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    PMS092412718583_LoanApplication

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    rk610050987

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    © All Rights Reserved
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    PMS092412718583_LoanApplication

    Uploaded by

    rk610050987
    1 views3 pages

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    Copyright:

    © All Rights Reserved
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    1 views3 pages

    PMS092412718583_LoanApplication

    Uploaded by

    rk610050987

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    PM Street Vendor’s AtmaNirbhar Nidhi(PM SVANidhi)

    (Common Loan Application Form)

    Application No. PMS092412718583


    Name of Bank/Lender

    Name of Street Vendor* Sudhaanshu Father/Spouse Name* Munmun Ray

    Date of Birth* 1/1/2000 12:00:00 AM Marital Status* Single

    Mobile No* 9912796870 Gender* Male

    Social Category* General


    Nativity

    PwD (Divyangjan)* Minority*

    KYC Details

    Aadhaar No* Voter ID Card No.* Driving License No Ration card No. Others(Govt Approved Document)

    428136324916

    Family Details

    Name* Relationship with Applicant* Age*

    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)

    DL/276402/240912/8546563

    Address as per e-KYC

    House No.* 644/313 OLD N0-27, GALI N0-6 GEETANJALI State* DELHI

    Ward/Village* SAGAR PUR


    Town/Dist*

    PIN* 110046

    Current Address

    House No.* 644/313 OLD N0-27, GALI N0-6 GEETANJALI State* DELHI

    Ward/Village* SAGAR PUR


    Town/Dist*

    PIN* 110046

    Vending Activity

    Name of Activity* Fast food and food Items

    Other

    Place of Vending* Fixed Location


    Vending
    DurationActivity
    of Vending* 01/2024

    Location/Area of Vending

    Stationary Vendor Dwarka sector 16 Nearest Landmark Badi Majid

    Mobile Vendor Nearest Landmark

    State* DELHI Town/Dist* SOUTH WEST

    ULB Name* Municipal Corporation of Delhi


    Ward/Village*

    Pin Code 110078

    Avg. Monthly Sales (₹)

    Avg. Monthly Sales (₹)* 35000

    Bank Account Details

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

    PUNJAB NATIONAL BANK ERODE PUNB0071510 0715101700002691

    Digital Payment

    Digital Payment Payment Aggregator UPI ID / VPA Durable QR Code

    Loan Outstanding

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

    No 0 0

    Loan Amount Required

    Loan Amount Required (₹)* 10000 Purpose Working Capital

    Local References

    Name Mobile No. Address

    Benefits availed under other Govt. Schemes

    Name Select

    Ayusman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY)

    Pradhan Mantri Matru Vandana Yojana (PMMVY)

    Deendayal Antyodaya Yojana-National Urban Livelihoods Mission (DAY-NULM)

    Pradhan Mantri Awas Yojana (PMAY) – Urban/Rural

    Pradhan Mantri Ujjwala Yojana (PMUY)

    Integrated Child Development Services (ICDS)

    Pradhan Mantri Jan Dhan Yojana


    Benefits availed under other Govt. Schemes

    Name Select

    Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY)

    Atal Pension Yojana (APY)

    Pradhan Mantri Kaushal Vikash Yojana (PMKVY)

    Seekho Aur Kamao

    Upgrading the Skills and Training in Traditional Arts/ Crafts for Development (USTTAD)

    Rashtriya Poshan Abhiyaan (RPA)

    Pradhan Mantri Mtrutva Suraksha Abhiyan (PMMSA)

    Swachh Bharat Mission (SBM)

    Pradhan Mantri Sahaj Bijli Har Ghar Yojana (SAUBHAGYA)

    National Food Security Act (Ration Card)

    One Stop Centre

    Pradhan Mantri Mudra Yojana (PMMY)

    Pradhan Mantri Suraksha Bima Yojana (PMSBY)

    Pradhan Mantri Shram Yogi Maan-dhan (PM-SYM)

    Hunar se Rozgar tak initiative

    Nai Roshni

    Green Skill Development Programme

    Other Schemes

    Other Schemes Details :

    None of the above

    Declaration and Authorization:

    a. I hereby certify that all information furnished by me/us is true, correct and complete. I have no borrowing arrangements except as indicated in the
    application form. I have not applied to any other lending institution under the PM SVANidhi scheme. There is/are no overdue owed by me to any bank. The
    information may also be exchanged by you with any agency, you may deem fit. You, your representatives or MoHUA, or any other agency as authorized
    by you, may at any time, inspect/ verify my/our assets etc. You may take appropriate safeguards/action for recovery of lending institutions’ dues.
    b. I have no objection to authenticate my Aadhaar number, share the same with other Ministries / Departments under the Government of India for the
    purpose of extension of benefits under any of their Schemes, carry out e-KYC and accessing my credit history & credit score by credit bureau, lenders
    and their authorized agents. The consent and purpose of collecting Aadhaar has been explained to me/us 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.

    Date: 11/09/2024 Signature of Applicant(s)


    Place:

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