Annexure - A
UNITED BANK OF INDIA

APPLICATION FOR UNITED CONSUMER AND CAR LOAN

To
The Chief Manager/Manager,
United Bank of India,
……………………. Branch
Photograph
Applicant 1
Photograph
Applicant 2
Dear Sir,
I/We request you to sanction a loan of Rs. ……………… (Rupees …………………..……………
……………………… only) for purchase of……………………………………
……………………………. costing Rs. …………………………… {Description of Article(s)}
Name of Article(s) Value (Rs.)
i)
ii)
iii)
from …………………………………….
{Name & Address of supplier(s)}
I/We undertake to repay the loan in …………… monthly instalments of Rs. ………… each
starting from …………………………………..
PARTICULARS OF BORROWER
1. Name in full (in Block Letters)
2. Age
3. Whether married
4. No. of dependents
5. Name of father/husband
6. Address (with telephone no)
i) Residence
ii) Office
APPLICANT 1 APPLICANT 2
-1-
7. For salaried applicant
i) Name & address of employer
ii) Designation/position & period since when employed

8. For professional & self-employed applicant
i) Particulars of profession and
name & address of his/her firm/co and details
ii) Designation/position & period since when engaged
9. Name, address, occupation & worth of guarantor(s), if any
10. Income (year-wise for last 2 years)
Gross Income
Net Income
Less: Personal drawings
Income Tax Paid
Net Surplus
11. Income Tax assessed/paid for the
last 2 years (enclose supporting
documents)
Income assessed
Tax assessed
Tax paid
12. Nature of account(s) maintained with UBI
-2-
13. Names and addresses of other banks
with whom any account is maintained (Particulars of borrowings, if any, to be given)
14. For salaried applicant
Particulars of monthly emoluments for the month of _______________ (a copy of the payslip/ employer’s certificate to be attached)
Applicant 1 Applicant 2
Gross Salary (in Rs.) Deductions (in Rs.) Gross Salary (in Rs.) Deductions (in Rs.)
Application for United Consumer and Car Loan
Basic PF Basic PF
DA IT DA IT
HRA Loan HRA Loan
Others Others Others Others
Total Total Total Total
Net Take Home Salary Net Take Home Salary
Common for all applicants
(Particulars of each applicant to be given separately)
15. Description of Property, if any, owned
(a) Particulars of Real Estate
Location
Area
Unencumbered (Yes/No)
::::
(b) Particulars of Shares held, if any
Name of the Company
i)
ii)
iii)
No. of shares Market Value
(c) Life Insurance Policy held :
Policy No.(s)
i)
ii)
iii)
Date of Maturity Sum Assured
(d) National Savings Certificates,if any.
Certificate No. Date of Maturity Face Value
-3-
16. Borrowings
(i) Borrowing against (a), (b), (c) & (d) above
(Details to be given in separate sheet)
:
Rs. ……………………………..
(ii) Present Outstanding Balance : Rs. …………………………….
17. Other liabilities
(i) Any Unsecured Liabilities (Details to be given in separate sheet) : Rs. …………………………….
(ii) Present Outstanding Balance : Rs. …………………………….
18. Statement of Financial Positions as on …………………………………………………..

LIABILITIES ASSETS
Capital Land & Buildings
Trade Creditors Furniture & Fittings
Other Creditors Stock-in-Trade
Others Trade Debtors
Surplus Cash in Hand & Bank
(Assets - Liability)
Others Deficit
(Liability - Assets)
_______________ _______________
TOTAL TOTAL
19. OTHER PARTICULARS
Name and address of the persons who can be referred to for information
(a)
(b)
I/We hereby(i) declare that the statements given above are true and correct.
(ii) further declare that no part of the loan will be utilised for any purpose other
than that stated.
(iii) agree to abide by all the terms and conditions of the loan, if sanctioned.
(iv) further agree to the Bank recalling the entire loan or the balance thereof if
the Bank comes to know of any incorrect statement on my part.
Signature of Applicant 1 Signature of Applicant 2
Date :
Place :
-4-
20. Chief Manager's / Manager's findings and sanction/recommendation :
Dy. Manager /Asstt. Manager Chief Manager / Manager
Date :
…………………………….Branch
RO’s observations and sanctions.
Regional Manager