INTERVIEW-CUM-APPRAISAL FORM
FOR VARIOUS ASPECTS OF DEVELOPMENT OF MINOR IRRIGATION
Annexure B-1

Name of the Applicant (s) ……………………………………………………………

A. SINKING OF NEW WELL :
1. Location of the proposed well :
(Give Survey / Khasra No.)
2. Type of proposed well :
3. Size of proposed well : Depth Diameter / Surface
4. Estimated total cost of the proposed well :
1. How is water proposed to be lifted from the proposed well ?
2. Area to be benefitted
B. REPAIRS TO WELL (S) :
1. Location of well(s) :
(Survey/Khasra No.)

2. Particulars of Proposed repairs
Nature of repairs Estimated Cost
a) Deepening
b) Walls
c) Others (specify)
___________________
Total ___________________

3. What is the arrangement for lifting the water from the well?

B. CONSTRUCTION OF TUBE WELL :

1. Location of well(s) :
(Survey/Khasra No.)
2. Type of size of tube well :
a) Electric or diesel (with H.P.)
b) Cavity or stainer
c) Size of boring pipe (diameter)
d) Size of delivery pipe (diameter)
3 Estimate of the cost (including boring material.
Labour charges, development of cavity, motor/
Diesel engine cost, accessories, water tank.
Pump-house, installation, digging and other charges).
4. How the excess water, if any, is proposed to be used ?
5. Area to be benefitted.

D. PURCHASE OF PUMPSET WITH OIL ENGINE / ELECTRIC MOTOR
1. Location where the proposed pump set / oil engine / electric motor is to be installed.

2. Give particulars of the pump set proposed to be purchased :
3. Estimated total cost including accessories
(Enclose quotation from the proposed supplier)
Item Make H.P.

Whether pumping system to be purchased is as per BIS mark? Y/N
4. Indicate the source of water :
5. Area to be benefitted
6. Cropping pattern :
Existing (pre-development) Proposed (post-development)
Crop Area (in acres) Total Value Crop Area (in acres) Total Value
Irrigated Un-irrigated Of Produce Irrigated Un-irrigated Of Produce
Kharif Kharif
i) i)
ii) ii)
iii) iii)
iv) iv)
Rabi Rabi
i) i)
ii) ii)
iii) iii)
Summer Summer
i) i)
Total (A) Total (B)
Annual expenditure incidental to the proposed activity : Rs. …………….. ( C )
Net increase in annual income (B-A-C) : Rs. …………………..
• Whether feasibility / clearance certificate from Groundwater Survey Deptt. Is obtained as required ? Y/N
• Whether quality of water is suitable for irrigation ? Y/N
• Indicate the water level during summer in the well / tube well. …………………..
• Tentative time required for completion of the proposed work ……………..
• Whether the applicant proposes to sell water and if so, indicate the net income ? ……………….
• Whether spacing norms between two wells, tube wells is maintained ?
7. Repayment – Loan of Rs. ……………….. to be repaid in …………….. Annual/HY/Quarterly / Monthly installments of Rs. …………………. Each plus interest due

Signatures of the Appraising Officer

Signatures/Thumb Impression of the Applicant
Place :
Date :

For Office Use

Memorandum for sanction of Term Loan for minor irrigation schemes
Observations of Appraising Officer :
1. The applicant(s) is / are genuine agriculturist/s and is/are capable of successfully pursuing the activity. Y/N
2. The farm has the necessary technical facilities / infrastructure to support the activity proposed by availing the loan. Y/N
3. The techno economic viability of the proposal has been found satisfactory. Y/N
4. The farmer has the knowledge of maintenance and operation of machinery. Y/N
5. After sale services including repairs facility are available adequately. Y/N
6. The estimated cost of the machinery / item being purchased is as per the market rate in the area. Y/N

Recommendations of the appraising Officer:
The relevant land record / documents have been obtained and verified and found correct. The farm was visited by me on …………………………….. (Give date).
a) Loan recommended : Rs.
b) Security proposed : (I) Hypothecation of ……………………………
(ii) Mortgage / charge on land measuring acres
(iii) Guarantee of
Shri ________________
s/o _______________________
Shri ________________
s/o ________________________
c) Repayment Schedule : _________ (Number of installments) Monthly/Quarterly/Half yearly / Yearly
d) Gestation period : _________________ (Number of months)
Therefore, the first installment will become due on ……………….
e) Insurance, wherever applicable :

Place Signature of Appraising Officer with name and designation
Date

Sanctioned

Place Branch Manager / Manager of Division
Date