Application form for Agricultural Credit
(To be obtained one time of whenever there is change)

Application No. ____________ Year _______

The Branch Manager
PHOTO
Dear Sir,

I/We, hereby apply for a loan / loans aggregating of Rs. ……………….. (Rupees ………………………………… ………………………. Only) and furnish below the necessary information.
Type of Credit Amount (Rs.)
1. Production Credit Loan (As per Annexure A) ……………………….. ………………………..
2.Term Loan (As per Annexure)
3. Name of Scheme
(In case of Govt. sponsored scheme)
Purpose
a) …………………………………… ……………………………………
b) …………………………………… ……………………………………
Total : a)
GENERAL INFORMATION
No. Full Name of the applicant(s) Age Educational Qualification Village Taluka / Block / P.O
1 Shri/Smt
S/o / W/o
2 Shri/Smt
S/o / W/o
3 Shri/Smt
S/o / W/o

Sl No. Name of the Family Members Relationship Whether Dependent Annual
Income (Rs.)
a)
b)
c)
Name of the Karta (in case of Joint Hindu Family) : ………………………………………..
3. Whether belong to a) Scheduled Castes / Backward Class/Minority Community
b) SF/MF / Agril. Labourer :
4. Deposits Accounts if any : Bank …………………….. Branch ………… A/c No. ………………

5. Particulars of land holding (if Lease hold / share cropper specify). Furnish Copies of land records
Village Survey No. / Block No. Title Area in acres Of which Irrigated Source of Irrigation Encumbrance if any
Owned Leased Share Cropper

7. Present annual Income Rs. ……………………..
(a) Agricultural income
(b) Other income (specify)Rs. ……………………..
……………………………
……………………………
Total income Rs. …..…………………

6. Particulars of existing liabilities as borrower, if any
Name of the Institution Purpose of Loan Present Outstanding Rs. Of which Overdue
Rs. Security Offered Installment amount repayable during the year Rs.
1. Our Bank
2. Other Banks (Specify)
3. Co-op Credit Societies
4. Land Development Bank
5. Other Creditors (Govt. dues)
9. Liabilities as Guarantor Loan sanctioned to Shri / Smt.
Name of the Bank / Institution
Amount of Loan Rs. :
Balance Outstanding Rs. (As on ………………….)
Status of Account : Regular / Overdue
10. Particulars of farm equipments / live stock / immoveable assets owned.
i) Moveable Number Present value (Rs.)
a) Plough cattle
b) Milch cattle
c) Oil engine/Ele. Motor/ Pumpsets
d) Power tiller
e) Tractors
f) Transport Vehicles
h) Other implements
ii) immoveable –
a) Particulars of the Property (Owner / Lease / Pattadar / share cropper) :
b) House / Building :
c) Tractor Shed / Farm Shed :
d) Fishing Ponds / Tanks :

11. Security(ies) proposed to be offered
i) Primary
a)
b)
ii) Collateral (where applicable)
a)
b)
12. Particulars about Guarantors, if any
Name of the Guarantors Address Worth (Rs.)
i) ……………………………… ………………………………………….
ii) ……………………………… ………………………………………….
I / We hereby declare that the particulars given above are true and correct to the best of my/our knowledge and belief. I / We hereby authorise the Bank to disclose all or any particulars or details of 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 to my/ our outside borrowings made above contain misrepresentation of facts.
I/We hereby declare that I/We have no borrowings / liabilities excepting those mentioned under Item (8) and (9) as on the date of application.
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.

Applicant’s name Signature(s)/Thumb Impression

1.
2.

Place
Date