Bio-Data Form - 1

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BIO-DATA

1. Name :

2. Father’s/Husband’s Name :
Mother's Name :
3. Date of Birth :

4. Permanent Address :

5. Present Address and Phone no :

6. Work Address , Phone No and :


Length of service/profession :
7. Qualifications/Experience :

8. Probable line of inheritance/


Family members. :
Name Age Relationship
--------------- ----- -----------------

9. Total Assets ( As per overleaf) :

10. Total Liabilities (As per overleaf) :

11. Net means( 7 minus 8) :

12. Other contingent liabilities :

13. Present Banker/Branch :

14. Deposit Account :

15. Borrowal Account :

16. Identical/ Associate concerns of


firm in which you are interested

Signature
Liabilities Value Assets Value

Loan Repayable Cash on hand


Cash in Bank
(A/c Details)
Paid up value of LIC
Policies *
Creditors Investment in
Govt. Securities
PF
PPF

Contingent Land & Building **


liabilities (approx.sale value)

Movable Items

Furniture & Fixtures

TV/Stereo/Fridge

Other Assets

Vehicle (Particulars)

Jewellary

Capital in Business

* PAID UP VALUE OF LIC POLICY


LIC Policy No. Date Plan Sum Insured Total Premium Paid Is it current?

** LAND & BUILDING


Sale Deed/ Date Purchase Location Particulars Area Approximate
Partition Deed No. Price Sale value

Signature

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