Term Loan Application Form

Cost of Project:

(₹ In Lakhs)

Means of Finance:

(₹ In Lakhs)

Working Capital Estimates

BIODATA OF THE PROMOTER/PARTNER/DIRECTOR/GUARANTOR

Personal Assets & Liabilities:

IMMOVABLE ASSETS: (Land, Building/House/Flat)                                                                                                      (₹ In Lakhs)

MOVABLE ASSETS Motor Vehicles/Investments-Shares/Mutual funds/Postal/LIC/FD etc.)                               (₹ In Lakhs)

Declaration

a) I declare that all the information furnished by me as above is true and complete. In- case any supporting documents are required to be produce data later date, I shall produce the same. I understand that action would be taken against me, if found incorrect.

b) I/We hereby also declare that the applicant/beneficiary owner(s) has no terrorist linkages and is not a part of the list of individuals/entities suspected of terrorist links and periodically circulated by the United Nations Security Council (UNSC) list or any other list (RBI, FAFF, NIA, MHA).

c) I/We hereby declare that the undersigned applicant/ beneficiary owner(s) is/is not a “Politically Exposed Persons” (PEP)*.