ALPHA CODE:
Borrower Number: -------

I/Werequest you to grant me/us a loan facilityfor '
To enable you to consider the proposal, I/We submit the following particulars.
Please complete all sections in BLOCK LETTERS and.tickm boxes wherever applicable
Name --------------------------
Category
Residence Address
. SC/ST/OBC/OTHERS/MINORITY COMMUNITY PAN/GIR No.: --------------------
--------------------------------------------------------------------------
------------------------------------------------- PIN: --------------
Telephone Fax: Mobile No. : ---------------------
No. of Years at Residence: IT] Changed Residence in past 3 years: INotChanged I ~ I Morethan Once I
Date of Birth : (DD) (MM) (YYYY) Age: IT]
Permanent Address ---------------------------------------------------------------------------
PIN: --------------
Tel. Fax: E-mail' ---------------------------------
Salaried: Please tell us about your Work:
NDaemsiegnoaftiOorng:ani~Eatxioencu:tive I]Managerial rl Clerk I
Department: ----------------------------------
OfficeAddress: --------------------------------
Self Emploved / Professional/Business: Please tell us
about your Work:
--------------------------------------------
Name of Company: -----------------------------
Office Address: ---------------------------------
PIN : -----------------
Tel.: Fax: ------------------
E-mail: ---------------------------------------
PIN: -------------
Tel.: Extn. No. : Fax: ----------
E-mail:
Working With~[j-Go~~iP-u-biiC-sect;r ITpublicLtd.
0 Pvt. Ltd. 0 Partnership
0 Proprietorship 0 MNC
Business Details: D Pvt. Ltd. D Partnership
0 Proprietorship D Others '-----
WorkingSince: ' Retirement Age: -------
Years at Current Job:
Greater than 5 Years
Between 3 to 5 Years
Between 1 to 3 Years
Less than 1 Year
Established Since: -------------------------------
D0
0
0
Designation: 0 Executive 0 Managerial
Gross MonthlyIncome: Rs.____---------------
Years in Current Business: G;] I 3 - 51 G:.::.:i]GJ
(Greater) (Less)
GrossMonthlyIncome: ----------------------
(
About Yourself Net worth
D Male
Annlicant Guarantor
Sex Education: B Metric 1. Total
D UnderGraduate Female § Graduate 2. Total
Post-Graduate
Marital Status :D Single Doctorate 3. Total
D Married
Assets 1+2
IfP<o''''"o",' ' Doctm 4. Total
D Divorced
Architect Liabilities
CA 5. Net
D Widowed
MBA Assets 3-4
Engineer 6. Amount of Collaterals
No. of Dependents: ------ Lawyer
(Excluding spouse) 7. Presence of Guarantor: Yes / No No. of Children: Others -------------- (If yes, give details in above column)
Credit Card Details:
Credit Cards Owned: ------ Card Issuer: ------- Other Assets 0 Color TV 0 Refrerator 0 Car
Card No.: ------------------------------------- 0 Two Wheeler Telephone
Bank of Baroda Account No. ---------------- CA / SB D Cellular Phone 0 PC
Branch Name: ----------------------------------- 0 Washing Machine
FOR CAR LOANS ONLY (CAR DETAILS): 1.
2.
Make / Model. ------------------------
Name of the dealer (For New Car) : ------------
Type of Vehicle: ----------------------------------------------
3. For Second Hand Car
(I) Approx. serviceable age of car' ----------------
(ii) Valuationas pergaragecertificate:-------------
(iii) Nameandaddressof Seller(Attachcopyof RC) :
Age of Vehicle:
------------------------------------------
(iv) Engine I Chassis No. . ------------------
Outstanding Loan
Details Source/Type
1)__--__------------
2)_____-------------
3)_____--------------
Amount of Loan Outstanding EMI Default IOverdue
Since
---------------- ----------------- ---------------- ----------------
---------------- ----------------- ---------------- ----------------
--------------- ----------------- ---------------- ----------------
About Your Bank Account (including credit facilities if any)
Name of the Bank Branch &
Telephone No.
Ale. Type Ale No. No. of years account
held
Main Bank ---------
Others:
1)
2)
------------------ --------------- ----------------- ---------------- -----------------
------------------ --------------- ----------------- ---------------- -----------------
-----------------------
ouf
Name
out your uaranfor :
Name
Qouse :
---------------------
Address ----------------------- Address ---------------------
----------------------- -------------------
Occupation ----------------------- Occupation ---------------------
-----------------------
Phone/Fax
Email
PAN/GIR Number
Phone/Fax ---------------------
Email
PAN/GIR Number
-----------------------
---------------------
------------------------ -------------------
Net Annual Income IRs.) : Net Annual Income IRs.
I/We hereby declare that all the particulars and information furnished in the application form are true, correct and complete and up-to-date in all
respects. I/We have not withheld any information. I/We confirm that I/We have had no insoivency proceedings initiated against me/us nor have I/We
ever been adjudicated insolvent. I/We also authorize Bank of Baroda or its agent to make references and enquiries relative to information in this
application which Bank of Baroda considers necessary. I/We also authorize Bank of Baroda to exchange, share, part with all information relating to
mylour loan details and repayment history information to other Banks/Financial institutionsl Credit Bureaus/Agencies as may be required and shall not
hold Bank of Baroda liable for use of this information. I/We undertake to inform Bank of Baroda regarding any change in mylour
residence/employmenUOccupationlTransfer and to provide any other information that Bank of Baroda may require. I/We further agree that mylour loan
shall be governed by the rules of Bank of Baroda which may be in force from time to time. Bank of Baroda reserves the right to reject any application
without providing any reason.
I/we under take to bear processing, service, documentation charges etc. stipuiated by the bank from time to time. I/we agree, note and understand that
Bank of Baroda shall be entitled at its sole discretion to call back, the entire loan/advance whether due and payable or not at any time without
assigning any reason and enforce its rights, remedies and securities.
Yours faithfully,
Place
Date
----------------------------------
---------------------------------- Signature of the Applicant
I am willing to stand as guarantor.
Place
Date
------------------------------
----------------------------- Signature of the Guarantorls
-'....-.
Prop"sed Loan Details: (To be filled bv Income Details:
Branches/Offices)
1. Gross Monthly Income (Rs.) -----------------------
Tenure Months:
2. Salaried Person
Purpose: '} (I) Monthly Basic (Rs.) -----------------------
(ii) % of PF deduction -----------------------
Purchase Price(Rs):
3. Annual Professional Tax -----------------------
Loan Amount(Rs):
4. For Tax Purpose
Rate ofInterest %: (i) Total Annual Savings under s/88: ----------------------
(ii) 100% Rebate Amount ----------------------
Margin %: (iii) Deduction under chapter VI A :
(iv) Other Rebate IDeduction claime£======================
5. Total Monthly house hold expenses: -----------------------
6. Monthly other loan amount -----------------------
7. Net Income of other Family members: ----------------------