West Bengal Financial Corporation

LOAN APPLICATION FORM

1	Name of the Applicant *	:
2	Full Office Address *	:
2.1	Telephone Number *	:
2.2	Email Id	:
3	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 *	:
4	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 *	:
5	Proposed line of activity for which the loan is being sought for *	:
6	Amount of Loan Requirement *	:	₹
7	Project Cost *	:	₹
8	Capital Cost *	:	₹
9	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.

User Name:

Password:

	Employee Loanee

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