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 MSME Loan Personal Details Form
        
 Fields marked with * are mandatory
* Name of the Enterprise
* Regd. Office Address
* Address of Factory/Shop
  Premises (Owned/Rented/Leased)
* Telephone No
* E-mail Address

 
* Mobile No

 
  PAN Card No

* Constitution (Please Select)
 Udyog Aadhaar No. / Registration No.
* Date of Establishment/Incorporation
* State (Branch Location)
* District
* Branch where loan is required

*   Name of Proprietors/ Partners/Directors of Company and Their Addresses:
Sr. No.NameDate of birthFather/SpouseAcademic QualificationCategory SC/ST/OBC/ (Minority/Women)Mobile No.
1
             
Sr. No.PAN No.Residential AddressAadhar No./Din No.Telephone No.(Residance)Experience in the line or activity(Years)
1
               

* Activity  Existing Since

Proposed# #if a different activity other than existing activity is proposed/ New unit

Whether the MSME unit is ZED rated (Yes/No)
If yes, the gradation obtained by the MSME unit (Tick appropriate one)




Names of Associate Concerns and Nature of Association:

Sr. No.Name of Associate Concern Address of Associate ConcernPresently Banking With Nature of AssociationExtent of Interest as a Prop./ Partner/ Director or Just Investor in Associate Concern
1

 


 Relationship of Proprietors/Partners/Director with the officials  of  the Bank/Director of the Bank

 Banking/Credit Facilities (Existing) (Rs.in lakh)

Type of Facilities Limit
(in lakh)
Outstanding as
on
Presently Banking
 With
Securities Rate of Interest Repayment
 Terms
Current Account
Cash Credit
Term Loan
LC/BG
Others
Total
If banking with our Bank, customer ID be given here:     

It is certified that our unit has not availed any loan from any other Bank / Financial Institution in the past and I am not indebted to any other Bank / Financial Institution other than those mentioned in column no. 20 above.


Credit Facilities (Proposed)

Type of Facilities Amount
(in lakh)
Purpose for
which Required
Primary Security(Details with approx. value to be mentioned)
 With
Whether Collateral Security Offered (If ,yes, then provide details on column--23 20)(Yes/ No)
Cash Credit**
Term Loan
LC/BG
Others
Total


**Basis of Cash Credit Limit applied

Cash Credit Projected
Sales Working cycle in month Inventory Debtors Creditors Other current assets Promoters Contribution


In case of term loan requirements, the details of machinery may be given as under  :

Sr. No.Type of Machine/EquipmentPurpose for which RequiredWhether Imported or IndigenousName of SupplierTotal Cost of Machine (in case of imported machine, the breakup of basic costs, freight, insurance and customs duty may be given)Contribution being made by the promotorsLoan Required
1

               

 Details of Collateral Securities Offered, if any, including third party guarantee
(As per RBI guidelines banks are not to take collateral security for loans upto Rs.10 Lakhs to MSME Units)
Third Party Guarantee:

Sr. No.Name of GuarantorFather spouse nameResidential addressTelephone no.(residence)Mobile No.Net worth (Rs. in Lakh)Aadhar No.PAN No.
1
Other Collateral Security:              
Sr. No.Name of owner of CollateralNature (Collateral Security)Details (Collateral Security)Value (Rs. in lakh) (Collateral Security)
1
               

Past Performance / Future Estimates
Past Performance / Future Estimates (Actual performance for two previous years, estimates for current year and projections for next year to be provided for working capital facilities. However for term loan facilities projections to be provided till the proposed year of repayment of loan)
Rs. in lakh Past Year
1 (Actual)
Past Year 2 (Actual) Present Year
(Estimate)
Next Year (Projection) Installed Capacity Utilized Capacity
Net Sales
Net Profit
Capital (Net Worth in case of Companies)


Status Regarding Statutory Obligations
Statutory Obligation: Remarks( Any details in Connection with the relevant obligation to be given)
Whether Complied with (select Yes /No). If not applicable then select N. A.
1. Registration under Shops and Establishment ACT

2. Registration under MSME (Provisional /Final)

3. Drug License

4. Latest Sales Tax Return Filed

5.Latest Income Tax Returns Filed

6.Any other Statutory dues remaining outstanding


ID Proof (Any of following):
ID Proof No.


Address Proof (Any of following):
Address Proof No.


Declaration:
I/We hereby certify/authorise that all information furnished by me/us is true, correct and complete; that I/We have no borrowing arrangements for the unit except is in the application; that there is no over dues/ statutory dues against me/us/promoters except as indicated in the application; that I/We have not been declared as defaulter/wilful defaulter by any Bank/FS and no Legal action has been taken/initiated against me/us by any Bank/FIs/We shall furnish all other information that may be required connection with my/our application that this may also be exchanged by you with an agency you may deem fit and you, your representatives or Reserve Bank of India or any other agency as authorised by you, may at any time, inspect/ verify my/our assessment of account etc. in our factory/business premises as given above; you may take appropriate safeguards/action for recovery of Bank’s dues including publication of defaulters name in website/submission to RBI; further agree that my /our loan shall be governed by the rules of your Bank which may be in force from time to time..


Photograph:
Please upload photograph


Signature:
To be signed by the Applicant at the designated Branches only


CHECK LIST:
1. Proof of Identity : Voter’s ID Card/ Passport/ Driving License/ Pan Card/ Signature identification from present bankers of proprietor, partner of director (if a company)(not mentioned at 26 A above)
2. Proof of residence: Recent telephone bills, electricity bill, property tax receipt /Passport/ voter’s ID card of Proprietor, partner or Director (if a company)
3. Proof of business Address (The list differs from 26 B above)
4. Applicant should not be defaulter in any Bank/F.I.
5. Last three years balance sheets of the units along with income tax / sales tax returns etc. (Applicable for all cases from Rs.2 lakh and above) However, for cases below fund based limits of Rs.25 lakh if audited balance sheets are not available, then un audited balance sheets are also acceptable as per extant instructions of the bank. **
6. Memorandum and articles of association of the Company / Partnership Deed of partners etc.
7. Assets and liabilities statement of promoters and guarantors along with latest income tax returns.
8. Rent Agreement (if business premises on rent) and clearance from pollution control board if applicable.
9. SSI / MSME registration/Udyog Aadhar Registration if applicable.
10. Projected balance sheets for the next two years in case of working capital limits and for the period of the loan in case of term loan (For all cases of Rs.2 lakh and above).
11. In case of takeover of advances, sanction letters of facilities being availed from existing bankers/ Financial Institutions along with detailed terms and conditions.
12. Photocopies of lease deeds/ title deeds of all the properties being offered as primary and collateral securities.
13. Position of accounts from the existing bankers and confirmation about the asset being standard with them. (In case of takeover).
14. Copy of VAT return if applicable.
** To enforce discipline and ascertain true financial position, no credit proposals (except schematic lending) above Rs.10 lakh from individual/firms shall be entertained without audited financials
For Cases With Exposure Above Rs.25 Lakhs
15. The audited balance sheets are necessary.
16. Profile of the unit (includes names of promoters, other directors in the company, the activity being undertaken addresses of all offices and plants, shareholding pattern etc.
17. Last three years balance sheets of the Associate / Group Companies (if any).
18. Project report (for the proposed project if term funding is required) containing details of the machinery to be acquired, from whom to be acquired, price, names of suppliers, financial details like capacity of machines, capacity of utilization assumed, production, sales, projected profit and loss and balance sheets for the next 7 to 8 years till the proposed loan is to be paid, the details of labour, staff to be hired, basis of assumption of such financial details etc.
19. Review of account containing month wise sales (quantity and value both), production (quantity and value), imported raw material (quantity and value), indigenous raw material (quantity and value), value of stocks in process, finished good (quantity and value), debtors, creditors, bank’s outstanding for working capital limits, term loan limits, bills discounted.
20. Manufacturing process if applicable, major profile of executives in the company, any tie-ups, details about raw material used and their suppliers, details about the buyers, details about major-competitors and the company’s strength and weaknesses as compared to their competitors etc.
. (The check list is only indicative and not exhaustive and depending upon the local requirements at different places addition could be made as per (necessity).
Data /information mentioned a point no. 17,18,19 may be sought from unit requesting limit of Rs. 50 lacs and above.


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