DETAILS OF BUSINESS CORRESPONDENT
APPLICATION FORM FOR APPOINTMENT AS CSP OPERATOR
1. Applicant Name (IN BLOCK LETTERS) :
2. Father’s / Husband’s Name :
3. Date of Birth : ______________ Age: _______
4. Gender (Please Tick) : Male / Female
5. Marital Status (Please Tick) : Married / Unmarried
6. Educational Qualification :
Working knowledge with computer system: Yes / No
7. Previous employment details, if any :
Name of the organization :
Length of service :
7.a.Whether member in any Self-Help Group: Yes / No
If Yes, please furnish details :
8. Address for communication : D. No. :
Area :
Street Name :
Village / Town :
Tehsil :
District :
State : PIN Code:
9. Permanent Address : D. No. :
Area :
Street Name :
Village / Town :
Tehsil :
District :
State : PIN Code:
10. Mobile No. : 1) 2)
11.Telephone No. : STD Code_________ Telephone No.__________
12. E-mail ID :
1
13. Currently Banking with :
14. Bank Account Number : A/c No. _________________ Branch________
15. KYC of the applicant :
Photo ID* : PAN / Election ID / Passport /
Driving License / AADHAAR Card/
ID Card No. :
Address Proof : Utility Bill (Electricity / Telephone/ Postpaid
Mobile / piped gas / water bill) – not more than
2 months old. (or)
Latest copy of property or municipal tax receipt(or)
Election ID/Passport/DL/Aadhaar card showing
Current address
*Preferably copies of PAN & AADHAAR Card to be submitted wherever available along with the
application.
16. Languages known :
Read Write Speak
English
Hindi
Regional Language (specify)
_______________________
Any other (specify)
________________________
17. Residing in the village / area since : __________ (No. of years)
18. Present Occupation :
19. Present monthly Income : Rs.__________
(Please enclose copy of I.T. Return / documentary evidence, if any)
20. Any experience in selling financial products: Yes / No
If Yes, please give details :
21. Do you have any police records : Yes / No
If yes, please give details
22. Do you have affiliation with any Political : Yes / No
Party
If yes, please give details
2
23. Details of assets & liabilities :
Movable Assets :
Cash :
Jewellery :
Vehicle(s) :
Life Insurance (premium paid only) :
Others ___________ :
Immovable Property : Sy. No. Location Extent Market Value
Agriculture Land :
Open Residential Land :
House :
Commercial property :
(documentary evidence / property extract must be attached)
Liabilities :
SL. TYPE OF NAME OF DATE OF LOAN PRESENT IRREGULARITY
NO LOAN BANK/FI SANC AMOUNT OUTSTANDING IF ANY
1.
2.
3.
4.
24. Details of the proposed CSP Outlet :
a. Location :
b. Distance from the link branch :
c. Status of proposed premises : Owned / Rented / Leased
d. Period of lease :
25.Existing Infrastructure available :
(eg. Office space, computer, Internet, landline telephone connection etc )
26. Are you willing to invest in procuring required furniture/computer systems/POS/handheld
device/other equipment for running the Kiosk outlet?
27. Amount of liquid cash you can invest in meeting cash requirements at the kiosk outlet?
3
28. Names, address and occupation details of two persons to whom reference
can be made.
Reference No.1
a. Name :
b. Address :
c. Occupation :
d. Mobile No. :
Reference No.2
a. Name :
b. Address :
c. Occupation :
d. Mobile No. :
I certify that the above information furnished is true to the best of my knowledge and belief.
Place: Signature of the Applicant
Date : Name:
-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x
FOR USE OF BUSINESS CORRESPONDENT
Verified the details of applicant and found correct. Enquiries made with local people and satisfied
with the antecedent of the applicant. Also satisfied about the capability of the applicant in smooth
conduct of activities at the CSP outlet.
Recommended Mr/Ms.___________ for appointment as CSP operator
at: Location _____________ , Link Branch ___________________, Branch Code_________
Under _________________ RBO.
Submitted to LHO, ______________ for approval.
Authorized Signatory
Name:
Designation:
Mobile No.
BC Name: Seal
4
FOR USE OF LINK BRANCH – SBI _____________ , BRANCH CODE-________
Received application of Mr/Ms _________________ as CSP operator at _____________
(location) from ___________________ Business Correspondent.
2.Verified the application and other documents submitted by BC and found correct. Generated
CIBIL report on the applicant, scrutinized and found no irregularities.
3.The proposed site has been inspected by Shri/Smt._______________, ______________
(designation) on __________ , verified the antecedents of the applicant and found satisfactory.
4. Recommended for appointment as CSP operator.
(OR)
Rejected the application on the following grounds:
Unsatisfactory features observed in CIBIL report
Adverse feedback received from local people on the applicant
Any other reasons (Please specify):
Place: BRANCH / CHIEF MANAGER
Date :
FOR USE OF MANAGER (FI), RBO -________
Visited the proposed location on ____________ and conducted additional due diligence on
applicant Mr/Ms.________________and found satisfactory. Forwarded to LHO for necessary
action.
(OR)
The application is returned / rejected due to the following reasons:
a.
b.
c.
Recommended Forwarded to LHO
Place:
Date : MANAGER (FI) CHIEF MANAGER (COMPLIANCE)
FOR USE OF DY. GENERAL MANAGER (FI), LHO -________
Based on the recommendations of Link Branch Manager & Manager (FI), approved application of
Mr./Ms. _____________ as CSP Operator at _______________ (location).
Place: DY. GENERAL MANAGER (FI)
Date :
5
SCORING SHEET FOR APPOINTMENT AS CSP OPERATOR
Name of the Applicant:
Part A – Quantitative Assessment
Sr. Parameter Criteria Marks Max. Marks
No. Marks Scored
1 Ownership of i)Owned 3
premises ii)Rented / leased 1 3
2 Type of premises i)Commercial 3
ii)Residential 2 3
3 Location i)Located at central 3
place/prominent place 3
ii)Located elsewhere at the 2
centre
4 Distance from link i)Distance between the place of
branch business of CSP & Link branch 3
is within 5 Kms. 3
ii)Beyond 5 Kms 1
5 Residential status i)Residing in the area for >3 yrs 2
ii)Residing in the area for >2 yrs 1 2
iii)Residing in the area for >1 yrs 0
6 Education i)Graduate and above 3
ii)12th Class Pass 2 3
0
7 Feedback received i) Positive & Acceptable 5 5
from local people ii)Not acceptable** 0
8 Amenities available i)Available
(adequate sitting ii)Not available 2 2
space & drinking 0
water)
9 Employer’s *** i)Satisfactory conduct certificate 1
certificate submitted submitted 1
(if employed in past) ii)Not submitted 0
TOTAL 25
* Minimum Eligible Quantitative Score: 15
**Application to be rejected if negative feedback received from local people
*** If not applicable, score is to be normalized
Authorized Signatory
SCORING SHEET FOR APPOINTMENT AS CSP OPERATOR Contd…
6
Name of the Applicant:
PART B: QUALITATIVE
A Knowledge Marks Score
High Has full knowledge in financial products and insight into
local trends. 5
Possesses computer knowledge
Medium Has working knowledge 3
Low New to the activity and no knowledge 2
B Financial soundness
High Having sufficient means to invest in infrastructure
required (present / future) for smooth conduct of the 5
outlet
Medium Getting support from family & friends in procuring the
required infrastructure and willing to mobilize the
required resources. 3
Low Not having sufficient means to run the activity. 0
C Sales Orientation
High Has experience in the line of activity 5
Medium Aware of sales methods like approaching shops and
houses (door to door) & getting contacts from prominent 3
local bodies and residents
Low No prior experience / New to the activity
0
D Acceptability
High Deep rooted and strong local rapport 5
Medium Moderate influence in the society 3
Low Limited influence in the society 2
E Experience in handling Cash / Accounts
High Has good experience in handling cash & keeping of 5
accounts
Medium Has some experience in handling cash / keeping 3
accounts
Low Has limited experience in handling cash/keeping of 2
accounts
Total 25
* Minimum Eligible Quantitative Score: 12
Authorized Signatory
Name:
Designation:
BC Name:
Mobile No.
BC Name: Seal
