Term Loan Application Form

Term Loan Form

Section 1
Section 2
Section 3
Section 4

Term Loan Application Form

Unit Details

Unit Name

Office Address

Address

Address Line 1

Address Line 2

Address Line 3

State

Constituency

Taluka

Pin Code

Village

Industrial Estate

Unit Location

Constitution

Contact No. (Alternate)

Website (if any)

PAN of Unit

Email of the Unit (Primary)

Project Cost (in Rs.)

Contact No. (Primary)

Email (Alternate)

Purpose of Loan

Contact No. (Alternate)

Email (Alternate)

Loan Amt Required (in Rs.)

Utilities

a. Prime Security

b. Additional Security

c. Collateral Security

d. Details of Guarantor(s)

Details of Financial Concessions / Waivers Availed in the past

Cost of Project :

(₹ In Lakhs)

Particulars

Land

Land development

Building and other civil works

Machinery – Imported

Machinery – indigenous

Electrification & DG Set

Office Equipment, Furniture

Dies and Moulds

Other fixed assets (please specify)

Preliminary and Pre. Op. expenses

Contingencies (10% of non firm cost)

Working Capital Margin

Total

Existing

Land_existing

Landdev_existing

Building_existing

Machinery_imported_existing

Machinery_indigenous_existing

Elec_existing

Ofice_existing

Dies_existing

Other_existing

Preop_existing

Cont_existing

Wc_existing

Existing_grand_total

Proposed

Land_proposed

Landdev_proposed

Building_proposed

Machinery_imported_proposed

Machinery_indigenous_proposed

Elec_proposed

Office_proposed

Dies_proposed

Other_proposed

Preop_proposed

Cont_proposed

Wc_proposed

Proposed_grand_total

Total

Land_total

Landdev_total

Building_total

Machinery_imported_total

Machinery_indigenous_total

Elec_total

Office_total

Dies_total

Other_total

Preop_total

Cont_total

Wc_total

CostProject_grand_total

(Enclose supporting Documents as per checklist)

Means of Finance:

(₹ In Lakhs)

Particulars

Capital –Equity / Preference shares

Internal Accruals

Unsecured loans a) Interest Free –

b) Interest bearing

Term Loan

Other Sources (specify)

Total

Existing

Cap_existing

Accrual_existing

LoanIF_existing

LoanIB_existing

Term_existing

Other_existing

Total_existing

Proposed

Cap_proposed

Accrual_proposed

LoanIF_proposed

LoanIB_proposed

Term_proposed

Other_proposed

Total_proposed

Total

Cap_total

Accrual_total

LoanIF_total

LoanIB_total

Term_total

Other_total

Total_finance

Biodata of the Promoter / Partner / Director / Guarantor

Promoter/Guarantor

Middle Name

Last Name

Mother's Name

Middle Name

Last Name

Spouse's Name

Middle Name

Last Name

State

Constituency

Pin Code

E-mail

Date of Birth

Religion

Academic Qualifications

Role in Organization

Family Income (in Rs.)

Litigations pending against firm (s)/concern/myself

Father's Name

Middle Name

Last Name

Marital status

Permanent Address

Taluka

Village

Phone No.

Gender

Occupation

Personal Assets & Liabilities:

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

Description of property	Full name of property	Extent of share	Purchase Value	Market Value

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

Items	Discription	Purchase Value	Market Value

Bank Details

Account No.	Bank Name	Bank Branch	Bank Address

Other Details

PAN No.

Upload Photograph (Passport Size)

Choose File

Upload PAN Card

Choose File

Voter ID

Aadhaar No.

Driving Lic. No.

Upload Aadhaar Card

Choose File

Emp Exch Ref No.

List of other concerns in which I have interest

Add Another Borrower?

Yes

Borrower Details

Promoter / Guarantor

Middle Name

Last Name

Mother's Name

Middle Name

Last Name

Spouse's Name

Middle Name

Last Name

State

Constituency

Pin Code

E-mail

Date of Birth

Religion

Academic Qualifications

Role in organization

Family Income

Litigations pending against firm (s)/concern/myself

Father's Name

Middle Name

Last Name

Marital status

Permanent Address

Taluka

Village

Phone No.

Gender

Occupation

Personal Assets & Liabilities:

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

Description of property	Full name of property	Extent of share	Purchase Value	Market Value

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

Items	Discription	Purchase Value	Market Value

Bank Details

Account No.	Bank Name	Bank Branch	Bank Address

Other Details

PAN No.

Upload Photograph (Passport Size)

Choose File

Upload PAN Card

Choose File

Voter ID

Aadhaar No.

Driving Lic. No.

Upload Aadhaar Card

Choose File

Emp Exch Ref No.

List of other concerns in which I have interest

Add more Borrower?

Yes

Borrower Details

Promoter / Guarantor

Middle Name

Last Name

Mother's Name

Middle Name

Last Name

Spouse's Name

Middle Name

Last Name

State

Constituency

Pin Code

E-mail

Date of Birth

Religion

Academic Qualifications

Role in organization

Family Income (in Rs.)

Litigations pending against firm (s)/concern/myself

Father's Name

Middle Name

Last Name

Marital status

Permanent Address

Taluka

Village

Phone No.

Gender

Occupation

Personal Assets & Liabilities:

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

Description of property	Full name of property	Extent of share	Purchase Value	Market Value

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

Items	Discription	Purchase Value	Market Value

Bank Details

Account No.	Bank Name	Bank Branch	Bank Address

Other Details

PAN No.

Upload Your Photograph

Choose File

Upload PAN Card

Choose File

Voter ID

Aadhaar No.

Driving Lic. No.

Upload Aadhaar Card

Choose File

Emp Exch Ref No.

List of other concerns in which I have interest

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)*.

I have read and agree to the above Terms and Conditions.

Term Loan Application Form