ANNEXURE -A- Individual Loan Application Form (Self-Employment Programme (SEP))

Self-Employment Programme (SEP)

(Individual Loan Application Form)

Application no: Date: Photo

(As
ULB Name (ULB Code): State Name:
received
from
Aadhar
I Personal Information
1 Name* Father's/Spouse's Name*
2 Date of Birth / Age* Gender (Please tick )* Male/Female/Transgender
3 Marital Status
(Single/Married) Mobile No.* Alternative Mobile No:
*
4 Social Category* General SC ST OBC

5 Minority community* Yes No If minority Muslim/Sikh/Christian/Sikhs/Jai

community ns/ Zoroastrians
(Please tick √)*
6 PWD (Divyangjan) Yes No No of dependents: Children Others
7 Member of SHG Yes No Are you a Street Vendor Yes No
Aadhaar No* Voter ID Card Driving License PAN Card Others (Govt
8 KYC documents* No* No Approved
Document

BPL Card NFS Card Ration Annual HH income < Rs. 3

9 Proof of Urban Poor (√)* Card lakh

House No. / Locality

10 Permanent Address Ward: Town/Dist: State: Pin:

Address proof (Pl
specify)

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 House No. / Locality
Ward: Town/Dist: State: Pin:
11 Current Address*
Address proof (Pl
specify)
II Financial Information
Saving Bank Name of Bank Branch & IFSC code Accoun
12 t No
account(s)
Details*
Bank/Lending Current Loan Monthly Category
13 Previouse Loan Institution Outstanding EMI (TL/CC/Composite)

III Proposed Micro Enterprise Details

14 Type of Microenterpries* Manufacturing/ Trading/ Services
15 Business Location (Address)
16 Area of Premises Owned Rental Nature of enterprise New business
Exisitng
17 Total Project Cost* Margin/Own Contribution/down
payment:
Loan Amount required Loan Category: Term Loan/Working Capital/ Composite loan (TL
18 Rs…………………………..
from Bank* + WC)
Declaration and No objection clause
a. I/We hereby certify that all information furnished by me/us is true, correct and complete. I/We have no borrowing
arrangements for
the unit except as indicated in the application form. There is/are no overdue/statutory due owed by me/us. I/We shall
furnish all other information that may be required by Bank in connection with my/our application. The information may
also be exchanged by you with any agency you may deem fit. You, your representatives or Reserve Bank of India, or any
other agency as authorized by you, may at any time, inspect/verify my/our assets, books of accounts etc. in our
factory/business premises as given above. You may take appropriate safeguards/action for recovery of bank's dues.
b. I/we have no objection to carry out validation for my Id proof, KYC documents and accessing my credit history &
credit score by credit bureau and carried out rating by rating agencies on behalf of portal operators and
lenders.

*Mandatory Fields

Date:
Place:
Thumb impression/Signature of Applicant(s)

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 ANNEXURE-B - Specimen of Common Sanction letter for financing under NULM-SEP

Ref. No. Branch

Sri/Smt Date

Dear Sir/Madam,

Sanction Loan under DAY-NULM Scheme

With reference to your application dated for advances under the Scheme named above, we are
pleased to sanction a limit of Rs.
(Rupees only) on A/c. under the
following terms and conditions:

Terms of Sanction:

Sanctioned a Cash Credit limit(New/Renewed/Enhanced)/Term Loan (New/Renewed/Enhanced/Repeat) for

Rs. Rupees only) under the following terms and

conditions:

(a) Amount of CC Limit /TL (New/Renewed/Enhanced/Repeat) for period in months):

Rs (Rupees only)

(b) Documents to be obtained.

i. Inter-se agreement (For Group and SHG Loan)
ii. Articles of loan agreement
iii. Demand Promissory Note
(c) Purpose of the credit facility:
(d) Rate of interest % p.a with monthly rest to be calculated on reducing balance method.
(e) Service Charge Nil (Loan to Individual/Group/SHG under NULM will be treated as advance to weaker
section)
(f) Repayment:
i. For CC: Each withdrawal of principal loan from C.C A/C is to be repaid within (12-24) months of such
withdrawal. Interest debited to the A/C is to be repaid/deposited within 30 days of application. Outstanding
balance of the CC A/C should not exceed the sanctioned limit under any circumstances.
ii. For TL: Principal loan and interest thereon is to be repaid in months, being sanctioned tenure of this loan.

(g) Interest subvention on Regular Accounts: All regular accounts will be eligible to get the benefit of interest

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subvention given by government under NULM-SEP scheme. Interest amount charged in account, above 7% (in

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case of Individuals/Groups/SHGs) & 4% (in case of Women SHG) interest rate, will be credited back directly in
loan account of the beneficiary, if the repayment in account is made as per terms of sanction and the account
is regular in all respect. Women SHG will be eligible to get the benefit of additional interest subsidy (3%) to
make effective rate 4%, if it fulfills the norms as specified by Government in this regard.

(h) Equated Monthly/Quarterly/Half-Yearly Installment in Term Loan:

i. Normal Installment:
ii. Installment if it qualifies interest subvention:
(i) Review/Evaluation of the CC A/C will be done after 12 months.

Signature of the Processing/Appraising Officer Signature of the Branch Manager

(With Office Seal)

Date: Date:

I/We, on behalf of individual/Group/SHG hereby accept the aforesaid terms &

conditions of the above-noted CC facility/Term loan sanctioned to our SHG by the above-mentioned Bank
Branch.

1.

2.

(Signature of Authorized representatives of the Individual/Group/SHG with office seal)

Date:
Place:

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 ANNEXURE C –CONSOLIDATED REPORT OF MONTHLY SANCTIONS

Name of the Branch with DP Code:

Report for the month of …………………………...

Sl Name of Loan Amount Date of Aadhaar CASA Mobile Category

no. the account Sanctioned sanction no of the account no of the (SEP–I /Sep-
Borrower number (in Rs) borrower number Borrower G/SHG/WSHG)

All fields are mandatory

Date:

Signature of the Branch Head with seal: