Application form for Baroda Loan to Pensioners.

The Chief/Senior Branch Manager

_________________________Branch
______________________
______________________

Dear Sir/Madam,

Re : Baroda Loan to Pensioners

I/We_____________________________________hereby apply for a loan of

Rs._____________(Rupees_______________________________)for_____________
________________ (purpose) under your scheme "Baroda Loan to Pensioners".

I/We have read the terms & conditions of your scheme and hereby agree to abide by
the same. I/We hereby submit below the particulars as required by you to enable you to
do the needful.
APPLICANT CO-APPLICANT
1 NAME IN FULL
2 FATHER'S NAME
3 DATE OF BIRTH/ AGE
4 ADDRESS:
PRESENT

CONTACT TEL./ E-
mail
PERMANENT

CONTACT TEL./ E-
mail
5 TYPE OF Central Civil / Defence / Railway Central Civil / Defence /
PENSIONER / State Govt. / BOB / Other Railway / State Govt. / BOB /
Other
6 PPO Number

7 Pension SB A/c No.

8 Drawing pension
through the Branch
since
9 Gross Monthly
pension
10 Total Deductions

11 Net Monthly Pension

12 OTHER INCOME
(including that of
family members :
Please specify)
13 Details of Nominee for Family Pension
Name (if minor, RELATION AGE ADDRESS
name of Guardian)
 14 Details of Legal Heirs

NAME (If minor, RELATION AGE ADDRESS

name of Guardian)

15 Details of loan availed from the Bank

TYPE OF LOAN AMOUNT BALANC MONTHLY INSTALMENTS
E
OUTSTA
NDING

I/We hereby declare that all the particulars and information furnished herein above are
true, correct and complete and they shall form the basis of any credit decision to be
taken by the Bank.

Date :
Place : (Signature of Applicant) (Signature of Co-applicant)

Recommended for sanction : Sanctioned as recommended :

Amount : _______/- purpose_____________

(Rupees ____________________________)

No. of instalments : @ Rs.____/- per month

or @ Rs.____/- per month + Monthly Interest.

Security/Documents
(Tick whichever is applicable)

(a) DP Note signed by the Borrower ( )

(b) Personal Guarantee of Nominee ( )
(c) Letter of Instalment ( )
(d) Authority letter from borrower ( )
(e) Undertaking from Legal Heirs ( )
(f) Letter of undertaking by borrower ( )
Any Other
(g) ( )
(h) ( )
(i) ( )

(Signature of Credit Officer) (Signature of Sanctioning Authority)

Date : Date :
Place : Place :