FKCCI MIEA - 2021 Application

Details of Enterprise(Required)
MM slash DD slash YYYY
Name of the Owner / MD / Director(Required)
Contact Person
MM slash DD slash YYYY
Sector Specification
Category Specification
Particulars of the entrepreneur:
Please describe the type of innovation you have introduced in your enterprise
a. The year of introduction, domain, how was the opportunity identified (Was is trying to solve an issue/problem/need for creating a new market).
Please mention about the uniqueness of your innovation, how it could bring an improvement in your enterprise, both financially and technically, especially during the impact of Covid-19 Pandemic. (Maximum 300 words).
How would you measure the impact of the innovation? If your innovation had an impact on the economic performance of your company, please elaborate the same by providing relevant details - comparative financial figures. (Please provide details around increase in net sales and net profit (after taxes), and reduction in total cost for the company due to the innovation. Also furnish these details at least for 3 quarters after the innovation was brought in. Please send scanned copy of the certificate from CA on the above details, to the email IDs mentioned in the information brochure.
Max. file size: 64 MB.
If your innovation has helped in improving the business and making it sustainable, please elaborate by providing relevant details. (Please mention about the impact on customer satisfaction etc).
If possible, please explain the number of attempts made, expenditure incurred and duration to complete the process of innovation. You may share expenditure on R & D incurred during Technology/ Product Development Phase. Also, please state any specific challenges faced during the innovation process which were possibly addressed and overcome by your efforts.
Please mention about National and International level certifications (like ISO9000/ISO14000/HACCP/GMP, etc. besides from other organizations and bodies). Please substantiate your statement with relevant soft copies of supporting documents.
Max. file size: 64 MB.
a. In case, your innovation has been filed as an Intellectual Property with the relevant office, please share the IPR Portfolio (as applicable) with respect to the following.
i. Current valuation of Patent Portfolio, No. of unique patents granted, No. of unique patent applications filed (Countries and geographies filed)
Max. file size: 64 MB.
Max. file size: 64 MB.
Max. file size: 64 MB.
Max. file size: 64 MB.
Max. file size: 64 MB.
Max. file size: 64 MB.
Max. file size: 64 MB.
If your innovation resulted in any kind of process or functional efficiency through adoption of latest or emerging technology through any other method/process. Please provide relevant details to support your response. You may share the quantitative information like process time reduction, standardization of processes, turn-around time etc. For cases of effective technology adoption, describe how technology played a role in this innovation.
If your innovation had a positive impact on the People, Society or Environment, please describe the impact by providing sufficient details. Guidance: Please include details around the energy savings, effective waste management, pollution control, safety of employee safety at work etc. Also describe if and how the innovation has helped create more jobs for the society. Has it helped, in any way, in the development of economically weaker sections of the society?
a. Details of Assistance/ incentives/ Programs/Grants/Policy Support availed from State/Central Government or any other Organization. Please elaborate and discuss the mechanism and how it enabled the innovation.
b. Details of the external availed from Consultants/ R & D Institutions/ Contacts or any such facilities.
Please identify various challenges/ impediments/ issues you came across, within and outside the organization that had to be overcome and how the organization could circumvent and achieve the expected results.
Beneficiary Name : FKCCI
Beneficiary A/c No. : 0412201002090
Beneficiary IFSC code : CNRB0000412 Beneficiary Branch Address : Majestic branch , K.G. Road , Bengaluru -560009
Account Type : current A/c
GST No : 29AAACF2404N1ZM
Self Declaration(Required)
I certify that the above information furnished by me is correct to the best of my knowledge. I am willing to provide additional details, as required, during the entire evaluation process and also make presentation before the jury and clarify/explain any details further.
Further I understand that, I am liable for disqualification from the evaluation process for any false declaration.
I understand that FKCCI reserves the right to either accept or reject my nomination without any notification.
MM slash DD slash YYYY