Application SI. NO. Category SF MF Others: Shri/Smt. S/D/W of Shri/Smt. S D Wof Shri/Smt. S D Wof
Application SI. NO. Category SF MF Others: Shri/Smt. S/D/W of Shri/Smt. S D Wof Shri/Smt. S D Wof
Application SI. NO. Category SF MF Others: Shri/Smt. S/D/W of Shri/Smt. S D Wof Shri/Smt. S D Wof
Full Name(s) of the Applicant(s) Date of Age Gender Aadhar No. Voter's ID
Birth (optional) /DL / PAN
Shri/Smt. S/D/W of No.
Shri/Smt. S/D/W of
Shri/Smt. S/D/W of
D.Details of family members:
H. Particulars of total land holdings of the applicant (If Lease hold/share cropper, specify):
I.Of total landed properties mentioned at ( H) above, land / crop details pertaining to
the loan applied :
J. Sources of Income:
Agricultural Income
Other Income (Specify)
Total Income
K.Particulars of Immovable Assets Owned:
I/We hereby declare that all information furnished by me/us is true, correct and complete to the
best of my/our knowledge and belief. I/We have no borrowing/liabilities excepting those mentioned
in the application form. I/We hereby authorise the Bank to disclose all or any particulars or details or
information relating to my/our loan accounts with the Bank, to any other financial institution,
government or any agency(ies) as may be considered necessary or desirable by the Bank. It will be in
order for the Bank to disqualify me/us from receiving any credit facilities from the Bank in case it is
proved that the declaration of my/our outside borrowings made above contain misrepresentation of
facts. I/We hereby undertake to abide by the terms and conditions that the Bank may stipulate in
sanction of this loan and inform Bank in the event of acquiring any other assets during the tenure of
the advance. The Bank may take appropriate safeguards/action for recovery of bank's dues.
1. 1.
2. 2.
3. 3.
CHECK LIST: (The check list is only indicative and not exhaustive and depending
upon the requirements of the bank addition/deletion could be made as per necessity)
i. Proof of identity: Self attested copy of Voter's ID Card / Driving Licence / PAN
Card/ Aaadhaar Card / Passport / Photo Ids issued by Govt. authority etc.
ii. Proof of Residence: Recent telephone bill / electricity bill / property tax receipt (not
older than 2 months) / Voter's ID Card / Aaadhaar Card / Passport /Certificate issued
by Govt. Authority I Local Panchayat / Municipality etc.
iii. Applicant's recent Photograph (2 copies) not older than 6 months.
iv. Particulars of Land Records.
ACKNOWLEDGEMENT
Received the loan application from Shri/ Smt .. ... .......... ...... . . .. ........... .......................
Residence of. . ........ ... .... . . . ............... . .............. . ........... . . ........................ ......... .
on . .... . . . ...... . ... ... . . . . . . . . ... for the purpose of. . .... ...... ....., .. . ............ .......... .............
All the required information / documents have been furnished on ............ .. ........ / yet to be
Customer copy:
All the required information / documents are furnished on .... .......... . ... . ................. ..... / yet
to be furnished by the applicant.
1. This is only an acknowledgement for having received the application and this should not be
construed as an indication of our acceptance of the proposal , a decision on which will be
taken only after due consideration of the proposal on its merit and / or on fulfilment of
conditions if any, that may be stipulated by the Bank.
2. The application will be taken up for consideration only after all the particulars / data /
documents as may be required are received by the Bank.
3. The application will be disposed of within ... ....... . .days from the date of receipt of all the
details /papers/documents /clarifications sought by the Bank .
4. In case the proposal is rejected/not considered the reasons for the same will be intimated to
the applicant.