CO-Rural Banking Department

Application Format for Agriculture Term Loans

(IND KRISHI INFRA FUND, IND PASHUDHAN MITHRA & IND Micro Food Processing Enterprises-
Individual/ Group)

Date: Photograph to
1. Name of the Farmer/ Agri Entrepreneur * be pasted at the
2. Business Address* time of signing
3. Telephone No.* of the
4. E mail Address* application in the
5. Mobile No.* designated
6. PAN Card No. branch.
7. Constitution (Please Select)*
Individual/ Joint/ Prop. Concern/Partnership/ Pvt Ltd Co/ Limited Co/ Trust/ others
8. Udyog Aadhaar No. / Registration No. 10.(a)GST No. (if applicable)
9. Date of Establishment/Incorporation*
10. State *
11. Place/ City where loan is required* District
12. Branch where loan is required. (If any)
13. Name of Proprietors/ Partners/ Directors of Company and Their Addresses: *
S.No Name Date of Father/ Academic Category Mobile No
Birth Spouse Qualification SC/ST/OBC/
Minority/Women
1.

S.No PAN No. Residential Address Aadhar Telephone No. Experience in the line of
No./DIN (Residence) activity (Years)
No.
1.

Activity* Existing since

Proposed#
#if a different activity other than existing activity is proposed/ New unit
14. Names of Associate Concerns and Nature of Association:
Extent of
Interest as a
Name of Address of Prop./ Partner/
Presently Nature of
Associate Associate Director or Just
Banking With Association
Concerns Concerns Investor in
Associate
Concern

15. Relationship of Proprietors/ Partners/ Directors with the officials of the Bank/ Director
of the Bank: Please select (Yes/ No)
16. Banking/Credit Facilities (Existing) (₹. in lakh)
 CO-Rural Banking Department
Presently
Type of Limit Outstanding Rate of Repayment
Banking Securities
Facilities (in lakh) as on Interest Terms
With
Current
Account
Cash
Credit
Term Loan
LC/BG
Others
Total

If banking with our Bank, customer ID to be given here:

It is certified that our unit/ firm has not availed any loan from any other Bank / Financial
Institution in the past and I am not indebted to any other Bank / Financial Institution other
than those mentioned in column no. 17 above.

17. Credit Facilities (Proposed)*

Security Offered
Whether Collateral
Purpose for Primary Security Offered (If , yes,
Type of Amount
which Security(Details with then provide details on
Facilities (in lakh)
Required approx. value to be column--23
mentioned) 20)
(Yes/ No)
Cash Credit**
Term Loan
LC/BG
Others
Total
*Mandatory Fields
**Basis of Cash Credit Limit applied

Projected
Cash Working Other
Credit Promoters
Sales Cycle in Inventory Debtors Creditors current
Contribution
months assets

18. In case of term loan requirements, the details of machinery may be given as under:
 CO-Rural Banking Department
Total Cost of
Machine ( in
case of
imported
machine, the
Whether Contribution
Type of Purpose for breakup of Loan
Imported Name of being made
Machine/ which basic costs, Required
or Supplier by the
Equipment Required freight,
Indigenous promoters
insurance
and
customs duty
may be
given)

19. Details of Collateral Securities Offered, if any, including third party guarantee
a) Guarantors Details:
Father Net
Name of / Residential Telephone No. worth Aadhar
S.No Mobile No. PAN No
Guarantor Spouse Address (Residence) (₹. in No.
name lakh)
1.
2.
3.

b) Other Collateral Security:

Name of owner of
Collateral Security
Collateral
S.
No. Value
Nature Details
(Rs. in lakh)
1.
2.
3.

20. Past Performance / Future Estimates

Past Performance / Future Estimates (Actual performance for two previous years, estimates for
current year and projections for next year to be provided for working capital facilities. However
for term loan facilities projections to be provided till the proposed year of repayment
of loan)
Past Year 1 Past Year 2 Present Year Next Year (Projection)
Rs. in lakh
(Actual) (Actual) (Estimate)
Net Sales
Net Profit
Capital (Net
Worth in case of
Companies)
 CO-Rural Banking Department
Installed Capacity
Utilized Capacity
21. Status Regarding Statutory Obligations:
Statutory Obligation: Remarks

22. a.) ID Proof (Any of following): Passport/ Voter Identity Card/ PAN Card/ Driving
Licence/ Job Card/ Aadhaar Card/
Identity Card (subject to the satisfaction of bank)
ID Proof No.
b.) Address Proof (Any of following):
Electricity Bill/ Telephone Bill/ Bank Account Statement of any other bank/ Letter from
reputed employer/ Letter from recognized public authority verifying the address of the
customer to the satisfaction of the bank/ Ration Card
Address Proof No:
23. Compliance to Financing facility under ‘Agriculture Infrastructure Fund’/ Animal Husbandry
Infrastructure Fund/IND Micro Food Processing Enterprises- (PMFME)- Individual” & “IND Micro
Food Processing Enterprises- (PMFME)- Group”:

I/We hereby certify/authorize that our unit/ company complies all guidelines as laid in
Scheme Guidelines for CENTRAL SECTOR SCHEME of financing facility under
Agriculture Infrastructure Fund’/ Animal Husbandry Infrastructure Fund/IND Micro Food
Processing Enterprises- (PMFME)- Individual” & “IND Micro Food Processing
Enterprises- (PMFME)- Group’.

Declaration:
I/We hereby certify/authorise that all information furnished by me/us is true, correct and
complete; that I/We have no borrowing arrangements for the unit except is in the
application; that there is no over dues/ statutory dues against me/us/promoters except as
indicated in the application; that I/We have not been declared as defaulter/willful defaulter
by any Bank/FS and no Legal action has been taken/initiated against me/us by any
Bank/FIsI/We shall furnish all other information that may be required in connection with
my/our application that this may also be exchanged by you with an agency you may deem
fit and you, your representatives or Regulatory authorities or any other agency as
authorised by you, may at any time, inspect/ verify my/our assessment of account etc. in
our factory/business premises as given above; you may take appropriate safeguards/action
for recovery of Bank’s dues including publication of defaulters name in website/submission
to RBI/ CIC etc. Further agree that my/our loan shall be governed by the rules of your Bank
which may be in force from time to time.
 CO-Rural Banking Department
Signature:

To be signed at the designated branch only

CO-Rural Banking Department