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    To Be Submitted Along With Documents As Per The Check List

    Uploaded by

    Monika Shukla
    This document is a loan application form for a scheme called Pradhan Mantri Mudra Yojana. It requests information such as the applicant's business details, financial history, loan amount and purpose, and documents required. The form has different sections seeking information on the applicant's enterprise, background, associates, existing banking facilities, proposed loan, past performance, statutory obligations, and a declaration. An acknowledgment slip is also included.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    To Be Submitted Along With Documents As Per The Check List

    Uploaded by

    Monika Shukla
    105 views4 pages
    This document is a loan application form for a scheme called Pradhan Mantri Mudra Yojana. It requests information such as the applicant's business details, financial history, loan amount and purpose, and documents required. The form has different sections seeking information on the applicant's enterprise, background, associates, existing banking facilities, proposed loan, past performance, statutory obligations, and a declaration. An acknowledgment slip is also included.

    Original Description:

    Mudra Yojana Application Form

    Original Title

    Kishore:Tarun Application Form

    Copyright

    © © All Rights Reserved

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    This document is a loan application form for a scheme called Pradhan Mantri Mudra Yojana. It requests information such as the applicant's business details, financial history, loan amount and purpose, and documents required. The form has different sections seeking information on the applicant's enterprise, background, associates, existing banking facilities, proposed loan, past performance, statutory obligations, and a declaration. An acknowledgment slip is also included.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    105 views4 pages

    To Be Submitted Along With Documents As Per The Check List

    Uploaded by

    Monika Shukla
    This document is a loan application form for a scheme called Pradhan Mantri Mudra Yojana. It requests information such as the applicant's business details, financial history, loan amount and purpose, and documents required. The form has different sections seeking information on the applicant's enterprise, background, associates, existing banking facilities, proposed loan, past performance, statutory obligations, and a declaration. An acknowledgment slip is also included.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 4

    Bank’s Logo

    LOAN APPLICATION FORMPRADHAN MANTRI MUDRA YOJANA


    ( To be submitted along with documents as per the check list )

    A. For office Use:


    Enterprise Name Application Sl. No. Name of the Branch Category
    Shishu/Kishor/Tarun
    B.Business Information:

    Name of the
    Enterprise
    Constitution √ Proprietary Partnership Pvt. Ltd. Ltd. Company Any Others (specify)

    Current
    Business
    State PIN Code
    Address
    Business Premises √ Rented Owned
    Telephone No. Mobile No. 91
    E-mail:
    Business Existing
    Activity Proposed
    Date of Commencement(DD/MM/YYYY)
    Whether the Unit is Registered √ Yes No
    If Registered (Please mention:Registration
    no. And the Act under which registered )
    Registered office Address
    Skill Certified (1) Self Skilled (2) I Unskilled (3)
    Social Category √ SC ST OBC Minority Community
    If Minority
    √ Buddhists Muslims Christians Sikhs Jains Zoroastrians
    Community
    C.Background Information of Proprietor/ Partners/ Directors:
    S.No Name Date of Sex Residential Academic Experience in
    Birth Address with Qualification the line of
    Mobile No. activity (Years)
    1.
    2.

    S.No Id proof Id proof Address Address PAN Relationship with the


    no. proof proof no. Card/DIN No. officials/ Director of the
    bank if any
    1.
    2.
    D. Names of Associate Concerns and Nature of Association:

    Names of Address of Presently Nature of Extent of Interest as a


    Associate Associate Banking with Association Prop./Partner/ Director or Just
    Concern Concern Concern Investor in Associate Concern

    E. Banking/Credit Facilities Existing: (In Rs.)

    Type of Presently Limit Outstanding Security Asset


    Facilities Banking with Availed As on …… lodged classification
    status
    Savings Account N. A. N. A.
    Current Account N. A. N. A.
    Cash Credit
    Term Loan
    LC/BG
    If banking with this bank, customer ID to be given here:

    It is certified that our unit has not availed any loan from any other Bank / Financial Institution in the
    past and I/we am/are not indebted to any other Bank / Financial Institution other than those
    mentioned in column no. E above.

    F. Credit Facilities Proposed:(In Rs.)

    Type of Facilities Amount Purpose for which Details of Primary Security Offered
    Required (with approx. value to be mentioned)
    Cash Credit
    Term Loan
    LC/BG
    Total
    G.In case of Working Capital: Basis of CashCredit Limit applied:(In Rs.)

    Actual Sales Projected


    FY- FY- Sales Working Inventory Debtors Creditors Promoter’s Limits
    Cycle in Contribution
    Months

    H. In case of Term loan requirements, the details of machinery/equipment may be given as


    under:
    Type of Purpose Name of Total Cost of Contribution being Loan Required
    machine for which Supplier Machine made by the (Rs.)
    / Equipment required promoters(Rs.)

    Total
    Repayment period with Moratorium period requested for
    I. Past Performance / Future Estimates: (In Rs.)

    Past Performance / Future Estimates (Actual performance for two previous years, estimates for
    current year and projections for next year to be provided for working capital facilities. However for
    term loan facilities projections to be provided till the proposed year of repayment of loan)
    Past Year-II Past Year-I Present Year Next Year (Projection)
    (Actual) (Actual) (Estimate)
    Net Sales
    Net Profit
    Capital (Net
    Worth in case of
    Companies)

    J. Status Regarding Statutory Obligations:

    Whether Remarks
    Complied with (Any details in
    Statutory Obligations (select Yes/No) connection withthe
    If not applicable relevant obligation to be
    then select N. A. given )
    1. Registration under Shops and Establishment Act
    2. Registration under MSME (Provisional /Final)
    3. Drug License
    4. Latest Sales Tax Return Filed
    5.Latest Income Tax Returns Filed
    6.Any other Statutory dues remaining outstanding

    K. Declaration:

    I/We hereby certify that all information furnished by me/us is true, correct and complete. I/We have no
    borrowing arrangements for the unit except as indicated in the application form. There is/are no
    overdue / statutory dueowed by me/us. I/We shall furnish all other information that may be required by
    Bank in connection with my/our application. The information may also be exchanged by you with any
    agency you may deem fit. You, your representatives or Reserve Bank of India or Mudra Ltd., or any
    other agency as authorised by you, may at any time, inspect/ verify my/our assets, books of accounts
    etc. in our factory/business premises as given above. You may take appropriate safeguards/action for
    recovery of bank’s dues.

    Space for Photo Space for Photo Space for Photo

    (Signatures of Proprietor/partner/ director whose photo is affixed above)

    Date:___________________

    Place:___________________
    CHECK LIST: (The check list is only indicative and not exhaustive and depending upon the
    local requirements at different places addition could be made as per necessity)

    1) Proof of identity - Self certified copy of Voter’s ID card / Driving License / PAN Card /
    Aadhar Card/Passport.
    2) Proof of Residence - Recent telephone bill, electricity bill, property tax receipt (not older than 2
    months), Voter’s ID card, Aadhar Card & Passport of Proprietor/Partners/Directors.
    3) Proof of SC/ST/OBC/Minority.
    4) Proof of Identity/Address of the Business Enterprise -Copies of relevant licenses/registration
    certificates/other documents pertaining to the ownership, identity and address of business unit.
    5) Applicant should not be defaulter in any Bank/Financial institution.
    6) Statement of accounts (for the last six months), from the existing banker, if any.
    7) Last two years balance sheets of the units along with income tax/sales tax return etc.
    (Applicable for all cases from Rs.2 Lacs and above).
    8) Projected balance sheets for one year in case of working capital limits and for the period of the
    loan in case of term loan (Applicable for all cases from Rs.2 Lacs and above).
    9) Sales achieved during the current financial year up to the date of submission of application. 10)
    Project report (for the proposed project) containing details of technical & economic viability. 11)
    Memorandum and articles of association of the company/Partnership Deed of Partners etc.
    12) In absence of third party guarantee, Asset & Liability statement from the borrower including
    Directors& Partners may be sought to know the net-worth.
    13) Photos (two copies) of Proprietor/ Partners/ Directors.

    Acknowledgement Slip for loan Application under PradhanMantri MUDRA Yojana

    Office Copy:
    Application (system Date of Application
    generated/manual) Number

    Name of the Applicant(s) Loan Amt. Requested for

    Signature of Applicant(s) Signature of Branch


    official

    --------------------------------------------------------------------------------------------------------------------------

    Acknowledgement Slip for loan Application under PradhanMantri MUDRA Yojana

    Applicants Copy:
    Application (system Date of Application
    generated/manual) Number

    Name of the Applicant(s) Loan Amt. Requested for

    Signature of Applicant(s) Signature of Branch


    official

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