BANK OF BARODA
APPLICATION FORM FOR MSEs
To be submitted along with documents as per the checklist

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REGD. OFFICE ADDRESS:
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TELEPHONE NOs. (Office)
EMAIL ADDRESS:
Mobile No.
PAN CARD NO.
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CONSTITUTION
Propritory/Partnership firm/Pvt. Ltd./Ltd. Company/Co-op. Society
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DATE OF ESTABLISHMENT :
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NAME OF PROPRIETOR/PARTNERS/DIRECTORS OF COMPANY AND THEIR ADDRESSES:
NAME
AGE
ACADEMIC QUALIFICATIONS
TELEPHONE NO. (Residence)
EXPERIENCE IN THE LINE OF ACTIVITY
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WHETHER BELONGS TO SC/ST/OBC/MINORITY COMMUNITY
RESIDENTIAL ADDRESS
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ADDRESS OF FACTORY/ SHOP:
(For Office Use)

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ACTIVITY :
Existing :
Proposed (#):
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NAMES OF ASSOCIATE CONCERNS AND NATURE OF ASSOCIATION:
ADDRESSES OF ASSOCIATE CONCERNS
PRESENTLY BANKING WITH
NATURE OF ASSOCIATION
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10(a)
(Rs. in lacs)
Type of facilities
Limit (In lacs)
Outstandings as on…..
Presently banking with
Security Lodged
Rate of Interest
Repayment terms
Current account
Cash Credit
Term Loan
LC/BG
10(b)
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CREDIT FACILITIES(PROPOSED):
Type of facilities
Amount (In lacs)
Purpose for which required
Cash Credit
Term Loan
LC/BG
In case of term loan requirements, the details of machinery may be given as under:
Type of Machine
Purpose for which required
Whether imported or indigenous
Name of supplier
Total cost of machine (in case of imported machine, the breakup of basic cost, freight, insurance and customs duty may be given)
Contribution being made by the promoters
Loan required
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YES / NO
Security offered
PRIMARY SECURITY (Details with approx. value to be mentioned)
Whether Collateral Security offered (Please mention yes or no) (If yes, then provide details in column 12)
YES / NO
YES / NO
Relationship of Proprietor/Partner/Director with the officials of the Bank/Director of the Bank
CREDIT FACILITIES (EXISTING) :
It is certified that our unit has not availed any loan from any other Bank / Financial Institution in the past and I am not indebted to any other Bank / Financial Institution other than those mentioned in 10(a) above.
If Banking with this Bank, customer No. be given here.
# If a different activity other than existing activity is proposed.
NAME OF ASSOCIATE CONCERN
EXTENT OF INTEREST AS A PROP. / PARTNER / DIRECTOR OR JUST INVESTOR IN ASSOCIATE CONCERN
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Details of Collateral Security offered, if any,including 3rd party guarantee *
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PAST YEAR - II (Actual)
PAST YEAR - I (Actual)
PRESENT YEAR (Estimates)
NEXT YEAR (Projections)
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Status regarding Statutory Obligations:
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Date :
Place:
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SIGNATURES OF PROPRIETOR / PARTNER / DIRECTOR WHOSE PHOTO IS AFFIXED ABOVE
Only one photo of properitor / each Partner / Each working Director is required to be affixed. Each photo will be certified/attested by the Branch Team with name and signatures on the photograph with Branch stamp. The concerned staff will put his name below the signatures.
I/Wecertifythatallinformationfurnishedbyme/usistrue;thatI/Wehavenoborrowingarrangementsfortheunitexceptasindicatedintheapplication;thatthereisnooverdues/statutoryduesagainstme/us/promotersexceptasindicatedintheapplication;thatnolegalactionhasbeen/isbeingtakenagainstme/us/promoters;thatI/Weshallfurnishallotherinformationthatmayberequiredbyyouinconnectionwithmy/ourapplicationthatthismayalsobeexchangedbyyouwithanyagencyyoumaydeemedfitandyou,yourrepresentatives,representativesoftheReserveBankofIndiaoranyotheragencyasauthorisedbyyou,may,atanytime,inspect/verifymy/ourassets, books of account etc. in our factory/business premises as given above.
SPACE FOR PHOTO
6. Any other statutory dues remaining outstanding
SPACE FOR PHOTO
SPACE FOR PHOTO
4. Latest Sales tax return filed
5. Latest Income tax returns filed
2. Registration under SSI (Provisional / Final)
3. Drug Licence
Net Profit
Capital(Net worth in case of companies)
Statutory Obligation
Whether Complied with (Write Yes / No ). If Not applicable then write N.A.
Remarks (Any details in connection with the relevant obligation to be given)
1. Registration under Shops and Establishment Act
(* As per RBI guidelines banks are not to take collateral security for loans upto Rs.10 lakhs to MSME Units)
PAST PERFORMANCE/FUTURE ESTIMATES (Actual performace for two previous years, estimates for current year and projections for next year to be provided for working capital facilities. However for term loan facilities projections to be provided till the proposed year of repayment of loan):
(Rs. in lacs)
Net Sales
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Proof of Minority
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* Photocopies of lease deeds/title deeds of all the properties being offered as primary and collateral securities.
* Position of accounts from the existing bankers and confirmation about the asset being Standard with them (In case of takeover).
* Profile of the unit (includes names of promoters, other directors in the company, the activity being undertaken,addresses of all offices and plants, shareholding pattren etc. (APPLICABLE FOR CASES WITH EXPOSURE ABOVE Rs.25 LACS).
*Projectreport(fortheproposedprojectiftermfundingisrequired)containingdetailsofthemachinerytobeacquired,fromwhomtobeacquired,price,namesofsuppliers,financialdetailslikecapacityofmachines,capacityutilisationassumed,production,sales,projectedprofitandlossandbalancesheetsforthenext7to8yearstilltheproposedloanistobepaid,thedetailsoflabour,stafftobehired,basisofassumptionofsuchfinancialdetailsetc.(APPLICABLE FOR CASES WITH EXPOSURE ABOVE Rs.25 LACS).
*Reviewofaccountcontainingmonthwisesales(quantityandvalueboth),production(quantityandvalue),importedrawmaterial(quantityandvalue),indigenousrawmaterial(quantityandvalue),valueofstocksinprocess,finishedgoods(quantityandvalue),debtors,creditors,bank'soutstandingsforworkingcapitallimits,termloanlimits, bills discounted. (APPLICABLE FOR CASES WITH EXPOSURE ABOVE Rs.25 LACS).
* Last three years balance sheets of the Associate/Group Companies (If any). (APPLICABLE FOR CASES WITH EXPOSURE ABOVE Rs.25 LACS).
*Lastthreeyearsbalancesheetsoftheunitsalongwithincometax/salestaxreturnsetc.(ApplicableforallcasesfromRs.2lacsandabove).However,forcasesbelowfundbasedlimitsofRs.25lacsifauditedbalancesheetsarenotavailable,thenunauditedbalancesheetsarealsoacceptableasperextantinstructionsofthebank.Forcases of Rs.25 lacs and above, the audited balance sheets are necessary.
CHECK LIST (TO BE GIVEN TO THE NEW CUSTOMERS BY BRANCH) OF DATA TO BE KEPT READY BY THE CUSTOMER
*Projectedbalancesheetsforthenexttwoyearsincaseofworkingcapitallimitsandfortheperiodoftheloanincaseoftermloan.(ForallcasesofRs.2 lacs and above)
*Incaseoftakeoverofadvances,sanctionlettersoffacilitiesbeingavailedfromexistingbankers/FinancialInstitutionsalongwithdetailedtermsandconditions.
* Memorandum and articles of association of the Company/Partnership Deed of partners etc.
* Assets and liabilities statement of promoters and guarantors alongwith latest income tax returns.
* Rent Agreement (if business premises on rent) and clearance from pollution control board if applicable.
* SSI registration if applicable.
Proof of business address
Proofofidentity–Voter’sIDCard/Passport/drivinglicence/PANCard/signatureidentificationfrompresentbankersofproprietor,partnerorDirector(ifacompany).
Proof of residence – Recent telephone bills, electricity bill, property tax receipt / passport / voter’s ID Card of proprietor, partner or Director (if a company).
* Manufacturing process if applicable, major profile of executives in the company, any tieups, details about raw material used and their suppliers, details about the buyers, details about major competitors and the company's strength and weeknesses as compared to their competitors etc. (APPLICABLE FOR CASES WITH EXPOSURE ABOVE Rs.25 LACS).
(Thechecklistisonlyindicativeandnotexhaustiveanddependinguponthelocalrequirementsatdifferentplacesadditioncouldbemade as per necessity)