LOAN APPLICATION FORM

Name of the Applicant  * :
Full Office Address  * :
2.1  Telephone Number  * :
2.2  Email Id   :
Full Factory Address  * :
3.1  Telephone Number   :
3.2  Email Id   :
3.3  District of the factory  * :
3.4  Constitution  * :
3.5  PAN   :
3.6  GST   :
3.7  Nature of project site  * :
Name of the CEO/key person of the applicant concern  * :
4.1  Mobile Number  * :
4.2  Email Id  * :
4.3  PAN Number  * :
4.4  Aadhaar Number  * :
4.5  Date Of Birth  * :
Proposed line of activity for which the loan is being sought for  * :
Amount of Loan Requirement  * :
Project Cost  * :
Capital Cost  * :
Working capital requirement  * :
10  Total capital outlay  * :
11  All Documents Upload  (Only 5 MB PDF File Allow)* :
I/We confirm that all the information and/or documents submitted by me/us in connection with my/our loan proposal are true and genuine and I/We understand that the loan proposal would be processed on such information and/or documents or may be rejected if any of these is found false/incorrect and, in that case, I /We shall not claim refund of the processing fee from the Corporation.
Date  * :
Partially filled up application and/or application without the requisite fees shall not be accepted. Please obtain acknowledgement of receipt on a photocopy of this form.






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