WAREHOUSE RECEIPT FINANCE SCHEME
Loan Application Form (farmers/ traders/ processors)

BRANCH________________________
Application No. _____________________ Year __________________
APPLICATION FORM FOR AGRICULTURAL CREDIT
Photo
The Branch Head
IDBI ltd
_________________
Dear Sir,
I/ We hereby apply for a loan of Rs…………………..(Rupees…………………………….
……………………….. Only) and furnish below the necessary particulars.
1. Purpose of Loan
2. Name of the Applicant
3. Address of applicant
4. Nature of activity
5. Age and Gender (for non individuals, give details of partners/ directors)
6. Whether SC/ ST/ OBC/ Physically Handicapped/ Minorities/ Weaker Sections/ Ex-Servicemen/ Resident of J&K or North East/ Others (for non individuals, give details of partners/ directors)
7. Established in (for non individuals)
8. Constitution
9. Details of relationships with IDBI, if any
10. Key Person (in case of non individuals)
11. Group Affiliation (in case of non individuals)
12. Current bank details
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WAREHOUSE RECEIPT FINANCE SCHEME
13. Limits with other banks/ financial/ informal lending institutions
Name of bank/ financial/ informal lending institution
Nature of relationship
Limit, if any
Balance o/s
14. Background/ profile of borrower
15. Particulars of Land Holding
Village
Total acres
Land revenue (Rs.)
Total irrigated acres
Sources of irrigation
Value of total acres (Rs. Lakh)
16. Basis for request of limits (enclose copies/ separate sheets, if required)
a. Location of the area
in which cultivation/ allied activity is proposed
Name of crop/ livestock
Survey/ Khasra No
b. Commodity
Present Price (Rs./ MT)
Scale of financing (%)
c. Income from agriculture in Rs. Lakh (for farmers)
SY (–2)
SY (–1)
SY (0)
SY (1)
SY (2)
Annual gross farm income (a)
Expenses (b)
Annual net farm income (c)=(a)-(b)
Income from allied activities
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WAREHOUSE RECEIPT FINANCE SCHEME
c. Performance & financial indicators (for non farmers)
FY (–2)
FY (–1)
FY (0)
FY (1)
FY (2)
Net sales
Gross Profit
Net Margin
Cash Accrual (CA)
Paid Up Capital
TNW
Term Liabilities
Net Fixed Assets
Non current assets
Current Assets
Current Liabilities (including short term bank credit)
Current Ratio
D/E Ratio
Debt/ CA
d. Position of payment of income and wealth tax for last 3 years
e. Specify arrangements for
Cultivation activities
Procuring inputs
Marketing of produce
Storing of produce
Transport of produce
f. Loan and interest servicing requirement
Gestation period
Installment frequency
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WAREHOUSE RECEIPT FINANCE SCHEME
17. Particulars of guarantors
Name
Address
Relationship with applicant
Networth (Rs. Lakh)
Basis of networth (enclose copies/ separate sheets, if required)
18. Declaration:
a) I/We hereby declare that the particulars given above are true and correct to the best of my/our knowledge and belief.
b) It will be in order for the Bank to disqualify me/us from receiving any credit facilities from the Bank in case it is proved that the declarations of my/our outside borrowings made above contain misrepresentation of facts.
c) I/We hereby declare that I/we have no borrowings from any other agency on the date of application other than those mentioned under Point No. 13.
d) I/We undertake not to borrow from any other agency without the permission of the Bank.
e) Whether the Applicant/s, Co-obligant/s, Guarantor/s is/are related to any Senior Officer of the Bank : Yes/No. If yes, specify the names of the officer with designation and the branch/office working and the nature of the relationship.
Name _________________________________________Relationship____
f) We certify that all the information furnished by me/us is true; that I/we have no borrowing arrangements for the unit with any Bank other than the facts mentioned under 13 above; that no legal action has been/is being taken against me/us; that I/we shall furnish all the information that may be required by you in connection with my/our application; that this may also be exchanged by you with any agency you may deem fit, and that you, your representatives, representative of Reserve Bank of India or any other agency as authorized by you, at any time, inspect/verify our assets, books of accounts, etc., in our farm factory and/or business premises.
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WAREHOUSE RECEIPT FINANCE SCHEME
g) I/We hereby undertake to abide by the terms and conditions that the Bank may stipulate in sanction of this loan and inform Bank in the event of acquiring any other assets during the tenure of the advance.
Place:
Date: Signature of Applicant/s
Details of Co-obligants/ Guarantor/s (separate sheet for each guarantor)
I. Address
Sl.
No.
Name with Surname
Age
Father’s Name
Occupation
Full Address with Name of Village/P.O./Tq./Dist./
Pin Code
II. Assets Owned
(Amount in Rs.)
Details
Location (Specify Door No. Sy.No.etc.
Purchase Price (Rs.)
Present Market
Value
(Rs.)
Annual Income
(Rs.)
III. Liabilities (both direct and indirect)
(Amount in Rs.)
Borrowed from
Purpose
Amount
Availed
Present Liability
Amount
Overdue
Security
Name of the Borrower in case of indirect liability
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WAREHOUSE RECEIPT FINANCE SCHEME
IV. Net worth of Co-obligant/Guarantor [II-III] Rs._________
I/We offer to stand as Co-obligant/ Guarantor/s for the credit facilities to be extended to _________________________.
We certify that all the information furnished by me/us may also be exchanged by you with any agency you may deem fit, and that you, your representatives, representative of Reserve Bank of India or any other agency as authorized by you, at any time.
Place:
Date: Signature of Co-obligant/Guarantor/s
FLOW CHART
Sr. No.
Particulars
Date of Receipt
Date of final compliance received
Date of submission to next Delegated Authority
Comments, if any, regarding time taken*
1.
At Delegated Authority 1
2.
At Delegated Authority 2
3.
At Delegated Authority 3
X--------------------------------Cut Here----------------------------------X
ACKNOWLEDGEMENT
Received the Loan Application from Shri/ Smt.________________________________________
R/o ____________________________on____________________________ for the purpose of _____________________________________________________________________
For IDBI Ltd.
Place:
Date: Delegated Authority 1
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