UNITED BNK OF INDIA
HEAD OFFICE.
11,HEMANTA BASU SARANI
KOLKATA – 700001

Application form for MSEs
To be submitted along with documents as per the checklist.

For office use
1. NAME OF THE ENTERPRISE:
2 REGD OFFICE ADDRESS:
3. ADRESS OF FACTORY/SHOP:
4. WHETHER BELONGS TO SC/ST/OBC/Minority community:
Telephone Nos.
Mobile No
EMAIL Address
PAN CARD No.
5. CONSTITUTION: Proprietorship / Partnership Firm /Pvt. Ltd / Ltd Company / Co-op society
6. DATE OF ESTABLISHMENT:
7. Name of Proprietor/Partners/Directors of Company and their addresses:
Name
Age
Academic Qualifications
Residential Address
Telephone No
(Residence)
PAN
No
Experience in the line of activity
8. ACTICVITY
Existing
Proposed (#) :
9. NAMES OF ASSOCIATE CONCERNS AND NATURE OF ASSOCIATION:
NAME OF ASSOCIATE CONCERN ADDRESS OF ASSOCAITE CONCERNS PRESENTLY BANKING WITH NATURE OF ASSOCIATION EXTENT OF INTEREST AS A PROP./ PARTNER/ DIRECTOR OR JUST INVESTOR IN ASSOCIATE CONCERN
10.
Relationship of Proprietor/Partner/Director with the officials of the Bank/Director of the Bank
10(a) CREDIT FACILITIES (EXISTING) :
Type of facilities
Limit (in lacs)
Outstanding as on ….
Presently banking with Security lodged
Rate of interest
Repayment terms
Current account
Cash Credit
Term Loan
LC/BG
If banking with this Bank, customer No. be given here
10(b).
It is certified that our unit has not availed any loan from any other Bank / Financial Institution in the past and I am not indebted Bank/ Financial Institution other than those mentioned in 10(a) above
11. CREDIT FACILILTIES (PROPOSED):
Type of facilities
Amount (Rs.
lacs)
Purpose for which
required
Security offered
PRIMARY SECURITY (Details with
apprpx. Value to be mentioned)
Whether Collateral
Security offered
(Please mention yes or no) (If yes, then provide details in column 12)
Cash Credit
YES/ NO
Term Loan
YES/ NO
LC/BG
YES/ NO
12. Details of Collateral Security offered, if any, including 3rd party guarantee *
(* As per RBI guidelines banks are not to take collateral security for loans upto Rs.10 lac to MSME Units)
13.
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) :
(Rs. in lacs)
PAST YEAR-II
(Actual)
PAST YEAR-I Actual)
PRESENT
YEAR
(Estimates)
NEXT YEAR (Projections)
Net Sales
Net Profit
Capital (Net worth
in case of
companies)
14. Status regarding Statutory Obligations :
Statutory Obligation
Whether complied with (write Yes/ No), If not applicable, then write N.A.
Remarks (Any details in connection with the relevant obligation to be given)
1.Registration under Shops and
Establishment Act
2.Registration under SSI (Provisional/ Final)
3.Drug Licence
4.Latest Sales-Tax Returns filed
5.Latest Income-Tax Returns filed
6.Any other statutory dues remaining outstanding
15.
SPACE FOR PHOTO
SPACE FOR PHOTO
SPACE FOR PHOTO
Signatures of proprietor/ partner/ director whose photo is affixed above
Only one photo of proprietor/ each partner/ each Director is required to be affixed. Each photo will be certified/attested by
the Branch Team with name and signature on the photograph with Branch stamp. The concerned staff will put his name
below the signature.
16. Whether the Applicant is made under any tie up arrangement or sponsorship by any Govt. Agency under any Govt. Scheme (Please tick on the links below).
a. Tata Motors; b. NSIC; 3) Ashok Leyland; 4) USG Automobiles; e) Kirti Solar; f) Govt. Scheme
17. Name of the Govt. Scheme [ ] Say, PMEGP, SJSRY etc.
I/We certify that all information furnished by me/us is true; that I/We have no borrowing arrangements for the unit except as I9ndicated in the application; that there is no overdues/ statutory dues against me/ us/ promoters except as indicated in the Application; that no legal action has been/ is being taken against me/ us/ promoters; that 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 deemed fit and you, your representatives, representatives of the Reserve Bank of India or any other agency as authorized by you, may, at any time, inspect/ verify my/ our assets, books of account etc. in our factory/ business premises as given above.
Place :
Date : Signature of applicant(s)
CHECKLIST (TO BE GIVEN TO THE NEW CUSTOMERS BY BRANCH) OF DATA TO BE KEPT READY BY THE CUSTOMER
1. Proof of identity – Voter’s ID Card/ Passport/ Driving License/ PAN Card/ signature identification from present bankers of proprietor, partner or director (if a company).
2. Proof of residence – Recent telephone bills, electricity bill, property tax receipt/ passport/ voter’s ID Card of proprietor, partner or director (if a company).
3. Proof of business address.
4. Proof of Minority.
5. *Last three years balance sheets of the units along with income tax/ sales tax returns etc. (Applicable for all cases from Rs.2 lacs and above). However, for cases below fund based limits of Rs.25 lakhs if audited balance sheets are not available, then unaudited balance sheets are also acceptable as per extant instructions of the bank. For cases of Rs.25 lacs and above, the audited balance sheets necessary.
6. * Memorandum and articles of association of the Company/ Partnership Deed of partners etc.
7. *Assets and liabilities statement of promoters and guarantors along with latest income tax returns.
8. *Rent Agreement (if business premises on rent) and clearance from pollution control board if applicable.
9. * SSI registration if applicable.
10. *Projected balance sheets for the next two years in case of working capital limits and for the period of the loan in case of term loan. (For all cases of Rs.2 lacs and above).
11. * In case of takeover of advances, sanction letters of facilities being availed from existing bankers/ Financial Ins0itutions along with detailed terms and conditions.
12. * Profile of the unit (includes names of promoters, other directors in the company, the activity being undertaken, addresses of all offices and plants, shareholding pattern etc. (APPLICABLE FOR CASES WITH EXPOSURE ABOVE Rs. 25 lacs)
13. * Last three years balance sheets of the Associate/ Group Companies (If any) (APPLICABLE FOR CASES WITH EXPOSURE ABOVE Rs.25 lacs)
14. *Project report (for the proposed project if term funding is required) containing details of the machinery to be acquired, from whom to be acquired, price, names of suppliers, financial details like capacity of machines, capacity utilization assumed, production, sales, projected profit and loss and balance sheets for the next 7 to 8 years till the proposed loan is to be paid, the details of labour, staff to be hired, basis of assumption of such financial details etc. (APPLICABLE FOR CASES WITH EXPOSURE ABOVE Rs. 25 lacs).
15. * Review of account containing month wise sales (quantity and value both), production (quantity and value), imported raw materials (quantity and value), indigenous raw material (quantity and value), value of stocks in process, finished goods (quantity and value), debtors, creditors, bank’s outstanding for working capital limits, term loan limits, bills discounted. (APPLICABLE FOR CASES WITH EXPOSURE ABOVE Rs. 25 lacs).
16. * Photo copies of lease deeds/ title deeds of all the properties being offered as primary and collateral securities.
17. * Position of accounts from the existing bankers and confirmation about the asset being Standard with them (in case of takeover).
18. *Manufacturing process if applicable, major profile of executives in the company, any tie-ups, details about raw material used and their suppliers, details about the buyers, details about major competitors and the company’s strength and weaknesses as compared to their competitors etc. (APPLICABLE FOR CASES WITH EXPOSURE ABOVE Rs. 25 lacs).
(The checklist is only indicative and not exhaustive and depending upon the local requirements at different places addition could be made as per necessity)