Annexure - I
Bank of Baroda
Revised Application Form For Baroda Kisan Credit Card

The Branch Manager
Bank of Baroda
_____________ Branch
_____________
Dear Sir
Re. : Availment of Baroda Kisan Credit Card facility from your bank
I / We the undersigned Mr. / Miss / Mrs. __________________________________ son / daughter / wife of ________________________ belonging to village ______________ Taluka ___________ District ___________________ hereby apply for sanction and issuance of Baroda Kisan Credit Card facilities for my / our farming activities.
For the purpose, I / We furnish the required information in the format enclosed which is correct as per my / our knowledge and belief. I am/ we are aware that in case any of the information furnished by me/us in this respect is proved to be incorrect, false or incomplete, my /our BKCC facility is liable to be cancelled/withdrawn forthwith by you without any notice to me/us.
I / We have read the latest rules and regulations of Baroda Kisan Credit Card scheme of your Bank and undertake to abide by / adhere to the same.
I / We hereby authorise you to debit our account for the material purchased / payment made through cheques / charge slip in case of material purchased by me/us from authorised Member Establishment dealers.
I / We hereby undertake to operate upon / maintain our accounts within the sanctioned limits.
Yours faithfully,
Signature Name
1. X________________________________ ___________________________________
2. X________________________________ ___________________________________
3. X________________________________ ___________________________________
4. X________________________________ ___________________________________
Annexure to Application for BKCC
Information to be furnished by the Applicants for Baroda Kisan Credit Card
1. Applicant Details
Sr. No.
Name of the Applicant
Age
Educational Qualification
Present Activity
Annual Income (Rs.)
Residential Address
(1)
(2)
(3)
(4)
(5)
(6)
(7)
I / We belong to following categories.