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Asset Liability Format

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234 views2 pages

Asset Liability Format

Uploaded by

riasuri86
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Form No.

187
Punjab & Sind Bank
(A Govt. of India undertaking)

STATEMENT OF ASSETS & LIABILITIES AS ON 31.03.2024

Date:
The Branch Manager
Punjab & Sind Bank,
Chandni Chowk, Delhi-06

Dear Sir,

I hereby append below the details of my Assets & Liabilities as required by you in connection with credit facilities
being sanctioned/renewed/reviewed by your Bank to me/us/Mr./Mrs./M/s.
________________________________________

1. Name

Borrower Guarantor

AADHAAR

PAN Passport No. DIN

2. Details of main occupation : including all


connected and associated occupations
3. DOB
4. Address:- Business Tel No.

Residence Tel No.


Email id
5. DETAIL OF ASSETS
(BUSINESS & PERSONAL)
Fixed Assets- Property/Machinery etc.

Address of Property/Machinery Area/ measurement Value Self Occ./ If encumbered Freehold/ Document
location (House No/Locality/ (total & share of Rented (Bank/FI name Leasehold Submitted
Khasra No. with PIN) undersigned) & amount of
loan)

Liquid Assets & movable property like stock in trade, vehicles etc.
Detail of Asset If encumbered (Bank/FI Value Document Submitted
name & amount of loan)

Deposit Accounts
Nature of account Bank’s name/Branch Account No. Approximate Balance

Others
Cash in Hand
Punjab & Sind Bank
Statement of Assets & Liabilities
Shares/Mutual funds/other inv
Govt. Securities
LIC etc. Policy No. Sum Assured Surrender Value Premium Paid

Any other Assets,


PF/PPF/NPS/KVP/NSC/IVP
Contribution/Deposit, Etc
Jewellery

TOTAL ASSETS:- Rs.

6. Liabilities
From Banks and from Market including deposits received (pledged/Hyp/mortgaged)
Name of Date of Loan Bal o/s Purpose of Status (Standard/ Security (Pledge/
Bank/FI, Sanction Amount Finance Irregular/NPA) Hyp/Mortgaged)
Branch

Others
Nature Amount
Income Tax Dues/Govt Dues outstanding
Others

TOTAL LIABILITIES: Rs.

7. Net Worth =Assets – Liabilities (5-6)


8. Income for last three years (attach payment F.Y. 2021 – 2022
assessment orders). F.Y. 2022 – 2023
F.Y. 2023 – 2024

I certify that the above information is true. I also confirm that no suit has been filed and there are no statutory
overdues pending against me/any other firm/company in which I am partner/director/guarantor.

SIGNATURE

VERIFIED BY

LOAN OFFICER INCHARGE BRANCH MANAGER

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