Annex I

Format of claim application letter

Ref.No: Date:

Deposit and Credit Guarantee Fund,

Kathmandu

Subject: Submission of claim of guaranteed loan

With reference to the agreement with Deposit and Credit Guarantee Fund, I am submitting this
application along with the details of ........loan accounts amounting to NPR…………………………(in
words………………………………………….).
1. The details attached to this letter are true and correct to the best of my knowledge and belief.
None of the employees of this …………………………Bank Ltd. have committed any negligence or
fraud with respect to the claimed loans.
2. It is certified that all the guarantee premium fees for the claim loans have fully been paid.
3. All the loan accounts claimed under this Application pertain to the DCGF’s Credit Guarantee
Scheme for NAFHA Project.

Attached Documents: On the behalf of member institution

1. Claimed loan details as per annex II. Signature:
2. Copy of Inspection Report. Name:
3. Copy of complete accounts details(Ledger) Position:
Address:
Stamp:
 Annex II
Details of loan claimed

Name of member Institution:

Branch Name:

Loa Name of Citizenshi Loan Loan Maturit Outstandin Date of Reaso Remark
n Borrowe p No. of Disburse Disburse y Date g Principal Last n of s
No. r Borrower d Date d of Loan Amount Recover Loan
Amount y Defaul
Attempt t