APPLICATION FOR FINANCING SMALL SCALE INDUSTRIES
AGRREGATE LIMIT ABOVE RS.25,000/AND UPTO & INCLUDING RS.2 LACS

The Branch Manager,
_________________Branch
Dear Sir,
I/We hereby apply for Advance Facilities and furnish the following information therefore.
Name :

Business Address : REGISTRATION NO.
(If registered with
Director of Industries)

TEL. NO.
Proprietor/Partners/Directors Name(s) Residential Address Tel. No.
_________________________ ________________________________________ ____________
_________________________ ________________________________________ ____________
_________________________ ________________________________________ ____________
_________________________ ________________________________________ ____________
_________________________ ________________________________________ ____________
_________________________ ________________________________________ ____________

Belongs to Scheduled/Caste/Tribe Technically Qualified/Experienced Educated Unemployed
Yes No. Yes No
Yes No
Whether belongs to Minority Community
Yes No

If yes, tick the appropriate box.
Muslims
Sikhs
Christians

Neo-Buddhists
Parsi (Zoroastrians)

Line of Activity

Present Banker Nature of Account with the Bank

Nature of Facilities Required
Category Purpose Amount (Rs.) Repayment
Term Loan
Working Capital

I/We certify that all information furnished by me/us is true, that I/We have no borrowing arrangement for the unit with any Bank, that no Legal Action has been/is being taken against me/us: I/We shall furnish all other 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, representative, representatives of Reserve Bank of India or any other agency as authorized by you, may, at any time, inspect/verify our Assets, Books of Accounts etc. in our factory and business premises.

Date : Yours faithfully,

Place: Signature of Applicant
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ENCLOSURES TO BE FURNISHED:

(a) Copies of latest Balance Sheets along with latest Trading and Profit & Loss Statement (in case of units already established).

(b) List of Machinery (existing/proposed to be acquired), as per specimen enclosed.

(c) In case of Term Loans for fixed assets copies of the estimates for construction of buildings, proforma invoice for machinery etc.