Central Bank of India



Central Bank of India

______________ Branch

Borrower’s / Guarantor’s Profile

(To be used in case of Individual Borrowers / partners / Directors / Members of HUF / Guarantors)

Name and Address of Borrowal Account:

Affix Recent Passport

Size Photo & sign

Across

|Account Number (If any) | |

|Full Name (Shri / Smt / Kum) | |

|Father’s / Husband’s Name | |

|Nationality | |

|Age & Date of Birth & Place of Birth | |

|Sex ( Male / Female) | |

|Educational Qualifications | |

|7.A. Employment Particulars | |

|i) Name & Address of Employer | |

|ii) Designation | |

|iii) Date of Joining | |

|iv) Number of years of service | |

|v) Gross Emoluments (Per annum, copy of latest salary slip to be | |

|enclosed) | |

|7.B. Occupation Particulars | |

|i) Nature of Business | |

|ii) Established since | |

|iii) Place of Business | |

|iv) Name of sister concerns / Associates and address thereof | |

|8.a. Present Address | |

|i) Flat /Door / Block No. | |

|ii) Name of Premises / Building | |

|iii) Road / Street / Lane | |

|iv) Area / Locality | |

|v) Town / City / District | |

|vi) Pin code | |

|vii) Telephone / Fax No. | |

|8.b. Whether the above premises is rented or owned? | |

|9.a. Permanent Address | |

|i) Flat /Door / Block No. | |

|ii) Name of Premises / Building | |

|iii) Road / Street / Lane | |

|iv) Area / Locality | |

|v) Town / City / District | |

|vi) Pin code | |

|vii) Telephone / Fax No. | |

|8. b. Whether the above premises is rented or owned? | |

|10. E-mail Address | |

|11.Particulars of family members | |

|Name |Relationship |Age |Marital status |Addresses (Res & Off) |

|i) | | | | |

| | | | | |

|ii) | | | | |

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|iii) | | | | |

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|iv) | | | | |

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|12. Income tax Permanent Account No. | |

|(Please enclose copy of last Income-tax and Wealth-Tax returns) | |

|Ward / Circle | |

|13. (i) Ration Card No. | |

|ii) Issuing Authority | |

|iii) Date of issue | |

|iv) Card Holder’s Name | |

|v) Address as given in the Card | |

|(If different from the address given above, reasons thereof) (Copy of | |

|Ration card to be enclosed) | |

|14. Election Commission Identity card No. | |

| Issuing Authority and Date | |

|15. (i) Passport Number | |

| (ii) Date and Place of issue | |

| (iii) Period of validity | |

|(Copy of relevant pages enclosed) | |

|16. (i) Driving Licence No. | |

| (ii) Valid Up to | |

| (iii) Issued by RTO at | |

|( Copy enclosed) | |

|17. (i) Credit Card No. | |

| (ii) Name of the Bank / Institution | |

| (iii) Valid up to | |

|18. Liabilities / Loans | |

| (i) Self / as a partner / co-parcener / ers | |

|Name under which |Sources (Bank or |Amount (Rs) |Purpose |Security |Terms of Repayment |

|borrowed |financial institutions)| | | | |

| | | | | | |

| | | | | | |

| | | | | | |

|As a Guarantor | |

| (i) Self / as a partner / co-parcener / ers | |

|Name of Principal |Sources (Bank or |Amount (Rs) |Purpose |Security |Terms of Repayment |

|borrower |financial institutions)| | | | |

| | | | | | |

| | | | | | |

| | | | | | |

|19. Details of Existing Bankers (Name & | |

|Address) | |

|Type of Account & Existing Balance | |

|(Specify if pledged & details thereof) | |

|20. List of moveable properties | |

|a) Vehicles (Copy of RC Book enclosed) | |

|i) Description (Two / Three / Four wheelers | |

|ii) Make | |

|iii) Registration No. | |

|iv) Year and Model | |

|b) Shares / NSCs / Bonds / Debentures / Bank Deposits / Units / LIC | |

|Policies | |

|Nature of security |Name of the Company / |Total No. of Security |Face Value |Maturity Value (For |Terms of Deposits (in |

|(share / Bond etc) |Bank / FI / Others | | |Bonds / Debentures) |months) |

| | | | | | |

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| | | | | | |

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| | | | | | |

|c. Any other e.g. Jewellery etc (Please specify) | |

|Means / Capital | |

|Proprietor’s Capital | |

|Partners’ Individual capital | |

|1) |Rs. |

|2) |Rs. |

|3) |Rs. |

|4) |Rs. |

|Total |Rs. |

In case of Companies:

CAPITAL

|Authorized |Issued |Subscribed |Paid up |Firm underwriting |

| | | | |commitments if any in case |

| | | | |of fresh issue |

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We enclose

i) 3 copies of Audited balance sheet and P/L a/c each for the year ended ___________.

ii) 3 copies of provisional Balance sheet and P/L a/c for the year ending ___________.

iii) Copy of partnership deed

Borrowing Powers:

We enclose

i) Certified copy of Resolution of General Body meeting held on ________ ( Annexed hereto ) and

ii) Three copies of Memorandum and Articles of Association of the Company (in case of new accounts)

We confirm that Memorandum and Articles provide powers to

i) Borrow up to Rs.___________

ii) Create mortgage, charge etc____________

Place: Yours faithfully

Date:

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