Annexure – A

Application for OD/WCTL/TERM LOAN under
United Trade Credit Scheme

To
The Chief Manager/Manager,
United Bank of India,
_____________ Branch
I/We request you to sanction credit facilities as stated in Item No. 12 of this form under United Trade Credit
Scheme of the Bank.
I/We furnish the following information
1. Name of the Concern & Constitution (in Block Letters)
(Proprietorship/Partnership/Pvt. Ltd./Public
Ltd./HUF etc)
2. Address with Telephone/Telex/Fax No.
2.1 Registered Office or main place of business
2.2 Branch/Godown
3. Details of Registration/Licences as applicable
under local laws e.g., (Xerox copies enclosed)
Trade Licence
Shop and Establishment Act
Sales Tax Registration
Drug Licence for Retail Trade
Rations and Civil Supplies
Any other
4. Line of activities
5. Date of Incorporation & Commencement of
business
6. Whether the proposal in new/switch over from
other Bank(s) ? Details to be given.
7. Name of the present Banker(s) and details of
facilities enjoyed if any, with present outstanding
Name of the Bank Amount of Loan Present Outstanding
Amount of default, if any
Branch & Address Funded Non Funded Funded Non Funded
8. Details of Proprietor/Partners/Directors/Karta of HUF
Name Address Age Net Worth (Rs. in lacs)
(Details of Assts & Liabilities shall be furnished scparately)
9. Nature of Goods traded
10. Terms of Dealership (supply arrangements,
payment terms and validity period)
11. Region/Area where the product(s) is/are sold
(mention name and address of major potential
customers)
(For Wholesale/Distributors only)
31.03………
(Actual)
31.03………
(Actual)
31.03………
(Projected)
12. Past performance for the last two years &
projection for current year next few years covering
the repayment of Term Loan.
12.1 Capital & Reserves
12.2 Sales as per Sales Tax Return or Sales Tax
Assessment or IT Return or Balance Sheet
12.3 Net profit
12.4 Value of Stocks & Book-Debts
12.5 Net Worth (Tangible)
12.6 20% of Sales
13. Working Capital facility applied for
13.1 Overdraft or Term Loan: Rs.
13.2 If Term Loan, period of repayment
14. Details of Securities Offered
14.1 Mortgage of Properties
Description of Security Owner Value (Rs in lacs)
14.2 Other Securities
Description of Security Owner Value (Rs in lacs)
15. Particulars of the Guarantor(s)
(Details of Assets & Liabilities shall be given separately)
Name & Address with
Telephone No Age Net Worth (Rs in lac)
16. Details of pending litigation, if any, against, proprietor/any of the partners/Karta of HUF/directors/guarantors
17. I/We certify that all information furnished by me/us is true, that I/We have no borrowing arrangements for the unit with bank except as indicated in the application, that there is no overdue/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 deem fit, and you/your representative, representatives of Reserve Bank of India or any other agency as authorized by you, may at time, inspect/verify my/our assets, books of accounts etc. in our Godown/Business Premises as given above.
18. I/We hereby agree as a pre-condition of loan/advances given to me/us by the bank that in case I/We commit default in the repayment of the loan/advances or in the repayment of interest thereon or any of the agreed installment of the loan on due date(s). the bank and/or the Reserve Bank of India will have an unqualified right to disclose or publish my/our name or the name of our company/firm/unit and its directors/partners/proprietors as defaulter in such a manner and through such medium as the bank of
Reserve Bank of India in their absolute discretion may think fit.
Date: (Signature of the Applicant)
Place:
List of Documents to be attached
1. Copies of Registration Certificate/Licence as applicable. In case of Ltd. Co. Memorandum & Articles of Association.
2. Copies of Sales Tax Return or assessment order and Income Tax Return or Assessment order for last 2 years and current period.
3. Copies of title deeds of immovable properties offered as security with latest Tax Payment Receipts.
4. Copies of liquid Security documents.
5. Copies of statement of existing CD or Borrowal Account for last one year.
6. Copies of documents relating to ownership/tenancy/lease of business premises.