Loan Application Form

[Pages:7]DAIRY LOANS

Loan Application Form

BRANCH

: ________________________

Application No.: ________________________ Year __________________

APPLICATION FORM FOR DAIRY LOAN

The Branch Head, IDBI Ltd, _________________

Dear Sir,

I hereby apply for a loan of Rs.................. (Rupees.....................

............................. Only) and furnish below the necessary particulars.

Purpose of loan: _____________________________________________________

Part A

1. Particulars of Applicant

Name of the Applicant

Networth (Rs. Lakh)

Basis of Networth (enclose copies/ separate sheets, if required)

2. Address of applicant (With Pin Code):

3. Nature of activity

:

4. Age and Sex

:

5. I belong to following category/ies. Tick which ever applicable.

? Hindu undivided family/ Others (Specify) Name of the Kartha, if belonging to Hindu Undivided Family ____________________________________

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? SF/ MF/ AL/ Other Farmer ? SC/ ST/ BC/ Minority/ Physically handicapped

6. Background/ profile of borrower :

7. Dealings with IDBI since

:

8. Details of relationships with IDBI, if any:

9. Current bank details

:

10. Limits with other banks/ financial/ informal lending institutions

Name of bank/

financial/Govt./Infor

Nature of

Limit, if Balance

mal lending

relationship

any

o/s

institution

11. Particulars of Land Holding, if any

Area in Acres

Village

Sy. No .

Total

Of whic

h irrig

ated

Source of

irrigati on

Land reve nue (Rs.)

Value of total

acres (Rs. Lakh)

12. Proposed investment

Particulars

Purchase of high yielding milch cattle (Elaborate on the breed, etc.) Construction of cattle shed

No./ Area

Cost per unit (Rs.)

Total cost (Rs.)

Remarks, if any

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(Elaborate on the facility to be created, etc.) Purchase of dairy equipments, (Elaborate on the equipments, etc.) Expenditure incurred for transportation of animals where the animals are not purchased locally (Elaborate) Transit insurance Others Total

13. Income from Dairy activity and Agriculture

SY

SY

SY

SY

SY

SY

SY

(?2) (?1)

(0)

(1)

(2)

(..)

(n)

Annual

gross

dairy

income

(a)

Expenses

(b)

Annual

net dairy

income

(c)=(a)-

(b)

Income

from

allied

activities

Note: SY means Seasonal Year i.e. period from season to season; In case data is available for FY or CY (Calendar Year), the same may be used.

14. Position of payment of income and wealth tax for last 3 years

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DAIRY LOANS

15. Specify arrangements for

Procuring cattle Procuring of Equipments, etc. (Elaborate on tie-up arrangements, if any) Construction of cattle shed Procurement of Green Fodder, Dry fodder and Cattle Feed Storing of fodder and feed Veterinary care Marketing of produce Transport of produce

16. Loan and interest servicing requirement

Gestation period Installment frequency

17. Particulars of guarantors

Name

Address

Relationship with

applicant

Networth (Rs. Lakh)

Basis of networth (enclose copies/ separate sheets, if required)

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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.

10.

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) I/ 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 10 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.

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: Applicant/s

Signature of

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