PM Street Vendor'S Atmanirbhar Nidhi (PM Svanidhi)

Download as pdf or txt
Download as pdf or txt
You are on page 1of 2

PM Street Vendor’s AtmaNirbhar Nidhi(PM SVANidhi)

(Common Loan Application Form)

* Mandatory fields
** Only for SV's from Assam and Meghalaya, not having Aadhaar Number
# Data Fetching From Aadhaar

Application No. PMS08215445367 Name of Bank/Lender State Bank of India

#Name of Street Vendor Sujala Father/Spouse Name* PALANI

#Date Of Birth 25/11/1976 Marital Status* Married

#Mobile Number* 9841544667 #Gender Female

Social Category* SC

Are you vending in the same Are you vending in the same
State you belong to?* district you belong to?*

PwD (Divyangjan)* Minority*

KYC Details

#Aadhaar No* Voter ID Card No.*

249139822760

Family Details

Name* Relationship With Applicant* Age*

PALANI Husband 48

Proof Of Vending

Vendor ID Card
Certificate of Vending No.
Letter Of Recommendation (LoR) No.

(Issued by ULB) (Issued by ULB) (To be issued by ULB electronically through PM SVANidhi Portal)

TN/252294/210804/2819398

Address as per e-KYC

#House No. / Locality 117 NULL #State TAMIL NADU

#Town/Dist CHENNAI #Ward/Village Choolaimedu

#Pin Code 600094    

Current Address

House No. / Locality* 117 NULL State* TAMIL NADU

Town/Dist* CHENNAI Ward/Village* Choolaimedu

Pin Code* 600094    

Vending Activity

Name Of Activity* Fast food and food Items

Other

Place Of Vending* Fixed Location

Duration Of Vending* 03/2020


Location/Area of Vending

Stationary Vendor EAST NAMACHIVAYAPURAM Nearest Landmark NEAR TEMPLE

Mobile Vendor Nearest Landmark

State* TAMIL NADU Town/Dist* CHENNAI

ULB Name* Chennai Municipal Corporation Ward/Village* CHOOLAIMEDU

Pin Code 600094  

Total Monthly Family Income (₹) (Family means husband, wife and unmarried children)

Total Monthly Family Income (₹)* 10000

Bank Account Details

Name Of Bank* Name Of Branch* IFSC Code* Account No*

State Bank of India NELSON MANICKAM ROAD, CHENNAI Sbin0011606 20276242720

Digital Payment

Payment Aggregator * UPI ID / VPA * Durable QR Code

State Bank of India 40402959870@sbi

Existing Loan Outstanding

Bank/Lending Institution Outstanding Amount (in Rs.) Monthly EMI (in Rs.)

Loan Amount Required Loan Tenure Status

1st Term Loan Amount 10000/- 12 Months

2nd Term Loan Amount 20,000/- 18 Months Active

3rd Term Loan Amount 50,000/- 36 Months

Loan Purpose* Working Capital Business Expansion Purchase Of Assets

Declaration and Authorization:

A.
I hereby certify that all information furnished by me is true, correct, and complete.I have not applied to any other lending
institution under the PM SVANidhi scheme. The information submitted herein may be exchanged by you with any agency, you may
deem fit. You, your representatives, Lending Institution (LIs) or MoHUA, or any other agency as authorized by you / MoHUA / LI,
may at any time, inspect/ verify my/our assets etc. You may take appropriate safeguards/action for recovery of lending institutions’
dues.

B. I understand that by submitting this application form, I am providing my consent for application for loans in remaining 2 cycles.
After full repayment of 2nd loan; in the 3rd cycle, maximum loan amount will increase to ₹50,000/-. I will become eligible for the
3rd cycle of the loan only after full repayment of current loan and submission of digital consent for the 3rd loan.

I understand that minimum repayment period of 9 months is required for the 2nd loan to be eligible for 3rd loan. If my loan is fully
repaid before 9 months, I would be eligible for the 3rd loan only after the stipulated period of 9 months from the date of
disbursement of the 2nd loan.

C. I have no objection to authenticate my Aadhaar number, share the same with other Ministries / Departments under the
Government of India or the State Government for the purpose of extension of benefits under any of their Schemes, carry out e-KYC
and accessing my credit history & credit score from credit bureau by the lenders and their authorized agents. The consent and
purpose of collecting Aadhaar has been explained to me in local language. MoHUA/Lending Institution has informed me that my
Aadhaar submitted herewith shall not be used for any purpose other than mentioned above, or as per requirements of law. I have
been informed that this consent and my Aadhaar will be stored along with my account details with MoHUA or their authorised
agent.

Date : 07/07/2022 Signature of Applicant(s)

Place : CHENNAI

You might also like