DATE Application Number

LOAN APPLICATION FORM

Applying for Loan: Bank________/ Community Enterprise Fund (CEF) __________/ Others (Govt. sponsored)______

I hereby apply for Bank loan / CEF Loan of Rs. For:

Name of Applicant(s) Fathers/ Husband's
Name

SHG name: VO name: CLF Name:

Name of SHG, VO & CLF

Village name: Block name: Rented/Owned

Residential Address

Rented/Owned
Business Address

Date of Birth: DD/MM/YYYY Age (in yrs.): Gender: Male/Female

Education Qualification:
Social Category:
(Illiterate/ Up to 10th/ 12th
General/OBC/SC/ST
/Graduate/Professional/others)

Document(s) for ID proof Voter ID No. Aadhaar No. MGNREGA Job Card/ Artisan Card
No./Any Others:
(pl. specify)

Address Proof (pl. specify)

Telephone No.: Mobile No.: E-mail:
Line of Business Activity Existing: Period:
(Purpose):
Line of Business Existing Period
Proposed:

Experience in doing business, If any (give details):

Past Performance/Future Estimates :( In Rs.)

Past Year- I Present Year

Next Year (Projection)
(Actual) (Estimate)

Net Sales

Net Profit

Existing Banking/Credit Facilities: (In Rs.)

Type of Presently Outstanding As on

Customer ID/SHGs/VO details
Facilities availing with (date)_________

Bank Name:
Savings Account

SHG/ Loan

Others

It is certified that my unit has not availed any loan from any other Bank/Financial Institution in the past
and I/we am/are not indebted to any other Bank/Financial Institution other than those mentioned in
column above.

Signature of Applicant
 Form No. 1
The Loan Appraisal Committee
Block Resource Centre – Enterprise Promotion
Name of Block : ________________________________________
District : ________________________________

Dear Sir / Madam

I am requesting for a loan from the group. I am giving below the following details to facilitate the process for
sanctioning my loan.

1. Full name of the Applicant: _________________________________________________

2. Amount required: Rs. ____________/ - (Rupees: _______________________________________) only.
3. Purpose: ______________________________________________________________________________

I undertake to repay the loan on the terms and conditions as stated below:

1. No. of installments: _____________ Monthly instalment amount: Rs. ___________ / -

Date of beginning the installments: ____________________________________
OR
I will repay the whole loan after _____________________ months, but I will pay the interest as per the
rules and regulations of the Group.

2. Interest: The rate of interest shall be Rs. _____ /- per month for every Rs. _____/- which works out to
______ % interest per annum. The interest will be charged only on the balance amount due to be paid.

3. Fine: If a person fails to repay the amount on installments, a sum of Rs. _____ /- shall be charged as fine
on every Rs.______/ - that has to be paid as installment during that month.

4. Dates for monthly installments:

SL SL SL
DATE AMOUNT DATE AMOUNT DATE AMOUNT
NO NO NO
1 9 17
2 10 18
3 11 19
4 12 20
5 13 21
6 14 22
7 15 23
8 16 24

All the facts given above are true.

I trust you will sanction the amount of loan I have requested for.

Thanking You,
Yours sincerely

Date:
Place: Signature / Thumb impression of the applicant.
 LOAN APPROVAL – SHG

Name of SHG : _____________________

Name of Village : _____________________

The loan application of Sri / Smt __________________________________ dated ____________ was discussed in the

SHG meeting held on ______________ and the application requesting an amount of Rs. __________ / - only, was

sanctioned for Rs. ______ / (Rupees ________________________________________) only / not sanctioned by a

majority vote.

Remarks (If any)

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Date:

President / Secretary

(Stamp and Signature)

LOAN APPROVAL – VO

Name of VO : _____________________

The loan application of Sri / Smt __________________________________ dated ____________ was discussed in the

SHG meeting held on ______________ and the application requesting an amount of Rs. __________ / - only, was

sanctioned for Rs. ______ / (Rupees ________________________________________) only / not sanctioned by a

majority vote.

Remarks (If any)

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Date:

President / Secretary

(Stamp and Signature)

 LOAN APPROVAL – CLF

Name of CLF : _____________________

Name of Village : _____________________

The loan application of Sri / Smt __________________________________ dated ____________ was discussed in the

SHG meeting held on ______________ and the application requesting an amount of Rs. __________ / - only, was

sanctioned for Rs. ______ / (Rupees ________________________________________) only / not sanctioned by a

majority vote.

Remarks (If any)

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Date:

President / Secretary

(Stamp and Signature)

LOAN APPROVAL – BRC

The loan application of Sri / Smt __________________________________ dated ____________ was discussed in the

SHG meeting held on ______________ and the application requesting an amount of Rs. __________ / - only, was

sanctioned for Rs. ______ / (Rupees ________________________________________) only / not sanctioned by a

majority vote.

Remarks (If any)

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Date:

President / Secretary

(Stamp and Signature)

 PROMISORY NOTE

I, Sri / Smt ___________________________________ a member/family member of

______________________ Group have received a sum of Rs.
(Rupees……………………………………………………) only, for my business
on ………………………………

I promise that I shall repay the amount with interest on installments by

(date)…………………………. If I fail to repay the amount on installments I shall pay the fine as
stated in the Rules and Regulations of the group. I shall hand over the installment amount, interest
and the fine to the Secretary. The assets which I shall buy from this loan shall belong to the group as
long as I do not repay the full amount. Only when I repay the full amount shall these assets be mine.

I hereby accept that if I fail to repay the amount received as stated in the Application form,
the group can take any action against me according to the Rules and Regulations of the group.

Date: Signature / Thumb impression of the

Recipient

Witnesses:

Name Signature

1.

2.

_______________________________________________________________________________________