This document is a loan application that collects information about the applicant such as name, family details, annual and monthly income, proposed business or activity, loan amount requested, and repayment terms. The applicant declares that the information provided is true and correct and authorizes the bank to share details of their loan accounts with other financial institutions as needed. They also acknowledge that misrepresenting outside borrowings could disqualify them from receiving credit.

1. Loan No.
1 . Name of the APPlicant (s)
2. Father's / Husband's Name
3. FullAddress
4.Age
5. MaritalStatus
6: WhetherBelongs to Schedule
Caste /Tribe / Backward Class
7. Applicant FamilY Details
(Family Ration card copy should be enclosed)
B.Familytotalannualincome :
9. ProposedActivitY/ Business :
1 0. Loan Anrount Required
11 . Anticipated mcnthly income from proposed activity business :
12. RepayntentPeriod :
lnstallmentAmount : , '
MonthlY/QuarterlY lnstallment : "
:
lMeher.ebydeclarethatthetotalincomeof1u:'',ist........
,]
'
I will take care / manage the assets,created out of the bank loan and prgmise you to repay
I
, , *. her:eby declare that the particulars given above are true and correct to the best of my /
our knowledge and belief.
| / we hereby authorized the bank, to disclose all or any panticulars or details or information
rerating to my / our roan accounts with the bank, to any other financlar instltution, Government or
any *E-*ory (ies) as may be eonsidered necessary or desirable by the bank'
Itwill be in orderforthe bank to disqualify me / us from receiving any creditfacilitiesfrom the
nanx in iarJii= **"d that the declarations of my / our outside borrowings from other agency on
the date of aPPlication.
Photo
Place
Date
Encl
Annual
lncome
Monthty
lncome
Applicant(s) Si g nature