To Personal Loan Department
Indian Overseas Bank
___________________________________________Branch P.L.A. No. __________ Date _________

I hareby apply for a Personal Loan of Rs. _________(DPN amount) Purpose of Loan – To Purchase
(including discount amount of Rs._______________) repayable in _________________________________
________________monthly instalment of Rs. ________________ _________________________________
beginning from _________________________________________ Cost Rs. __________________________

Full Name (in block letters): Mr./Mrs./Miss _______________________________________________________
Age ____________No. of dependants _____________Marital Status: Married / Single ___________
Address __________________________________________________________________________
____________________________________________________________Phone:________________
Rent, if not owned: Rs. per month.
Office/Business address ______________________________________________________________
____________________________________________________________Phone ________________
Name of the employer/Business _______________________________________________________
Kind of Business ___________________________________________________________________
Proprietary/Partnership Position held _______________________No of years (if in service)________

If employed: Confirmed/Unconfirmed

Salary, if employed : Rs. ____________ per month
Fixed allowances : Rs. ____________
Income if in business : Rs. ____________ per month Total income : Rs. ___________ per month
Other income, if any : Rs. ____________ per month Deductions : Rs. ___________ per month
Source : _______________ Net Salary drawn : Rs. ___________

INVESTMENTS (in applicant’s name) LIABILITIES
Business (net assets) : Rs. __________________ Business : Rs. __________________________________
Deposits : Rs. __________________ Personal : Rs. ________________ Total Rs. _________
Name of Bank ____________________________
Shares & Securities : Rs. __________________ Details of other liabilities under instalment purchase / loans

House Properties To whom owned Original Balance Due each
& Purpose amount Due Month
Location _________________________________
Extent ___________________________________ P.F.Loan _________________________________________________
Value __________________: Rs. _____________ Staff Housing Loan _________________________________________
Landed Properties Society Loan ______________________________________________
Location _________________________________ Jewel Loan _______________________________________________
Extent ___________________________________ Festival Loan ______________________________________________
Value __________________: Rs, _____________ Personal Loan _____________________________________________
Life insurance Policies Other Deductions __________________________________________
Date of Policies : __________________
Face value : Rs. _______________
Surrender value : Rs. _______________
Premium Payable : Rs. _______________ Details of any judgement, garnishee or other legal Proceedings pending Date of last premium paid ____________________ against the applicant, (if none, state, `None’, otherwise explain in letter)

Reference (Name & Address) Guarantor ________________________________________________
Bank Reference, (if any) Name: ___________________________________________________
Office address: ____________________________________________
1. Name __________________________________ _________________________________________________________
House address: ____________________________________________
Address ________________________________ _________________________________________________________
Employment / Buisness _____________________________________
_______________________________________ No. of years (if in Service) _________ Confirmed/Unconfirmed
_______________________________________ Total monthly income: Rs. __________________________________
Deduction Rs. ____________ Net Salary drawn Rs. ______________
2. Name __________________________________ Net Worth: Rs. ___________Age __________Years _____________
Any other comments _______________________________________
Address ________________________________

I affirm that each of the statements made by me in this application
Is true and made with the knowledge that you will rely thereon

Signature of applicant

Reserved for the use at the Branch Date received _______________________ 19_________

Date of receipt of replied from Loan granted

References Guarantor Date Loan No. Amount Invoice price Name of
Of the article Dealer

Gist of Confidential Report ___________________________________________________________________________
Recommendations of the Manager.
Please confirm whether
(i) Salary certificate obtained in respect of both
applicant and guarantor (if in employment)
(ii) No objection certificate from employer obtained
(if employed in any other Bank).
(iii) Income-Tax assessment order/Sales-Tax/
Agricultural Income Tax return for the current year obtained (if in business or in Agriculture) in respect of both applicant and guarantor

Date: _____________________ Signature of the Manager.

For use at Central Office/ Regional Office Office Note
Branch ___________________________________
Loan amount Rs. ___________________________
Purpose __________________________________
Value: Rs. ________________________________
No. of instalment : _________Rs.______________
Applicant’s income per month : Rs._____________
Rent : Rs. _________________________________
No. of dependants __________________________
Other borrowing : Rs. _______________________
Credit reports : Satisfactory/Unsatisfactory
May be sanctioned/declined

Sanctioned under discertionary limit.