ANNEXURE- A

Photo with
signature

APPLICATION FOR SME CREDIT CARD

01. Name of the unit

02. Constitution Proprietary Partnership
Company
03. Address - Business

Telephone No.
04. Address Residential
Photo ID
Address Proof
Telephone / Mobile No.
e- mail address

05. Age of proprietor /Mng. 18-30 years 31-45 years

Partner 46 & above

06. Owning a House Own (Not mortgaged) OWN

Not owning
07. Academic Qualifications Technical Professional
Graduate Undergraduate
08. Spouse Detail Employed Not working
09. Income Assessed Under IT Yes No.
10. Taken Life Insurance Policy Yes No.
11. Whether belongs SC/ST Minority Community ?
Male Female
Ex-Serviceman
12. Aadhar Udyog No. PAN No. and GST No.

Business Details
13 Description of Activity
Dealing with business since

14. PROJECT DETAILS

RS. IN LAKHS
Cost of project Amount Means of finance Amounts
Fixed assets
Current assets Working capital
Term loan
Others
TOTAL TOTAL

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15. TRACK RECORD
Year 1 Year 2 Year 3 Year 4 Year 5
Sales
Profit

16.Banking with UGB

Details of deposit A/c Since

Details of Advance A/c Since

Loans Repaid

17. Marketing Arrangements : Tie ups Ancillary Units

Others

18. TOL CA
TNW CL

19. DSCR
20. Amount of loan required
21. I / we certify
i. All information furnished by me is true, correct and complete
ii. I /We have no borrowing arrangement for the unit with any Bank except as indicated in the
application.
iii. There are no overdues /statutory dues against me /us
iv. No legal action has been taken against me /us.
v. The information may also be exchanged by you with any agency you may deem fit.
vi. I / we shall furnish all other information that may be required by Bank in connection with my
application.
vii. You, your representative or any other agency as authorized by you may at any time inspect /
verify my / our assets, books of accounts, etc., in our factory / business premises as given
above.
viii. You may take appropriate safeguards / action for recovery of Bank’s dues including
publication of defaulter’s name in website / submission to RBI
ix. We further agree that my / our loan will be governed by the rules of Utkal Grameen Bank
which may be in force from time to time.

Place:
Date: Signature of the Applicant
Note : Documentary proof in the form of originals with self attested copies to be
produced for verification. Originals to be returned and attested copies to be filed along
with application.

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 APPRAISAL NOTE FOR SME CREDIT CARD

(Quantum of Finance Maximum Rs.10.00 lakhs)

PROPOSAL FOR SANCTION OF
1.
2.
CREDIT SCORE: /60. (Minimum 36) (as per annexure-I) Segment :MSE/SBF/C&I
1. Name of the unit
2. Constitution
Registration No. of the
unit.( if applicable)
3. Name of the Proprietor/ Partners
/directors
4.Business Address

Phone/Cell No.
5. Nature of activity
6. Banking with us from
7. Details of Limits as on date. Existing limits Proposed Limits
CC (HYP) CC (HYP)
(Rs.in lakhs) TL TL
LC /BG LC /BG
Total indebtedness
8. Brief History 1.
(Brief bullet points only) 2.
(on Management, products, marketing tie- 3.
up etc.,) 4.
5.
9. Project Details Project Cost Rs.
(If term loan is required)
Bank Loan Recommended Rs.
(As per assessment in annexure-III)
Debt /Equity-

10.Financial Position: (Rs. In lakhs)

Years 1 2 3 4
(Act) (Act) (Est) (Proj)
Sales income
Profit
Profit / Net sales
Tangible Net worth
TOL /TNW
Current Ratio

11. Working Capital Requirement Working capital limit of Rs. Has been assessed as
per the Projected turnover method (Nayak
Committee method) as per the workings as on
annexure-II.
12. Adverse remarks unattended in last
Inspection & audit report, if any.
13. Whether borrower/ promoters figure
as defaulters in CIBIL report
for individuals.
14. Details of Associate concerns. Any
NPA’s

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15. Terms & conditions
i) Primary Security Hypothecation of plant & machinery purchased
out of bank finance. Hypothecation of all kinds of
Stocks & receivables.
(cover period for receivables ----- days)
ii) Collateral Security

iii) Guarantee Personal guarantee of Sri.

(Indicate Net worth of Guarantors with date of
compilation of opinion reports)
iv) Margins WC TL
v) Documents As per SME documentation
vi) Submission of stock statements To be submitted annually. Submit once in the last
quarter of the year.
vii)Validity WC loan is valid for 3 years, but is subject to
annual review.
viii) Insurance Stocks/Equipment to be insured for full market
value for all possible risks with bank clause.
ix) Inspection Quarterly / Half yearly.
x) Repayment
xi) Rate of interest -------% above/below PLR effective rate;
xii) Upfront fees/Processing Charges
xiii) Charges with ROC (if applicable)

16. Recommendations
Recommended for sanction of working capital limit of Rs.
Term Loan of Rs.
______________
Total limit
On the above terms and conditions
Signature Appraised & Assessed by Sanctioned by
Name
Designation
Date
Enclosure:
Applicant’s application & others
Controlled by
Signature
Name
Designation, Date

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 ANNEXURE-B

SCORING MODEL- SME CARD

NAME OF THE UNIT-

Sr.No And Parameters Max Marks Criteria Marks
Marks scored
1.Age 3 18-30 3
31-45 2
46 & above 1
2.Owing House 3 Own (NM) 3
Own (M) 2
Not owning 0
3.Academic Qualification 5 Technical 5
Professional/PG 4
Graduates 3
Less than graduation 2
4.Experience in line of trade 4 More than 5yrs 4
3-5 years 3
1-3 years 2
Less than 1yr 1
5.Loyalty (Deposits /Advances 3 Dealing with UGB more than 3
3 yrs
1-3 years 2
Less than 1 yr 1
6.Spouse details 2 Employed 2
Home Maker 0
7.Assessed For IT 2 Assessed 2
Not assessed 0
8.Has life Insurance Policy 2 Yes 2
No 0
9.Track Record of repayment of 3 Prompt / No loan 3
personal loan Irregular 0

10.Continuous Profits 5 Last 5 years 5

Last 3 years 3
Last year 1
11.Sales show rising trend 5 Last 5 years 5
Last 3 years 3
Last year 1
12.Marketing 3 Tie up arrngt. In operation 3
Ancillary 2
others 1
13.TOL /TNW 5 Less than 1 5
1 to 2 4
2 to 4 3
More than 4 0
14.CA /CL (Current Ratio) 5 More than 1.33 5
1 to 1.33 3
Less than 1 0
15. D.S.C.R 5 More than 2 5
1.5 to 2 3
1 to 1.5 2
Less than 1 0
16.Routing of sales turnover 5 100% 5
through the account 75% 4
50% 3
<50% 1
TOTAL (NORMALISED TO 60) 60
NB: In case any of the above parameters is not applicable , the scoring should be normalized
out of 60

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 Annexure-C

Name of the Borrower:

ASSESSMENT OF WORKING CAPITAL

I. For MSE, SBF and Retail traders:

Projected Turnover Method (Nayak Committee Method)

A. Estimated Sales for the Current year `

B. Working capital required (25% of A) Rs.

Eligible Bank Finance (80% of B) Rs.

Bank finance Required Rs.

Working Capital Assessed/recommended is

II. For Self Employed and Professionals
50% of Gross annual income as declared in their Income Tax return.
III. Comments on Production aspects: (covering location advantages, availability of raw
material and other utilities like water, power, fuel, labour etc.

IV. Brief Comments on Marketing Aspects:

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 ANNEXURE-D

Name of the Borrower

Assessment of Term Loan

1. Project Details

Rs. in lakhs
Project cost Cost Margin (%) Margin amount Required Bank
Finance
Plant & Machinery
Land & Buildings
WC Margin
Contingencies
Total Project cost
Means of finance
Own funds
Borrowings from
friends and relatives
Bank finance
Others
Total means of
finance

Debt /Equity-

2. Term Loan Assessment:- Rs. in lakhs

Years 1 2 3 4 5 6
(Act) (E) (E) (E) (E) (E)
Net profit
Depreciation
Cash Accruals
Repayment
obligations
(including
interest)
DSCR

Average D.S.C. R-

3. Details of machinery / equipment proposed to purchase:

4. Project implementation schedule.

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 ANNEXURE-D-(1)

(for SRTO’s)
Name of the Borrower:

Term Loan assessment for Transport Operators (SRTO)

Cost of Vehicle/s Rs.
Borrower’s Margin ( %) Rs.
Term loan recommended Rs.
Assessment:

Earnings
1 Total No. of Kilometers to be run per day (estimated)/ No.
of trips per day

2 Earnings per Km / earning per trip

3 No. of working days in a month

4 Total monthly earnings 1 x 2 x 3 …..A
Expenses
5 Cost of Fuel per liter

6 Quantity of fuel required per month

7 Cost of fuel per month

8 Monthly Wages / batta for driver / cleaner etc

9 Maintenance

10 Repair
11 Insurance (annual premium / 12)
12 MV Tax (annual tax /12)
13 Interest on borrowings
14 Sustenance
15 Other expenses
Total Monthly Expenses (5 to 15)….B
16 Monthly surplus …. A – B
17 Monthly TL repayment
18 DSCR 16/17

Brief details of above workings:

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 ANNUAL REVIEW OF UGB -SME CREDIT CARD
PROPOSAL FOR REVIEW OF WC AND TERM LOAN SCANCTIONED UNDER
“UGB- SME CREDIT CARD” SCHEME

1. Name of the unit

2. Constitution Proprietorship/Partnership/Private limited
Company
3 Name of the Proprietor/partners/ directors
4. Business Address

Phone/Cell No.
5. Nature of Activity
6. Date of last Sanction /Review
7. IRAC Position as on
8. Present Position of Accounts as on date Facility Limit DP O/S Irregularity
of review (Rs. In lakhs) if any
CC
TL
LC/BG

Total Indebtedness

9.Conduct of WC a/c (Rs. In lakhs) Annual Turnover estimated Rs.

Annual Credit Summations in
the account Rs.
(Atleast 50% should be routed in the
account, other wise sanctioning authority
has to take a view on continuation of
facility)
Value of the account :Rs.
(Interest/Exchange/commission Booked)
Any Cross selling Products Booked :
(Give the name of the product booked)
10.a) Whether earlier sanctioned terms
complied with?
b) Comments on non-achievement of
estimated sales/profit.
c) No. of times the account was irregular
last year and reasons.
11.Comments (from risk angle)
(On other associates, Competition, quality
of products, I&A comments, CIBIL report for
individuals etc., and other relevant to Risks.
Bullet points only)
11. Recommendations
The conduct of WC loan and Term Loan has been reviewed and found satisfactory.
Recommended for continuation of Working Capital limit of Rs.
On the above terms and conditions as already set out in the original sanction dated- (Mention
the date)

Signature Appraised by Approved by

Name
Designation
Date