Applying for Incubation / Start-up Certification / Both

1. Name of start up:

2. Contact details:

a. PRIMARY CONTACT PERSON (should be one of the full time founders)

i. Designation

ii. Email

iii. Mobile Number

b. Registered Address

c. Office Address (if different from above)

d. Email

e. Office Phone

f. Website

3. Legal Status of firm: (E.g. PVT. LTD / Partnership)

4. Registration number and date:

Firm registration (as applicable)

5. What problem are you trying to solve? <Describe the market need / gap that your product /
service addresses>

i. What is the estimate of the addressable market size. Describe how you
arrived at this and indicate assumptions used.

6. Describe your offering (product or service) with key features, Explain how it addresses the
need

7. Describe your offering (product or service) with key features, uniqueness and differentiator.
Explain how it addresses the need>

8. Who is/are the END CUSTOMERS? and why they would use your product / service?

9. Technology behind the core offering by the Start-up (tick applicable):

a. To be developed, Self Developed, Acquired / Licensed, Off the Shelf

i. If Self Developed technology development time & linkages used / is the

technology Patentable / status of patent and-or application / countries
where applicable / if not yet patented what are the strategies for protection
 ii. If Acquired / Licensed from whom & terms conditions

iii. If Off the Shelf comments on the innovation from the startup

10. Explain the Innovative/ Novelty / Unique Features of your core offering. How is your
solution different from existing/competitor products/substitutes?

11. Who are your competitors and what is your competitive advantage? (Comparison with
Existing Products / Companies)

Existing Existing Existing

Features
YOUR prod. / prod. / prod. /
of
STARTUP company company company
Product
1 2 3

Note: In case of claims that there are NO COMPETITORS should be adequately

justified (in not more than 100 words).

12. Explain how the business generates revenue, the expected volume (if estimated)>

13. Current Status

a. What is the current status of the business - ideation/ under development/ pilot
launch/ revenue generation started etc . If already launched, describe the traction
so far.

b. Do you have paying Customers ? If yes then how many are repeat customers
(indicate %) and what is the current Order Book Size

c. List your major customers / first adopters (if any)

14. What is the annual turnover of your company since Incorporation (as per IT Returns filed)?

Year Year Year Year Year

Year
1 2 3 4 5

Turnover in
INR lakh
15. Details of all Founders:

SL Name Educational Work Experience Permanent Contact: Phone,

No Qualifications (Std. (Company, No. of Address Mobile, Email
passed / Degree, Year, Years, Functional
University) Area)

16. In case Shareholders / Founders are also share holders in other companies (Pvt. Ltd. /
Partnerships), the same MUST be declared separately.

17. Capital structure with name of shareholders for Pvt. LTD company:

a. Authorised Capital

b. Paid up Capital

c. Share Holding Structure

Founder Designation / Full Time (FT)

Name of % tage
No. of shares (YES / Role in or Part time
Shareholder Holding
NO) Company (PT)