This form is to be filled in by the Applicant
LATEST
PHOTOTHE MOGAVEERA CO~OPERATIVE BANK LTD.
,b,PPLICATION FORM FOR OVERDRAFT/CASH CREDIT!BILLS DiSCOUNTING & TERM LOAN
(FRESH/RENEWAL)
To,
The Branch Manager,The Mogaveera Co-operative Bank ltd., 078l
Application r-.lo._-'---,- .
~ BranchDate : _
Dear Sir,
!/We request you to grant melus the banking facilities mentioned below for the
conduct of our business. For your information IIWe furnish in the form particulars of
my/oUi business, statement of assets and liabilities etc. We agree to abide by the
rules-bye-laws ofthe bank, which are now in force or may hereafter come into force.
FACILITiES REQUIRED AMOUNT DURATION
a. Overdraft/Cash Credit
b. Bills discounting
c. Term Loan
1. Name of the ConcemlCompanylfirm/types6fbu~ness .
2. Regd. Address(Attach Proof)
Address of Godown/Factory!Branches, if any(Attach Proof)
3. Banks Membership No.
4. Constitution of the Borrower/firm,!Concern/Company
5. Date of Establishment
6. Registration No. of the firm
7. Telephone Nos. Office:
_____ Nuinberof shares _
_______ Resi.: _
· ,., .. , .
8. Name/s Partner/Proprietor/DirectorCapital of each Share of
Profit/toss:Residentiat Ageaddress &telephone Nos.
AI. 1.~ __
2.2. _
3.3. ,
4.4. _
----,-~.--------5.. 5. -----------~
9. Purpose of the facility required :
10. Nature of Business:
11. Particulars of the securities offered such as marketable goods, machineries, fixed deposits,vehicle or any other property etc. (Enclose stamped receipts in support of payments)
a. Security offered (in case of new application) Value of Security
b. Nature of Security already offered (in case of renewal)
c. Additional Security if any ,
Rs.
d. Strike outwhichever is not applicableAbove securities are owned by me/us and not encumbered in any manner.Above securities. i.e. flat/gala is not owned by me/us but owned by _
Assets & liabilities of the firm as on : _
12. liabilities Amount Rs. Amount Rs.
1. Capital2. Borrowing from Banks3. Borrowing from others
1. Fixed assets:2. Stock in trade:3. Sundry Debtors:
(give details separately)4. Other assets:4. Sundry Creditors
(Give details separately) ------TOTAL TOTAL
BUSINESS iNCOME:13. a. Profit earned during the
Previous Accounting year : Rs. Year _
b. Any other income, Nature ofinvestment (Please specify) : Rs._~ __ =-~-:-
Annual Income Total of 13 (a+b)"
14. Insurance policy in force. AmountInsured due date (pI. attach copy) : Rs. Due Date: _
15. Information about tax payments made for the previous year, if yes, (pI. attach copy)
a. Wealth Tax paid : Rs. Year
b. Income Tax paid (attach Chalian &
Returns) : Rs. Year
c. Year last assessed : Rs. Year
d. Advance Tax paid for the Current Yea : Rs. Date
: 3:
e. Income Tax permanent No. Dt. when issued
f. Sales tax paid for the year(Attach Challan) Rs. Year
g. Sales tax payment in arrears As. From
h. State and/or centra! sales(Attach Challan) As. Year
i. Tax Registration No. Date:
16. if manufacturing company excise dutiespaid (details to be furnished)
17. Is the business premises owned by the firm
18. State whether on ownership basis, rentalbasis, lease basis, leave & licence etc.
19. Monthly Rent & other outgoings(Attach latest Receipt) Bill No. date
20. Name & Address of the Bankers withwhom you are dealing Name Address A/c. No.
1.
2.
21. Facility enjoyed with other Bank(Give details) Name Address Nature of
facility
22. Name of the sureties offered 1-
2.3.
4.
23. Nature of account held with the Bank CurrentlSavings/R.D./F.D. Rs.
Since24. Turn Over Rs.
25. Average Balance Rs. :
26. Maximum Balance As. As on Date
27. Minimum Balance Rs. As on Date
28. Are you a Surety to anyone, If so(Give details) Name 1.
2.
Are they regular in repaymentsParticulars of loans taken fromthis Bank
Loan No. Branch Amount Sanctioned I Amount
on I outstan-ding
~ I
IiiI!
I - ..----
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29. I/We hereby declare that all the information and answers given above are true and correctin every respect. If any of them found to be not true than the Bank may take suchaction against me/us as the Bank may think fit. IIwe also undertake to communicate tothe Bank any changes in the above information.
(NJe authorlse the Bank to :
1. couect independently any information you would like to obtain from any othersources in respect of the firm and or Directors. Partners. proprietor.
2. I/We undertake to give access and permission to the Bank/Its Agent/Servant to inspectbooks of accounts, stocks, securities, machineries etc. at any time they so desire.
It is hereby agreed and understood by me/us that the Bank will be at liberty always and at ailtimes to recall all or any advances granted to me/us including interest accrued and I/We jointlyand severally undertake to repay the same in full on demand by the Bank.
30. I/We undertake to display the Bank's namebcard at shops/godowns where goods/stockshypothecated are stored/proposed to be stored. I/We undertake to send the stockstatements regularly to the Bank.
31. IIWe make the aforesaid declaration knowing that on the faith and strength thereof ourapplication for a loan/cash credit/overdraft facility will be considered by you, and that theadvance. If sanctioned, is liable to be recalled forthwith in case the aforesaid decla.rationturns out to be not true in any manner whatsoever.
32. That the aforesaid goods/machineries proposed to be hypothecated to you as security forthe loan/cash credit/overdraft facility asked for. are either my/our own absolute property orthat ItWe have such interest in them as entitles me/ue to hypothecate them to the Sank tothe full extent of the Bank's advance to melus against these goods and that they are notsubject to any attachment. lien claim or charge of any sort.
33. That my/our banking business will be confined to your Bank and I/We will deposit my/ourearnings in my/our account with you and that I/We will not borrow any money fromany source/Bank other than yourselves.
34. That the advances. if granted will be utluseo for the purpose for whichit is granted.
Name/s Yours faithfully.
1. _All Directors/Partners
ORProprietor
(SIGNATURE)
2. _
3. _
35. INJe/Our Firm/Companyam/have become a memberls of more than one credit society, names of which aregivenbelow(1) _ (2) . ~
I/We do hereby declare as required by rule 45 of Maharashtra Co-operative SocietiesRules. 1961 that I/We shall borrow only from _. ~ _
Place Date ~ _
Witness1) Name~ _ 1. _
2. _1. _
2. _~ Name _
Applicant's SignatureOate : _
: 5:
NOTE FOR THE APPLICANT
The application should accompany the following:
1. Firm's/Company's introductory letter.
2. Balance Sheet, Profit & Loss Account duly certified by the Chartered Accountant andapplicant/s for the past 3 years. (C.A. Should put his registration number and must certifyas it as fiied with the income tax authorities)
3. Certified Photostat copies of :-
a. Latest Income Tax Advance paid challans and assessment order.Latest Income Tax Returns for three years,
b. Sales Tax Assessment Order & Sales Tax and CST registration certificates.
c. Latest Professional Tax, Income Tax & Sales Tax paid challans.
d. Certified stocks statement of the firm/Company/concern.
e. list of Sundry Debtors & Creditors with details.
f. Consent & Particulars of Sureties in the prescribed format attached.
g. Copy of Shops & Establishments Licence/Factory licence or any other Licrnce renewedup to date.
h. Stocks Statements for the iast month.
i. If applied for bill discounting facility, list of companies with their addresses on whombills are drawn, which are proposed to be discounted names of transport cos.. whoselorry receipts are to be accepted and irrevocable power of attorney,
j. Certificate of registration & partnership deed in case of Partnership firm.
k. Certified copy of Memorandum & Articles of Association, Certificate of Incorporation,Resolution authorising to raise term loan/overdraft and security offered in case ofPvt. Ltd.lLtd. companies.
I. Certified copies of Ration Cards of the applicant and sureties.
m. Certified Xerox copies of latest Electricity bills, Telephone bills & Rent/maintenancereceipt of office, shop or latest municipal tax paid receipts,
**********
FOR OFFICE USE (Concern Branch should certify)
1. Last loan granted on ___________ Rs. _ closed on _
2. Whether recoveries were regular
3. Whether sureties recoveries are regular
a) S. NO.1 b) S. NO.2
4. Scrutinised by ---:- _ Checked by ~ _
Branch Manager
Branch Accountant
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FOR OFFICE USE ONLY
Liability if any as Borrowerfrom the Bank
Liability if any as suretyto loan due to the Bank
Applicant Amount sanctioned & Loan Ale. No. a) State Name & Loan A/c. No. Amt. o/s
R / IrrLoan Amt. outstanding b) State Name & Loan A/c. No. Amt. ols
Regular/Overdue/closed after due date~~~~~~--~--~~-777--~~~------~~--~~--------~--~--------SURETY NO.1) Amount sanctioned & Loan A/c. No. a) State Name & Loan A/c. No. Amt. ols
R / Irr
R! IrrLoan Amt. outstanding b) State Name & Loan A/c. No. Amt. 0/5
Regular/lnstls. due Rs. R / Irr
SURETY NO.2) Amount sanctioned & Loan Alc. No. a) State Name & Loan A/c. No. Amt. o/s
Loan Amt. outstanding b) State Name & Loan A/c. No. Amt. olsR / Irr
Regular/instls. due Rs. _ R / Irr
SURETY NO.3) Amount sanctioned & Loan Alc. No. a) State Name & Loan A/c. No. Amt. 0/5
R /Irr
Loan Amt. outstanding b) State Name & Loan A/c. No. Amt. o/s
Regular/lnstls. due Rs. R / Irf
SURETY NO.4) Amount sanctioned & Loan Ale. No. a) State Name & Loan A/c. No. Amt. 0/5
R / Irr
Loan Amt. outstanding b) State Name & Loan A/c. No. Arnt. 0/5
R / Irr
ENCLOSURES
Certified :- YES NO NA
1. Balance Sheet & Profit & Loss Account for the 0 0 0past 3 years including current year 0 0 0
2. List of Debtors/Creditors 0 0 03. Income Tax Receipt 0 0 04. Wealth Tax Receipt 0 0 05. Sales Tax Receipt/Professional Tax Paid Challan 0 0 06. RentReceipt/Maintenance receipt 0 0 07. Municipal Licences of Factory/Shop/Office 0 0 08. Collateral Security document 0 0 09. Other Bank's Confidential Report . 0 0 010. Sales Tax assessment order 0 0 011. Excise duty paid challan 0 0 012. S.S.I. Registration Certificate 0 0 013. Project Report 0 0 0
14. Proforma Invoice of new machinery 0 0 015. Copy of income Tax Returns 0 0 016. Stocks Statements 0 0 0
17. Statements of Sales 0 0 0
18. Statements of Purchases 0 0 019. Certificate of registration of firm 0 0 020. Certificate of Incorporation. certified copies of Memorandum &
Articles of Association, certified copy of resolution for availing credit facility 0 0 021. Any other liability with other Banks. 0 0 0
DATED:Signature of the Branch Manager
: 7:
INFORMATIOt'J IN RESPECT OF SURETY NO.
The Manager,The fJlogaveera Co-op. Bank Ltd ..
-.------~- Branch,MUMBAI.
Dear Sir,
! agree to stand surety to the credit facilities requested by _" _for Rs. and submit the following information for your consideration.
1. Full Name
2. Banks' Membership No. & No. ofShares held Membership No. Shareholding No.
3. Residential Address
(Please attach xerox copy ofRation Card)
4. 'Ielspnone Nos. Office _ Res. _
5. Name of Office/Name of Business
6. Designation & Age __________________ Age _
7. Office Address
8. Native Place address
9. Have you any borrowing from theBank to repay Liability Rs. taken on
10. Date of Birth
. 11. Monthly Salary if in service or annualincome from business or profession(salary certificate or Income-taxassessment order or income-taxReturns to be attached)
12. Income Tax paid last year
Rs. , _
Rs. .,.-- Year _
13. Advance Tax paid forthe current year
14. No. of years in Service/business
Rs. Year
15. Name of the person/s for whom you arealready a surety liability Rs.
16. Are they regular in repayment
17. Name & Address of the Bankers withwhom you are dealing
18. State the total investment in businessand/or other property
19. Any other information that may helpus in considering the proposal
! hereby declare that, all the information statements and answers are true andcorrect in all respects.
Signature of Surety
Mumbai, Date _ (Name
: 8:
tile cadit facilities requested by ~" ..- and submit the following information for your consideration.
Sharehoiding No.
0';'
tileLiability Rs. taken on
--- .•.~------
areLiability Rs.
information statements and answers are true and
Signature of Surety
(Name
: 9:
INFORMATION IN RESPECT OF SURETY NO.3
The Manager,The Mogaveera Co-op. Bank Ltd.,
------- Branch,MUMBAI.
Dear Sir,
I agree to stand surety to the credit facilities requested by _for Rs. and submit the following information for your consideration.
8. Native Place address
9. Have you any borrowing from theBank to repay Liability Rs.
10. Date of Birth
11. Monthly Salary if in service or annualincome from business or profession(salary certificate or Income-taxassessment order or income-taxReturns to be attached) Rs.
12. income Tax paid last year Rs. Year
13. Advance Tax paid for the current year Rs. Year
14. No. of years in Service/business
15. Name of the person/a for whom you arealready a surety
16. Are they regular in repayment
17. Name & Address of the Bankers withwhom you are dealing
18. State the total investment in businessand/or other property
19. Any other information that may helpus in considering the proposal
1. Full Name
2. Banks' Membership No. & No. ofShares held
3. Residential Address(Please attach xerox copy ofRation Card)
4. Telephone Nos.
5. Name of Office/Name of Business
6. Designation & Age
7. Office Address
Membership No. Shareholdiny No.
Office _ Res. _
___________________ Age _
taken on
Liability Rs.
I hereby declare that, all the information statements and answers are true andcorrect in all respects.
Mumbai, Date _
Signature of Surety
(Name
: 10 :
INFORMATION IN RESPECT OF SURETY NO.4
The Manager,The Mogaveera Co-op. Bank Ltd.,
Branch,MUMBAi.
Dear Sir,
I agree to stand surety to the credit facilities requested by _for Rs. and submit the following information for your consideration.
1. Full Name
2. Banks' Membership No. & No. ofShares held Membership No. Shareholding No.
3. ResidentialAddress(Please attach xerox copy of
Ration Card)
4. Telephone Nos. Office _ Res. _
5. Name of Office/Name of Business
6. Designation & Age ____________________ Age _
7. Office Address
8. NativePlaceaddress
9. Have you any borrowing from theBank to repay
10. Date of Birth
Liability Rs. taken on
11. Monthly Salary if in service or annualincome from business or profession(salary certificate or Income-taxassessment order or income-taxReturns to be attached)
12. Income Tax paid last year
Rs. _Rs. Year _
13. Advance Tax paid for the current year
14. No. of years in Service/business
15. Name of the person/s for whom you arealready a surety
16. Are they regular in repayment
Rs.~. year _
Liability Rs.
17. Name & Address of the Bankers withwhom you are dealing
18. State the total investment in businessand/or other property
19. Any other information that may helpus in considering the proposal
I hereby declare that, all the information statements and answers are true' andcorrect in af respects.
Signature of Surety
Mumbai, Date _ (Name
: 11 :
MANAGER'S REMARKS:
DECISION OF THE BOARD OF DIRECTORIS/LOAN COMMIITEE :
Placed before the Loan Committee Meeting held on --- _
Acash Credit/Team Loan/Overdraft of Rs. has been
recommended for sanction to the board, on the term and condition as laid down by the Manager.
Sanctioned by the Committee Rejected by the Committee
CHAIRMAN
Date:
Plaeed before the Board of Directors for action on :
Sanctioned/Rejected/await information
Date:
CHAIRMANBoard of Directors