Interview-Cum-Assessment Form for investment Credit Requirements
(For loans upto Rs. 25,000/-)

Annexure – B
Name of the Applicant _________________________________

1) Project Cost & Source of Fund
Sr. No Proposed Investment Make / Brand / H.P. Breed Name of Suppliers Estimated Cost Margin / subsidy Bank loan
I.
II.
III.
IV.
Total :

2. Cropping Pattern :
Existing (pre-development) Proposed (post-development)
Crop Area (in acres) Total Value Crop Area (in acres) Total Value
Irrigated Un-irrigated Of Produce Irrigated Un-irrigated Of Produce
Kharif Kharif
i) i)
ii) ii)
iii) iii)
iv) iv)
v) v)
Rabi Rabi
i) i)
ii) ii)
iii) iii)
Summer Summer
i) i)
Total Total

3. Anticipated annual surplus out of the activity(ies) for which loan is sought : Rs. ………
4. Repayment – Loan of Rs. …………………. to be repaid in ……….. Annual/HY/quarterly / monthly installments of Rs. …………………. Each plus interest due

Signature of Appraising Officer Signature/Thumb Impression of Applicant(s)
Place :
Date :

For Office Use

Memorandum for sanction of Term Loan
Observations of Appraising Officer :
1. The applicant(s) is / are genuine agriculturist/s and is/are capable of successfully pursuing the activity. Y/N
2. The farm has the necessary technical facilities / infrastructure to support the activity proposed by availing the loan. Y/N
3. The techno economic viability of the proposal has been found satisfactory. Y/N
4. The estimated cost of the machinery / item being purchased is as per the market rate in the area. Y/N
Recommendations of the Appraising Officer :
The relevant land record / documents have been obtained and verified and found correct. The farm was visited by me on ………………………… (Give date)
a) Loan Recommended : Rs. ………………………….
b) Scheme : General / IRDP / PMRY / DIR / Any other (Specify)
c) Security proposed : (I) Hypothecation of …………………………
(ii) Mortgage / charge on land measuring --------------acres
(iii) Guarantee of
(a) Shri …………………………
s/o …………………………
(b) Shri …………………………
s/o ………………………….

d) Repayment schedule : ………….. (Number of installments) Monthly / Quarterly / half yearly / yearly
e) Gestation period : ……………… (Number of months)
Therefore, the first installment will become due on ……………….
f) Insurance, wherever applicable :

Place: Signature of Appraising Officer with name and designation
Date

Sanctioned

Place Branch Manager
Date