APPLICATION CUM PROPOSAL FORM FOR STAR PENSIONER’S LOAN
(To be filled in by the applicant)

The Manager,
BANK OF INDIA,
___________ BRANCH,

I/We wish to apply for a loan of Rs._________________
(Rs.______________________________only) for__________________________________

I/We agree to abide by all the terms and conditions prescribed by the Bank, from time to time. I/We agree to execute all the necessary documents and to create securities in Bank’s favour as desired by the Bank.

To enable the Bank to consider my/our request, I/We furnish below the required particulars/information and undertake to furnish to the Bank any other information/particulars required for the purpose from time to time till the loan is repaid in full.

Part A : (Particulars of Applicant) – Details of first applicant to be given unless specified otherwise.

1. Name in full (First Applicant/Borrower)
(i) Mr./Mrs./Ms.___________________________________________________________
(Surname) (Name) (Middle-name)
(Joint Borrower, if any):-

(ii) Mr./Mrs./Ms.___________________________________________________________
(Surname) (Name) (Middle-name)

2. Date of Birth (i) ________________ (ii) ______________

3. Age (i) ________________ (ii) ______________

4. Maritial Status : Married/Unmarried 5. Number of Dependents

6. If spouse working : Yes/No

7. If yes, his/her monthly income (Gross) Rs._______________ Net Rs._____________

8. Residential Address (Present)_____________________________________________
_____________________________________________________________________
_____________________________________________________________________
__________________________________________Tel.No._____________________
How many years you have been staying at above address?__________years
House/Flat owned/rented/in the name of ____________________________________

9. If the present address is not the permanent address, give details of Permanent address :
_____________________________________________________________________
_____________________________________________________________________
House/Flat owned/rented/in the name of _____________________Tel.No.__________

10. Ration Card No._______________issued on _______________by________________

11. Whether holding Passport? Yes/No
If yes, details thereof : 1st applicant 2nd applicant
(i) Number ____________________ ____________________
(ii) Date of issue ____________________ ____________________
(iii) Date of Expiry ____________________ ____________________
(iv) Issuing Authority ____________________ ____________________
 
12. Occupation : service/Business/Self employed Since __________years
If employed, details about the employment:
Name & Address of the employer__________________________________________
_____________________________________________________________________
_____________________________________________________________________
__________________________________________Tel.No._____________________

Employed since _____________________Designation__________________________
Gross Annual Salary : Rs._______________________________________
Present monthly net take home pay: Rs.___________________________
Income-Tax payer : Yes/No, If yes, PAN No.________________________
If having business/self-employed, details about the same :-
Nature of business/Self-employment activity:__________________________________
Type of organisation : Proprietary/Partnership
Business Registration/Licence No.__________________________________________
Business Address ______________________________________________________
_____________________________________________________________________
__________________________________________Tel.No._____________________
Business premises owned/rented/in the name of_______________________________
If business/self-employment is in partnership, please provide details of names of
partners and their addresses :
Name/s of the partner/s and address _______________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Gross/Net Annual Income : Gross Rs._____________________Net Rs.____________
Income-tax payer : Yes/No. If yes, PAN No.__________________________________

13. Whether 1st applicant maintains account/s with the branch : Yes/No
If yes, details : - S/B a/c. no.______________ since ________ present bal.__________
Other a/cs : type._______________________ since ________ present bal.__________

14. Details of Accounts maintained with other branches/Banks
a) Name & Address of other branch of Bank of India____________________________
_____________________________________________________________________
_____________________________________________________________________
Savings Bank a/c. no._____________ since ___________ present bal._____________
Other a/cs : type.________________ since ___________ present bal._____________
b) Name & Address of other Bank/s where deposits are maintained :-
_____________________________________________________________________
_____________________________________________________________________
Savings Bank a/c. no._____________ since ___________ present bal._____________
Other a/cs : type.________________ since ___________ present bal._____________

15. Whether presently a borrower of Bank/Other Banks/Institutions : Yes/No
If yes, please furnish following details:
Name & address of the Bank/institution______________________________________
_____________________________________________________________________
_____________________________________________________________________
Purpose for which loan is availed___________________________________________
Amount borrowed : Rs._______________________ since date___________________
Present outstanding : Rs._____________________Repayment due by_____________
Repayment terms :- Monthly/Quarterly/Half-yearly instalment Rs.__________________
 
16. Details of sources of monthly & annual income/outgo :
(As per salary slip/certificate/personal balance sheet/income tax return etc.)
Principal sources Other sources
(i) (ii) (i) (ii)
Gross income Rs.___________ ________________
Deductions/outgo Rs.___________ ________________
Net ___________ ________________

17. Position of Assets and Liabilities of 1st applicant : as on
Details of assets/savings (Rs.) Details of liabilities/dues (Rs.)
i) LIC policies : _______________ i) dues to bank : ____________
ii) Bank Deposits : _______________ ii) dues to employer : ____________
iii) Others Deposits : _______________ iii) dues to others : ____________
iv) NSC/PPF/IVP/KVP : _______________
v) Shares/Deb. Units : _______________
vi) Land/Building/House : _______________
vii) Car : _______________
viii) Gold & Silver/Jewellary : _______________
ix) Other assets : _______________ ____________
Total assets Total liabilities
=============== ============

18) Position of Assets and Liabilities of 2nd applicant : as on __________________________
Details of assets/savings (Rs.) Details of liabilities/dues (Rs.)
i) LIC policies : _______________ i) dues to bank : ____________
ii) Bank Deposits : _______________ ii) dues to employer : ____________
iii) Others Deposits : _______________ iii) dues to others : ____________
iv) NSC/PPF/IVP/KVP : _______________
v) Shares/Deb. Units : _______________
vi) Land/Building/House : _______________
vii) Car : _______________
viii) Gold & Silver/Jewellary : _______________
ix) Other assets : _______________ ____________
Total assets Total liabilities
=============== ============

19) Bank details of the 2nd applicant (maintained with branches / Bank)
a) Name & Address of other branch/es of Bank of India_________________________
_____________________________________________________________________
_____________________________________________________________________
Savings Bank a/c. no._____________ since ___________ present bal._____________
Other a/cs : type.________________ since ___________ present bal._____________
b) Name & Address of other Bank/s where deposit a/c. maintained :-
_____________________________________________________________________
_____________________________________________________________________
Savings Bank a/c. no._____________ since ___________ present bal._____________
Other a/cs : Type.________________ since ___________ present bal._____________

* * * * * * * * * *
PART B (Details about the proposed loan)

1) Amount of Loan required Rs._______________________________________________
2) Purpose of the loan :_____________________________________________________
3) Cost / Expenses to be incurred : Rs._________________________________________
4) Source of the repayment of the proposed loan : ________________________________
5) Security proposed to be offered for the said loan :_______________________________
____________________________________________________________________________
(enclose details of expenses made / to be incurred )

* * * * * * * * * *
 
PART C (Details of the Guarantor for the proposed)
1) Name & address of the guarantor proposed to be offered
Mr./Mrs./Ms.
(Surname) (Name) (Middle-name)
Address
Date of Birth : Age : Years
2) Relationship with the 1st applicant
3) Occupation of the guarantor:
4) Details of Income (Annual) Gross Rs.________________ Net Rs._______________
(Please enclose proof of Income of the Guarantor)

* * * * * * * * * *
PART D (Declaration by applicants)
1) I/We declare that the proposed loan is required by us for _________________
And that the loan would be utilised only for the said purpose.
2) The foregoing information provided by me/us is true and correct and provided to the Bank to enable the Bank to take decision about granting or otherwise of the loan to me/us.
3) I/We undertake that if, based on the information provided by us / my our guarantor/s, Bank sanctions loan/s to me/us and in case at any point of time hereinafter it transpires that any information provided / to be provided by me/us/our guarantors is found to be incorrect/false or that the loan availed of by me/us is not used for the purpose mentioned above, the bank shall be at liberty to recall the advance forthwith, irrespective of the contracted terms of the loan and charge me penal/additional interest as deemed fit. I/We would repay forthwith, the entire loan outstanding then together with interest/penal additional interest and other charges.
4) I/We undertake to provide further information as Bank may ask from me/us from time to time.
5) I/We undertake to execute necessary documents for the loan at my costs and to create adequate security for the loan as desired by the Bank prior to disbursement of the loan.

Yours faithfully,

Signature of the 1st Applicant______________________

Signature of the 2nd Applicant______________________

ANNEXURE TO APPLICATION FOR STAR PENSIONER’S LOAN
(Details to be filled in by the guarantor)

1. Name in full (Guarantor)
i) Mr./Mrs./Ms.___________________________________________________________
(Surname) (Name) (Middle-name)

2. Date of Birth :_______________________ 3. Age :____________________________

4. Residential Address ____________________________________________________
_____________________________________________________________________
_____________________________________________________________________
House/Flat owned/rented/in the name of ____________________________________
5. Details of Passport held, if any
If yes, details thereof :
(i) Number ____________________ (ii) Date of issue____________________
(iii) Date of Expiry_______________ (iv) Issuing Authority_________________
6. Occupation : service/Business/Self employed Since :______________Years
If employed, details about the employment:
Name & Address of the employer__________________________________________
_____________________________________________________________________
_____________________________________________________________________
Employed since _____________________Designation__________________________
Gross Monthly Salary : Rs._____________ Net Take Home salary:Rs.______________
Income-Tax payer : Yes/No, If yes, PAN No.___________________________________
If having business/self-employed, details about the same :-
Nature of business/Self-employment activity:__________________________________
Type of organisation : Proprietary/Partnership
Business Registration/Licence No.__________________________________________
Business Address ______________________________________________________
_____________________________________________________________________
__________________________________________Tel.No._____________________
Gross/Net Annual Income : Gross Rs._____________________Net Rs.____________
Income-tax payer : Yes/No. If yes, PAN No.__________________________________

Details of Accounts maintained with Banks
a) Name & Address of Bank :_____________________________________________
_____________________________________________________________________
_____________________________________________________________________
Savings Bank a/c. no._____________ since ___________ present bal._____________
Other a/cs : type.________________ since ___________ present bal._____________

Liabilities with Banks/Institutions, if any
Name & address of the Bank/institution______________________________________
_____________________________________________________________________
_____________________________________________________________________
Purpose for which loan is availed___________________________________________
Amount borrowed : Rs._______________________ since date___________________
Present outstanding : Rs._____________________Repayment due by_____________
Repayment terms :- Monthly/Quarterly/Half-yearly instalment Rs.__________________
Details of sources of monthly & annual income/outgo :
(As per salary slip/certificate/personal balance sheet/income tax return etc.)
Principal sources Other sources
(i) (ii) (i) (ii)
Gross income Rs.___________ ________________
Deductions/outgo Rs.___________ ________________
Net ___________ ________________
 
7. Position of Assets and Liabilities of 1st applicant : as on
Details of assets/savings (Rs.) Details of liabilities/dues (Rs.)
i) LIC policies : _______________ i) dues to bank : ____________
ii) Bank Deposits : _______________ ii) dues to employer : ____________
iii) Others Deposits : _______________ iii) dues to others : ____________
iv) NSC/PPF/IVP/KVP : _______________
v) Shares/Deb. Units : _______________
vi) Land/Building/House : _______________
vii) Car : _______________
viii) Gold & Silver/Jewellary : _______________
ix) Other assets : _______________ ____________
Total assets Total liabilities
=============== ============

I hereby declare that I am agreeable to stand as guarantor to Mr./Mrs./Ms._________________ ________________________ for the loan applied. The foregoing information provided by me/us is true and correct and provided to the Bank to take decision about granting or otherwise of the loan to me/us.
I undertake that if, based on the information provided by me, Bank sanctions loan/s to Mr./Mrs./Ms.___________________________________ and in case at any point of time hereinafter it transpires that any information provided/to be provided by me is found to be incorrect/false, the bank shall be at liberty to recall the advance forthwith, irrespective of the contracted terms of the loan. I would repay forthwith, the entire loan outstanding then together with interest/penal additional interest and other charges.
I undertake to provide any further information as Bank may ask from me from time to time. I also undertake to execute necessary documents for guaranteeing the loan.

Yours faithfully,

Signature of the Guarantor______________________