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BOTH TL AND WC APPLICATION

All Dates should be in dd/MM/yyyy format

Fields marked as * are mandatory

Application Details

*Bank / Institution Reference No. ....................................

*Bank / Institution Branch Name ....................................
Bank / Institution Branch Code ....................................

Borrower Details
Whether borrower already
assisted by bank Yes No
Outstanding Amount on date of .................................... in Rs.
sanction of credit Facility
NPA Yes No
Whether Borrower Covered by
CGTSI previously Yes No

None Borrower ID CGPAN ....................................

* Constitution ....................................
* Borrower / Unit Name ....................................
....................................
....................................
....................................
* Unit Address * State: ....................................
....................................
....................................
....................................
*District: .................................... *City ....................................
* PIN code ....................................
ITPAN of Firm .................................... SSI Registration ....................................
Number
Nature of Industry .................................... Industry Sector: ....................................
*Type of Activity .................................... Number of ....................................
Employees
Projected Optimum Sales ........................... in Rs. Projected Optimum ....................................
Turnover Exports in Rs.
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Promoter Details
Chief Promoter's Information
* Title * First Name Middle Name Last Name
*
(Surname)
Name ................... .................................... .................................... ....................................
* Gender Male ITPAN of Chief ....................................
Female Promoter
Date of ............................... Social Category ....................................
Birth
Legal ID Name ........................... Value ...........................
Other Partners / Promoter Directors
1. Name .................................... ITPAN .................................... Date of Birth ....................................

2. Name .................................... ITPAN .................................... Date of Birth ....................................

3. Name .................................... ITPAN .................................... Date of Birth ....................................

Project Details- Outlay

* Collateral Security Taken Y N # Third Party Guarantee Y N

* Collateral security is any other security offered for the said loan. For example, hypothecation of jewellery, mortgage of house, etc.
# When the borrower furnishes the guarantee of any other person / corporate not connected with the project, it is considered as Third Party Guarantee.
Guarantors
1. Name Net Worth(as on date of
.................................... ....................................
sanction of facility)
2. Name Net Worth(as on date of
.................................... ....................................
sanction of facility)
3. Name Net Worth(as on date of
.................................... ....................................
sanction of facility)
4. Name Net Worth(as on date of
.................................... ....................................
sanction of facility)
Name of Subsidy / Equity Support Scheme ....................................
Primary Security Details
Security Name Particulars Value(in Rs.)
Land .................................... ....................................
Building .................................... ....................................
Plant and Machinery .................................... ....................................
Other Fixed / Movable Assets .................................... ....................................
Current Assets .................................... ....................................
Others .................................... ....................................
Total in Rs.
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Means Of Finance
Term Credit Sanctioned .......................... in Rs. -->
Promoters Contribution .......................... in Rs. Promoters Contribution .......................... in Rs.
Subsidy / Equity Support .......................... in Rs. Subsidy / Equity Support .......................... in Rs.
Others .......................... in Rs. Others .......................... in Rs.
Project Cost .......................... in Rs. Working Capital Assessed .......................... in Rs.
Project Outlay .......................... in Rs.

FacilityDetails

Scheme ..........................
Loan Type BO
Composite Loan N

Term Credit Details

Amount Sanctioned in Rs. * Date of Sanction ..........................
* Credit to be
..........................
Guaranteed
Date of first disbursement
..........................
if already made
Amount Disbursed .......................... in Rs. Date of last and final
disbursement if already ..........................
made
* Tenure (months) ..........................
Interest Type Fixed Floating * Type of PLR ..........................
* Prime Lending Rate
.......................... in % ................. in %
(corresponding to the * Interest Rate
(p.a.) (p.a.)
tenure of loan limit)
Repayment Schedule
Moratorium .......................... [in Months]
First Instalment Due Date ..........................
Periodicity ..........................
* No of Instalments ..........................
Outstanding Amount .......................... in Rs. as on ..........................

Working Capital
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Fixed
Interest Type Floating * Type of PLR ....................................
.......................... in
%
* Prime Lending Rate
................... in %
(corresponding to the * Interest Rate ................... in % (p.a.)
(p.a.)
tenure of loan limit)
Fund Based
* Date of Sanction ...................
Limit Sanctioned
Non Fund Commission .................... * Date of Sanction .................
Based .. ..
Fund Based .................................... in Rs.
Credit to be guaranteed
Non Fund Based .................................... in Rs.
Outstanding Fund Based Facility
Amount .................................... in Rs. As On ....................................
Outstanding Non Fund Based Facility
Amount ..................... As On .....................
Whether Repayment in
Spread Over PLR .................................... Yes No
Equal Instalments
Fixed Asset Coverage
Tangible Net Worth .................................... ....................................
Ratio
Current Ratio ....................................
Minimum DSCR .................................... Average DSCR ....................................

Remarks ...............................................................................................................
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