PART-II
CENTBUY
(For Common Application Form, Guarantor’s Consent Letter & Acknowledgement-Please fill PART-I)

01. DETAILS OF ARTICLES TO BE PURCHASED
02. TOTAL COST OF ARTICLES Quotation No.
Date
Name of the supplier
Cost
03. UNDERTAKING IN CASE OF ARTICLES TO BE PURCHASED
04. PROPOSED MARGIN (15% FOR ARTICLES)
05. AMOUNT OF LOAN REQUIRED
06. WHETHER MONTHLY INSTALLMENTS WILL BE REMITTED BY EMPLOYER
(If yes attach undertaking from employer)
YES / NO
07. WHETHER INSTALLMENTS WILL BE PAID BY APPLICANT DIRECTLY YES / NO
08. I/We submit followings papers/documents in support of my above submission.
(Please mark tick against each)
(i) Original salary Slip/salary Certificate for previous month
(ii) Latest I.T.Return/I.T. Assessment order/ Form no 16
(iii) Declaration of Articles to be Purchased
(iv) Undertaking from Employer
(v) Proof of Other Income
(vi) Photo ID or Proof of residence in the form of
a. PAN Card
b. Election ID card
c. Pass port
d. Govt/Defence ID card
e. ID card issued by employers

Place: Signature of the Applicant

Date: Signature of the Joint-Applicant