This document contains a loan application form requesting information about the applicant's employment history, financial details, existing loan obligations, spouse details, guarantor details if applicable, security being offered, and references. It requests information such as the applicant's name, address, designation, income, tax status, existing loans and their details, loan amount requested, processing fees, loan repayment plan, spouse income, guarantor details like name, address, relationship and income if being offered, assets being offered as security, and contact details of two references including one non-relative.

1. To be filled if applicant is not employed currently
Name & Address of Previous Employer / Business :
City : State :
Designation :
Pin Code : Tel.: (O) :
No. of Years in Previous Employment / Business :
Name of the Spouse :
Is He / She an Earning Member ? If Yes, please provide Net Monthly Income Rs. :
Office Name & Address :
Spouse Details
Financial Details
Loan Servicing Details
Date of Birth : DD: MM: YYYY:
Tel. : (O) :
Salaried / Pensioners
Gross Monthly Salary : (Rs.)
Net Monthly Salary : (Rs.)
Pension : (Rs.)
Other Income (If any) : (Rs.)
Investment in Shares / Units / Bank Deposits / Others (Please specify) :
Total Investment in Value : (Rs.)
Self-employed
Gross Monthly Income : (Rs.)
Net Monthly Income : (Rs.)
Other Income (If any) : (Rs.)
Are you a Tax Payer? Yes No
Do you have any other Existing Loan(s) ?
Loan 1
Loan Type :
Name of Financier :
Monthly Instalment :
Loan Amount :
Current Outasanding :
Balance Months to go :
Date of Loan Availed :
Purpose of Loan :
Have any additional Loans(s) Servicing ? Yes No
Yes No (If yes, please provide the folowing details)
Loan Request
Loan Amount Requested : Rs.
Mode of receiving Processing Amount :
Upfront Processing Fees : (Rs.)
Drawn on :
By Cash in a bank
Cheque No. : Date of Receipt :
Loan Request Plan : Lumpsum Annuity Combination of Lumpsum and Annuity
If Lumpsum Plan : Amount Requested Rs.
If Annuity Plan : Whether Monthly Quaterly
If Combination of Lumpsum and Annuity Plan : Lumpsum amount Requested Rs.
/-
Half Yearly Annual
/- Balance in Monthly Annuity

2. Guarantor Details
(If Applicable)
Type of Guarantor :
Name of Guarantor :
Father's / Spouse's Name (in case of individual only) :
Residence Address :
Individual Corporate Relationship with Applicant :
Date of Birth : DD: MM: YYYY:
State :
Fax :
Office Address :
State :
Fax :
Mobile No.: Pager No.:
Pin Code :
City :
Tel. :
E-mail :
City :
(O) (R)
(O) (R)Tel. :Pin Code :
Designation :
In case Self-Employed, please provide the business commencement date : DD: MM: YYYY:
No. of Years in Current Employment / Business :
Gross Monthly Salary / Income : (Rs.)
Net Monthly Salary / Income : (Rs.)
Investment in
Total Investment in Value : (Rs.)
Shares Bonds / Units Bank Deposits NSC
Gross Annual Turnover : (Rs.)
Net Annual Income : (Rs.)
Others (Please specify) :
Are you a Tax Payer? Yes No
Would you like to avail of any other facility offered by the SQB? Yes No If yes, Please tick on relevant boxes.
Fixed Deposits
Vehicle Loan
Assets Finance
Personal Loan
Home Loan
Business Loan
Security Document Details
Abour your references
(One reference has to be non-relative / non-colleague)
Security Document :
Security Document :
Security Document :
Security Document :
Total Value of Securities given : Rs.
Ref. No.:
Ref. No.:
Ref. No.:
Ref. No.:
Date of Purchase :
Date of Purchase :
Date of Purchase :
Date of Purchase :
Reference 1
Name :
Relation with applicant :
Address :
Tel. (R) : (O) :
Pin Code :
Mobile :
E-mail :
Reference 2
Name :
Relation with applicant :
Address :
Tel. (R) : (O) :
Pin Code :
Mobile :
E-mail :