Application form for Baroda Loan to Pensioners

The Chief/Senior Branch Manager
_________________________Branch
______________________
______________________
Dear Sir/Madam,
Re : Baroda Loan to Pensioners
I/We_____________________________________hereby apply for a loan of
Rs._____________(Rupees_______________________________)for_____________
________________ (purpose) under your scheme "Baroda Loan to Pensioners".
I/We have read the terms & conditions of your scheme and hereby agree to abide by
the same. I/We hereby submit below the particulars as required by you to enable you to
do the needful.
APPLICANT CO-APPLICANT
1 NAME IN FULL
2 FATHER'S NAME
3 DATE OF BIRTH/ AGE
ADDRESS:
PRESENT
CONTACT TEL./ Email
4
PERMANENT
CONTACT TEL./ Email
5 TYPE OF
PENSIONER
Central Civil / Defence / Railway
/ State Govt. / BOB / Other
Central Civil / Defence /
Railway / State Govt. / BOB /
Other
6 PPO Number
7 Pension SB A/c No.
8 Drawing pension
through the Branch
since
9 Gross Monthly
pension
10 Total Deductions
11 Net Monthly Pension
12 OTHER INCOME
(including that of
family members :
Please specify)
Details of Nominee for Family Pension
Name (if minor,
name of Guardian)
RELATION AGE ADDRESS
13
I/We hereby declare that all the particulars and information furnished herein above are
true, correct and complete and they shall form the basis of any credit decision to be
taken by the Bank.
Date :
Place : (Signature of Applicant) (Signature of Co-applicant)
Recommended for sanction :
Amount : _______/- purpose_____________
(Rupees ____________________________)
No. of instalments : @ Rs.____/- per month
or @ Rs.____/- per month + Monthly Interest.
Security/Documents
(Tick whichever is applicable)
(a) DP Note signed by the Borrower ( )
(b) Personal Guarantee of Nominee ( )
(c) Letter of Instalment ( )
(d) Authority letter from borrower ( )
(e) Undertaking from Legal Heirs ( )
(f) Letter of undertaking by borrower ( )
Any Other
(g) ( )
(h) ( )
(i) ( )
(Signature of Credit Officer)
Date :
Place :
Sanctioned as recommended :
(Signature of Sanctioning Authority)
Date :
Place :
Details of Legal Heirs
NAME (If minor,
name of Guardian)
RELATION AGE ADDRESS
14
Details of loan availed from the Bank
TYPE OF LOAN AMOUNT BALANC
E
OUTSTA
NDING
MONTHLY INSTALMENTS
15