Term Loan Application Form

Unit Details

Unit Name

1. Address :

Registered Office Address

Unit Address

Address Line 1

Address Line 2

Address Line 3

State

Pin Code

Taluka

Industrial Estate

Constituency

Village

2. Constitution :

2. Constitution

3. Product/Line of Activity :

3. Product/Line of Activity

4. Contact Details :

Contact No. (Primary)

Email (Alternate)

Legal Entity Identifier (LEI) No.

Contact No. (Alternate)

Email (Alternate)

Product / Line of activity

Contact No. (Alternate)

Website (if any)

Purpose of Loan

Email of the Unit (Primary)

PAN of Unit

5. Loan Applied (figures in Rs.) :

Loan Amt Required (in Rs.)

6. Utilities :

a. Power (Connected Load)

b. Water (Qty. of water required/day)

c. Source of water

7. Security offered Towards Loan :

a. Prime Security

b. Additional Security

c. Collateral Security

d. Details of Guarantor(s)

8. Details Of Financial Concessions/Waivers Availed in the past :

Details of Financial Concessions / Waivers Availed in the past

13. Working Capital Estimates

Description

Raw materials

Work in progress

Finished Goods

Debtors

Sub Total A

Less Creditors

Sub Total B

Less: Bank Finance

Add: Working expenses

Working capital margin

No. of days

RawMaterials_Days

WorkInProgress_Days

FinishedGoods_Days

Debtors_Days

SubTotalA_Days

LessCreditors_Days

SubTotalB_Days

BankFinance_Days

WorkingExpenses_Days

WorkingCapitalMargin_Days

RawMaterials_I

WorkInProgress_I

FinishedGoods_I

Debtors_I

SubTotalA_I

LessCreditors_I

SubTotalB_I

BankFinance_I

WorkingExpenses_I

WorkingCapitalMargin_I

RawMaterials_II

WorkInProgress_II

FinishedGoods_II

Debtors_II

SubTotalA_II

LessCreditors_II

SubTotalB_II

BankFinance_II

WorkingExpenses_II

WorkingCapitalMargin_II

III

RawMaterials_III

WorkInProgress_III

FinishedGoods_III

Debtors_III

SubTotalA_III

LessCreditors_III

SubTotalB_III

BankFinance_III

WorkingExpenses_III

WorkingCapitalMargin_III

14. Details of litigations / legal cases related to the :

14. Details of litigations / legal cases related to the

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Upload the excel file here

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15. Declaration :

a) I/We certify that all the information furnished by me/us is true; that I/we have no borrowing arrangement except as indicated in the application, for the unit with any bank/Institution; that no legal action has been/is being taken against me/us by bank/Institution/Government agency; that I/We shall furnish all other information that may be required by you in connection with my/our application; that this and any other information available with you pertaining to the borrowing unit, present, and future, may also be exchanged by you with any agency you may deem fit, and that you, your representatives, representatives, of RBI, CIBIL or any other agency as authorized by you, may at any time inspect/verify our assets, books of account etc. in our factory and business premises.

b) I/We further certify that as on date there are no overdues to financial institutions/banks from the undersigned, the other promoters and the company/companies in which I/the other promoters have interest as a promoter/director/partner/proprietor. I/We further certify that there are no statutory overdues pending against me/the company of other companies in which I am/the other promoters are Director/Directors.

c) 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).

d) I/We hereby declare that the undersigned applicant/ beneficiary owner(s) is a “Politically Exposed Persons” (PEP)*

* PEPs (Politically Exposed Persons) – Indian individuals with prominent public roles (Heads of States/Governments, senior politicians, senior government/Judicial/ military officers, senior executives of state-owned corporations, important political party officials, etc.) and immediate family members having close business or personal relation

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)

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Upload PAN Card

Choose File

Voter ID

Aadhaar No.

Upload Aadhaar Card

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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 a “Politically Exposed Persons” (PEP)*.

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

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.

Upload Aadhaar Card

Choose File

List of other concerns in which I have interest

Declaration

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

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.

Upload Aadhaar Card

Choose File

List of other concerns in which I have interest

Declaration

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

Term Loan Application Form

Unit Details

1. Address :

2. Constitution :

3. Product/Line of Activity :

4. Contact Details :

5. Loan Applied (figures in Rs.) :

6. Utilities :

7. Security offered Towards Loan :

8. Details Of Financial Concessions/Waivers Availed in the past :

9. Cost of Project : (₹ In Lakhs)

10. Means of Finance: (₹ In Lakhs)

13. Working Capital Estimates

14. Details of litigations / legal cases related to the :

15. Declaration :

Biodata of the Promoter / Partner / Director / Guarantor

Personal Assets & Liabilities:

Bank Details

Other Details

Borrower Details

Personal Assets & Liabilities:

Bank Details

Other Details

Borrower Details

Personal Assets & Liabilities:

Bank Details

Other Details

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