CONSUMPTION LOAN

ANNEXURE

1) Name of the borrower with address :

2) Land holding - Irrigated/un-irrigated : Acre

3) Category : SF / MF / LL / RA

4) Details of family members :

Name of family member Relationship Whether dependent Annual Income (Rs.)

5) Purpose of loan : General consumption/medical
expenses/educational need/
marriage ceremony /funerals/
birth/other religious ceremonies

a) In case of medical expenses, state :
(i) Name of the patient/s :
(ii) Age :
(iii)Relation :
(iv) Nature of illness :
(v) Name of attending Doctor :
(Please enclose a certificate from the Doctor)

b) In case of children’s education, state :
(i) Name of child/children with age :
(ii) Class/year studying :
(iii)Whether payment of school fees/
examination fees
(iv) Name of the school/college :
(v) Name/type of examination :
(Please enclose a certificate from the Head of the Institute certifying that the above child/children are
students and studying in the classes mentioned above).

c) In case of other purposes, e.g. marriage,
Funeral, birth and other religious cere-
monies, relevant details to be submitted

d) Security offered :Silver / Gold Ornaments
Weight (gms) – Value (Rs.)

Signature of the Applicant