Central Bank of India- sme

MSME Loan

MSME Loan Personal Details Form

Fields marked with * are mandatory

City MSE Center : Name of the Enterprise : Regd. Office Address : Address of Factory/Shop : Whether belongs to SC/ST/OBC/Minority Community : answer YesNo Select Category : category Telephone No : Mobile No : Email ID : PAN Card No : Constitution : const Date of Establishment : Date of Establishment State(Branch Location) : Branch City : City Branch : Branch


Name of Proprietors/ Partners/Directors of Company and Their Addresses:

Sr. No.	Name	Spouse/Father Name	Age	Qualification	Residential Address (Max 300 char.)	Telephone No.(Residence)	Experience in the line or activity(Years)
1

Existing Activity:

Proposed Activity (Other than Existing Activity):


Names of Associate Concerns and Nature of Association:

Sr. No.	Name of Associate Concern	Address of Associate Concern (Max 300 char.)	Presently Banking With	Nature of Association	Extent of Interest as a Prop./ Partner/ Director or Just Investor in Associate Concern
1


Relationship of Proprietors/Partners/Director with the officials of the Bank/Director of the Bank answer YesNo

*Credit Facilities (Existing) (Rs.In Lakhs):

Type of Facilities	Limit (in lakh)	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.

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 to any other Bank/Financial Institution other than those mentioned in the above columns.

Credit Facilities (Proposed) :

Type of Facilities	Amount (in lakh)	Purpose for which Required	Security Offered
			Primary Security (Details with approx. value to be mentioned)	Whether Collateral Security Offered (Please mention yes or no) (If yes, then provide details in Activity field(Form 2))
Cash Credit				answer YesNo
Term Loan				answer YesNo
LC/BG				answer YesNo

In case of term loan requirements, the details of machinery may be given as under :

Sr. No.	Type of Machine	Purpose for which Required	Whether Imported or Indigenous	Name of Supplier	Total Cost of Machine (In case of imported machine, the breakup of basic costs, freight, insurance and customs duty may be given)	Contribution being made by the promotors	Loan Required
1

* Details of Colletral security,if any, including 3rd party guarantee (Max 400)


(* As per RBI guidelines banks are not to take collateral security for loans upto Rs.10 lakhs to MSME units)

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 (Estimate) *	Next Year (Projection)
Net Sales
Net Profit
Capital (Net Worth in case of Companies)

Status Regarding Statutory Obligations:


Statutory Obligation	Whether Complied with (select Yes/No). If not applicable then select NA	Remarks (Any details in Connection with the relevant obligaiton to be given)
1. Registration under Shops and Establishment ACT	answer
2. Registration under SSI (Provisional /Final)	answer
3. Drug License	answer
4. Latest Sales Tax Return Filed	answer
5.Latest Income Tax Returns Filed	answer
6.Any other Statutory dues remaining outstanding	answer

Document 1

Document 2

Document 3

I/We certify that all information furnished by me/us is true; that I/We have no borrowing arrangements for the unit except as indicated 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 Reserve Bank of India or any other agency as authorised by you,may,at any time,inspect/verify my/our assets,books of account etc. in our factory/business premises as given above.

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