__________ Branch

Date ____________

1. Name of the applicant / key person with address

2. Name & Other details of the Earning Family Members including key person: _______________________

     Name                Age            Profession/ Source of Income             Financial Liability/ Indebtedness if any
                                                                                                                                 

i)

ii)

iii)

iv)

3. Whether belongs to SC/ ST :

4.    Amt. of Limit approved : ____________________________

5.    Total family income: ______________________________

6.    Approximate Family Expenses: __________________________________

7.    Net Surplus:_________________________________________

8.    Recommendation :-

a) Maximum Limit __________________

b) Interest :- @ 12%p.a. at monthly rest.

c) Disbursement : Through OD a/c (Cash withdrawal only by the borrower himself/herself )

d) Review : A/c. will be reviewed annually for continuation/ enhancement
revision of the limit.

e) Special instructions :

i. Withdrawal from OD a/c will be allowed after completion of all the formalities

ii. Personal Accident Risk will be covered under the appropriate policy of the Bajaj Allianz Ltd. and premium will be borne by the borrower.

iii. Terms & Conditions of the sanction shall have to be accepted by the borrower in writing and the sanction will remain valid up to 2 months from the date of sanction.

iv. Bank may add/ modify/ substitute any terms in future without prior consent of the borrower.

v.  Directives of RBI will be binding on the borrower.

vi. Personal Guarantee of the all the earning members whose income has been considered for fixing the limit.

vii. Other terms & conditions are as usual

Date :                                                             RDO / Dy.Manager                                         Manager

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