APPLICATION FORM

STATE BANK OF INDIA
………………………………….. BRANCH

APPLICATION CUM INTERVIEW FORM FOR FINANCING OF TERM LOAN
FACILITY TO THE I-WAY FRANCHISEES OF SIFY UNDER SBI-SIFY TIE UP
ARRANGEMENT.

1. Name of the unit
Identification Code :
2 Address of the unit
Ph. No:
Fax No.
Email/Website
Premises owned /rented
3 Address of Regd. Office in case of
Corporates
Premises owned/rented
4 Address for correspondence
Ph. No.
Fax. No.
Email/Website
5 Other business, if any
6 Year of Commencement of
Business
7 Experience in the line of activity
8 Constitution
DETAILS OF PROPRIETOR/PARTNERS/DIRECTORS
Name &
Qualification
Age PAN Residential
Address
Phone/Mobile Net Worth
(Opinion report on the bank’s prescribed format should be prepared)`
DETAILS OF EXISTING BANKING ARRANGEMENTS
Name of the
Bank/Branch
Facility Limit Outstanding Banking since
DETAILS OF ASSOCIATE/SISTER/IDENTICAL FIRMS
Name of the
unit
Name of the
Prop/partners
Banking with limit Outstanding
Particulars of registration under Shops &
Establishment Act/Sales Tax Act/ Any
other Act.
Position regarding Statutory Assessment
Under IT/Sales Tax/Any other Year upto
which assessment completed
CREDIT FACILITIES REQUIRED
Fund based Limit required
Term Loan
BREAK UP OF ASSETS
Description Brand Supplier Amount
Computer hardware
Furnishing
Interior decoration
Electrical
installation
Networking
Payment to site
Others (please
specify)
DETAILS OF SECURITY OFFERED
Primary
Collateral
IMMOVABLE PROPERTY
Description of
Property
Name of the Owner Value of the
Property
Basis of valuation
( Rs/ Lacs)
LIQUID SECURITIES
Description Name of the
Owner
Face Value When
acquired
Present value
DETAILS OF GUARANTOR(S)
Name of the
Guarantor & Address
Age Qualification Networth Banking
with
I/We declare that the information given in the application form are true, correct and
complete and that they shall from the basis of any kind of facility State Bank of India
may deicide to extend to me/us. I/We shall furnish all other information that may be
required by the Bank in connection with my application. The information may also be
exchanged by you with any agency you may deem fit. You may take appropriate safe
guards/action for recovery of bank dues including publication of defaulters names in
website/submission to RBI. I/We confirm that I/we have no borrowing arrangements for
the unit with any bank except those indicated in the application. I/We confirm that I/We
are not defaulter of any bank/any financial institution. I/We confirm that there are no
over dues / statutory dues owed by me/us and I/We have/had no insolvency proceedings
against me/us nor have I/we ever been adjudicated insolvent. I/we undertake to abide by
the Rules and Regulations of State Bank of India in respect of the facilities being
extended to me/us.
Date :
Place :
Signature of the Borrower
Name of the interviewing Official
Designation :
LIST OF DOCUMENTS TO BE ATTACHED
1. Partnership deed in original ( to be returned) and a copy thereof
2. Memorandum & Articles of Association with Certificate of incorporation in
original (to be returned) and copies thereof.
3. Copies of the balance sheet (s) of the firm/company for past three years
4. Latest copy of Income tax, sales tax assessment order etc.
5. Statement of account from the existing banker for last 3 months
6. Photocopies of PAN card of partners/Directors wherever available
7. Statement of personal assets and liabilities of proprietor/partners/directors
/guarantors
8. 2 copies of photographs of proprietor/directors/partners
9. Copies of the relevant license/ statutory clearances, documents pertaining to
ownership/ Tenancy/lease agreement in respect of premises where activity will be
carried out / Service or trade related agreements etc.
10. Copy of Title deeds relating to collateral security being offered.
11. Certification from ISS (International Security Standards) or any other certification
agency if any.
Opinion cum comfort letter to be provided by S ify (On Letter Head of Sify)
1. Name and Address of franchisee
2. Year of appointment of dealer
3. Identification code
4. Range of services provided
a. Browsing ı
b. Net-to Phone ı
c. Scanning ı
d. Printing ı
e. Gaming ı
f. Any other ı
Please Specify ___________________________________
5. Limit recommended (final decision as per banks policy)
We hereby confirm that the information given above is true to the best of our knowledge
and shall be treated strictly confidential and without any liability on the company for and
credit decision taken by bank and accept the terms and conditions stated in the MoU
signed by Bank and Sify dated:
Name of the Authorized official:
Mr./Mrs. ____________________
Designation ____________________ Signature
Date:
Office Stamp and Seal