Check List For Loan Process-1

APPLICATION FORM
LOAN REQUIREMENT: _____________CR,
1. NAME OF THE ENTERPRISE:
2. REGD. OFFICE ADDRESS:
3. ADDRESS FACTORY /SHOP:
4. TELEPHONE/ FAX/ EMAIL:
TELEPHONE NOs.(Office)
Mobile No EMAIL ADDRESS:
PAN CARD NO.

5. CONSTITUTION: Proprietary/Partnership firm/Pvt. Ltd./Ltd. Company/Co-op. Society
6. DATE OF ESTABLISHMENT:
7. NAME OF PROPRIETOR/PARTNERS/DIRECTORS OF COMPANY AND THEIR ADDRESSES:
NAME AGE ACADEMIC TELEPHONE NO. EXPERIENCE IN THE LINE OF
QUALIFICATIONS (Residence) ACTIVITY

8. ACTIVITY: Existing:
Proposed
(#):
# If a different activity other than existing activity is proposed.
9. NAMES OF ASSOCIATE CONCERNS AND NATURE OF ASSOCIATION:
NAMES OF ASSOCIATE ADDRESSES OF PRESENTLY NATURE OF Extent of Interest As a

CONCERNS Proprietor/Partner/Director or just
ASSOCIATE BANKING WITH ASSOCIATION Investor in the associate concern
CONCERNS
10 CREDIT FACILITIES / FINANCIAL ASSISTANCE (EXISTING)

(in ‘000’s)
Type of facilities Limit Outstanding Presently with Bank/ Security Rate of Repayment terms
Financial Institution
(In ‘000’s) as on….. Lodged Interest
Current account
Cash Credit
Term Loan
LC/BG
TOTAL
11. CREDIT FACILITIES (PROPOSED):
Type of facilities Amount Purpose for Security offered
(In ‘000’s) which
required PRIMARY SECURITY (Details with Whether Collateral Security

approx. value to be mentioned) offered (Please
mention yes or no) (If yes,

then provide details in
column 12)
Cash Credit YES / NO
Term Loan YES / NO
LC/BG/ SBLC YES / NO
In case of term loan requirements, the details of machinery may be given as under:
Type of Purpose for Whether Name of Total cost of machine (in Contribution Loan required
Machine imported or case of imported being made by
machine,
which required indigenous supplier the promoters
the breakup of basic
cost,
freight, insurance and
customs duty may be
given)
12. Details of Collateral Security offered, if any, including 3rd party guarantee
a) Free hold property - with full details like – Land, Building, extent of Area, Card and Market Value,
Location, property whose name,
b) If property documents lying in bank: full details of properties, Latest outstandings in Banks, any one
time settlement opted, etc.,
13.
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):
(Rs. in ‘000’s) PAST YEAR - II PAST YEAR - I Actual) PRESENT YEAR NEXT YEAR (Projections)
(Actual) (Estimates)
Net Sales
Net Profit
Capital (Net worth

in case of
companies)
13A. Sources of Income for Loan Repayment:
1.
2.
3.
4.
5.
14. Status regarding Statutory Obligations:
Statutory Obligations Whether Complied with Remarks (Any details in connection with
the relevant obligation to be given)
(Write Yes / No ) If Not
applicable, then write N.A.
1. Registration under Shops and
Establishment Act
2. Drug License No.
3. Latest Sales tax / vat/ returns

filed (attach copies of each return
filed for the last 3 years)
4. Latest Income tax returns filed
5. Any other statutory dues

remaining outstanding
15.
SPACE FOR PHOTO SPACE FOR PHOTO SPACE FOR PHOTO

SIGNATURES OF PROPRIETOR / PARTNER / DIRECTOR WHOSE PHOTO IS AFFIXED ABOVE
Only one photo of proprietor / each Partner / Each working Director is required to be affixed. Each photo will be certified/ attested by the
Branch Team with name and signatures on the photograph with Branch stamp. The concerned staff will put his name below the signatures.
Date: Place:
I/We certify that all information furnished by me/us is true; that I/We have no borrowing arrangements for the unit
except as indicated in the application; that there is no overdues/ statutory dues against me/us/promoters except as
indicated in the application; that no legal action has been/is being taken against me/us/promoters; that I/We shall
furnish all other information that may be required by you in connection with my/our application that this may also be
exchanged by you with any agency you may deemed fit and you, your representatives, representatives of the Central
Bank of this country or any other agency as authorised by you, may, at any time, inspect/verify my/our assets, books of
account etc. in our factory/business premises as given above.

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APPLICATION FORM

LOAN REQUIREMENT: _____________CR,

1. NAME OF THE ENTERPRISE:

2. REGD. OFFICE ADDRESS:

3. ADDRESS FACTORY /SHOP:

4. TELEPHONE/ FAX/ EMAIL:

Mobile No EMAIL ADDRESS:

PAN CARD NO.

7. NAME OF PROPRIETOR/PARTNERS/DIRECTORS OF COMPANY AND THEIR ADDRESSES:

NAME AGE ACADEMIC TELEPHONE NO. EXPERIENCE IN THE LINE OF

QUALIFICATIONS (Residence) ACTIVITY

# If a different activity other than existing activity is proposed.

9. NAMES OF ASSOCIATE CONCERNS AND NATURE OF ASSOCIATION:

NAMES OF ASSOCIATE ADDRESSES OF PRESENTLY NATURE OF Extent of Interest As a

10 CREDIT FACILITIES / FINANCIAL ASSISTANCE (EXISTING)

11. CREDIT FACILITIES (PROPOSED):

Type of facilities Amount Purpose for Security offered

(In ‘000’s) which

required PRIMARY SECURITY (Details with Whether Collateral Security

mention yes or no) (If yes,

Cash Credit YES / NO

Term Loan YES / NO

LC/BG/ SBLC YES / NO

freight, insurance and

customs duty may be

Capital (Net worth

13A. Sources of Income for Loan Repayment:

applicable, then write N.A.

1. Registration under Shops and

2. Drug License No.

3. Latest Sales tax / vat/ returns

4. Latest Income tax returns filed

5. Any other statutory dues

SPACE FOR PHOTO SPACE FOR PHOTO SPACE FOR PHOTO

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