ANNEXURE - A

Application for Loan under
UBI Personal Loan Scheme and United Professional Loan Scheme

To
The Chief Manager/Manager
United Bank of India
_________________ Branch
  
Applicant's Photograph
(Applicant 1)


 
  
Applicant's Photograph
(Applicant 1)


 


 

Dear Sir, I/We request you to sanction a loan of Rs.________________ (Rupees ________________ _____________________________________) only under Personal Loan Scheme of the Bank. I/We furnish the following information.

Applicant 1 Applicant 2
   
1. Name of the Applicant :
  
2. Age :
  
3. Name of Father/Husband :
 
4. Address of the Applicant
    and Tele. No.
    i) Residence

:
  
  
   ii) Office :
   
  
5. For Salaried Applicant
    i) Name and address of the
       Employer		 :
   
    
    ii) Applicant’s designation/
       position in the Employer’s
       organization and period
       since when employed		 :
  
   
6. For Professional and
    Self- Employed applicant
    i) Name and address of his/her         firm/company and details
:
1
Applicant 1 Applicant 2
   
    ii) Line of activity of the firm/
        company or the profession		 :
  
   iii) Applicant’s designation/
        position in the firm/company
        and period since when engaged 		:
  
   iv) Nature and value of securities
        offered		 :
 
  
  
7. For Salaried Applicant
   
    i) Monthly gross salary and net take home salary for the month of________________________
       (to be certified by the employer)
  
            Applicant 1                           Applicant 2

 
Gross Salary
Basic    Rs__________
DA      Rs__________
HRA   Rs__________
Others Rs__________
Total   Rs__________		 Deductions
PF      Rs__________
IT       Rs__________
Loan   Rs__________
Others Rs__________
Total   Rs__________		   Gross Salary
Basic    Rs__________
DA      Rs__________
HRA   Rs__________
Others Rs__________
Total   Rs__________		 Deductions
PF      Rs_________
IT       Rs_________
Loan   Rs_________
Others Rs_________
Total   Rs_________
        
Net Take Home Salary            Rs_________ Net Take Home Salary             Rs_________
 
    ii) For Professional and Self-
        Employed applicant		 Applicant 1 Applicant 2
 
  
   Gross Annual Income 
   (To enclose latest Income Tax
   Assessment Order/Return filed)		 : Rs__________ Rs_________
  
8. Particulars of a/c maintained with
    this branch or any other branch
    of this Bank or any other bank		 :
  
9. Purpose of Loan :
  
10. Amount of Loan applied for : Rs___________
  
11.Two persons who can be
     referred to for information (Please
     give names and addresses)		 :
2
 
I/We undertake to repay the loan in __________ nos. monthly installments of such amount to be fixed by you, commencing one month after the disbursement.

I/We also undertake to abide by the terms and conditions laid down by the Bank in respect of the loan, if sanctioned, and agree to the Bank recalling the entire loan in the event of coming across any incorrect statement on my part.

I/We also enclose herewith the following papers/documents for your perusal and doing the needful.

A Letter of Authority addressed by me/us to my/our employer/employers authorizing them to deduct such sum beginning from such month as may be stipulated by the Bank from my/our monthly salary and remit the same to you for deposit to my/our loan account till full liquidation of the same together with interest and other charges and also authorizing them to pay the outstanding loan, if any, out of my terminal benefits in case of my/our death, retirement, resignation or discontinuance of the service and also an undertaking from my/our employer/employers confirming the same.

Copy of my/our photo-identity card(s) issued by Election Commission / PAN Card from IT authorities.

Pay slip issued by my/our employer/employers for last two months / copy of Income Tax Return filed with the Income Tax authorities for the last two years.

Copy of Form 16 in respect of financial year ended ______________ for tax deducted at source from income chargeable under the head "Salaries".

Employer’s certificate about my/our name(s), address(es), designation(s) and the period(s) of completed service.

Proof of my/our professional qualification, particulars of profession and period of engagement in such profession.

Copy of my/our bank pass book(s) with your bank for last 3 months.

I/We hereby declare that -

The statements given above are true and correct.

No part of the loan will be utilized for any purpose other than that stated.

                                                                                                    Yours faithfully,

Date:                                              Signature of applicant 1:
Place:

                                                     Signature of applicant 2:

Witness Signature
Full Name
Address
3