f. Audited Balance Sheet of the Last 3 FYsMax. file size: 200 MB.g. Business PlanMax. file size: 200 MB.44. Link to the website of the FPO:45. Contact Details of the POC:Name:Designation:Email ID:Contact Number:Section X - DeclarationI declare that the information provided is true and to the best of my knowledge. I understand that my application might be rejected at any stage, if any of the information furnished in the form is found to be inaccurate.Signature of the authorized officer of the FPO/Nominating InstitutionName:Designation, Organization:Score Detail - FPOTOTAL SCORE :
