Small Business Banking

Unsecured Product Secured Product NFB

Business Loan Secured OD LC

Unsecured OD Cash Credit BG

Quick OD Secured Term Loan LER

Others CGTMSE Buyer Credit

Standup India Others

LCBN

Merchant Loan

Others

Type of Facility Rs. In Lakhs Tenure (Months) Purpose Label Code

A. BUSINESS DETAILS (FIELDS IN RED REPRESENT MANDATORY FIELDS)

Account No. /(s)

Udyog Aadhar No

Pan Card

Date of Incorporation D D M M Y Y Y Y

Office Residence Factory Permanent

Whether the MSME unit is ZED rated Yes No
If yes, the gradation obtained by the MSME unit (Tick appropriate one)
Bronze Silver Gold Diamond Platinum
B. INDIVIDUAL APPLICANT / CO-APPLICANT / PROPRIETOR / PARTNER / DIRECTOR / OTHER DETAILS
Individual Applicant/ Co-Applicant -I / Partner - I/ Proprietor / Director I / Other - I (__________________)

Co-Applicant /
Guarantor Photograph

Spouse Name

Mothers Maiden Name

Others (__________________)
PIO/OCI
CKYC No. Existing Cust ID
PAN Card
Passport No./ Voter ID
Passport No./ Driving Licence. Expiry Date
Driving Licence/Others

( (
( (

Community Hindu Muslim Christian Sikh Buddhist Zoroastrian Parsi Jain Others

Permanent Residence Address

Relationship With Applicant Gurantor Beneficial Owner Authorised Signatory

Category SC ST OBC General Others _________________

Education Matricuate Undergraduate Graduate Postgraduate Professional Others _________________
Maritial Status Unmarried Married Others Number of Dependents Person With Disability Yes No

CO-APPLICANT - II / PROPRIETOR - II / PARTNER- II / DIRECTOR II / OTHERS II DETAILS

Co-Applicant-II / Partner-II / Proprietor/ Director II / Other II (__________________)

Co-Applicant /
Guarantor Photograph

Mothers Maiden Name

Others (__________________)
PIO/OCI
CKYC No. Existing Cust ID

Passport No./ Voter ID Passport No./ Driving Licence. Expiry Date

Driving Licence/Others
( (
( (

Community Hindu Muslim Christian Sikh Buddhist Zoroastrian Parsi Jain Others

Permanent Residence Address

Relationship With Applicant Gurantor Beneficial Owner Authorised Signatory

Category SC ST OBC General Others _________________

Education Matricuate Undergraduate Graduate Postgraduate Professional Others ____________
Maritial Status Unmarried Married Others Number of Dependents Person With Disability Yes No
C. FINANCIAL/INCOME DETAILS/ITR INCOME/PAST PERFORMANCE/FUTURE ESTIMATES
Financial Year Year Turnover (Rs. in Lacs) Profit as per P & L Installed Capacity Utilized Capacity
Capital (Net Worth
( Rs. in Lacs) in case of companies)
Past Year II 20 - 20

Past Year I 20 - 20

Provisional 20 - 20

Present Year (Estimate) 20 - 20

Next Year (Projections) 20 - 20

Fill below details for Cash Credit limit

Projected

Cash Credit Sales Working Inventory Debtors Creditors Other current Promoters
Cycle in assets Contribution
months

D. EXISTING LOAN DETAILS / FACILITY DETAILS

Loan Bank Name Type of Loan Account No. Loan Amount EMI Loan Opening Date Tenure ROI Security Outstanding
As on

E. DETAILS OF ASSOCIATES/GROUP ENTITITIES (IN LAKHS) DETAILS AS ON………………………….

Name of Existing Exposure Year Of Nature Net Sales/ Net Net Address of Presently Nature of Extent of Interest as a
the entitiy Customer (In Lac) Incorporation of Business Total Income Profit Worth Associate Banking Association Prop./ Partner/
ID (If Any) Concerns With Director or Just Investor in
Associate Concern

F. BANKING DETAILS

S. No. Name of the Bank Branch Account Number Banking Since

G. STATUTORY OBLIGATIONS:
Statutory Obligation: Remarks( Any details in Connection with the relevant obligation to be given)
Whether Complied with (select Yes /No). If not applicable then select N. A.

1. Registration under Shops and Establishment ACT Yes/ No/ NA

2. Registration under MSME (Provisional /Final) Yes/ No/ NA

3. Drug License Yes/ No/ NA

4. Latest Sales Tax Return Filed Yes/ No/ NA

5.Latest Income Tax Returns Filed Yes/ No/ NA

6.Any other Statutory dues remaining outstanding Yes/ No/ NA

H. SECURITY DETAILS
(a) Primary Security (b) Liquid Collateral (c) Other Collateral
Type of Security Value as Type of Relationship Value as on date Type of Collateral Value as
on date (in lacs) Security with Borrower (in lacs) on date (in lacs)
(LIP, KVP, NSC, Letter of Credit (LC)
Stock Fixed Deposits)
1. Bank Guarantee (BG)
Book Debts 2. Stand by Letter of
Others _______________ 3. Credit (SBLC)
(d) Property Collateral
Type of Security
1 2 3
(Immovable Property)
Type of Property
Name of Registered owner
Relationship Borrower
Property Address

Area (in Sq. ______ )

Age of Property (in yrs)
Market value as on date (in lacs)

(e). In case of Term loan Requirements, the details of Assets may be given as under :
Type of Purpose for Imported / Name of Total cost of Contribution Loan required
Assets which Indigenous supplier Assets made by the
required promoters

*In case of imported machine, the breakup of basic cost, freight, insurance and custom duty may be given.

I . REFERENCE DETAILS ( BUSINESS REFERENCE )

Relationship with applicant / co-applicant

(Customer, supplier, Competitor)

Reference II

Relationship with applicant / co-applicant

(Customer, supplier, Competitor)

J. INFORMATION ON OTHER PRODUCTS AND OFFERINGS

K. INFORMATION ON SUBSIDY
TUFS CLCSS IDLSS FPTUFS Others _____________ Value of Asset Rs. _______________

To be handed over do the customer

ACKNOWLEDGEMENT FOR RECEIPT OF APPLICATION FORM

Axis Bank has received your application for a Small Business Banking /Facility of Rs .______________
Axis Bank will convey its decision (within 2 weeks for credit limit up to Rs. 5 lakh and within 3 weeks for credit limit above Rs. 5 lakh and up to
Rs. 25 lakh for Micro & Small enterprises borrowers) and (within 30 working days for other borrowers) from the date of receipt of the
application provided the application is complete in all respects and is submitted along with all the documents as per 'check list' provided in
the application for loan and/or any additional documents as may be required by the bank for proper appraisal of the application. The
computation of timelines shall starts from the day on which all documents required for a proper appraisal of the application are provided by Signature of Sales Manager Sourcing Channel
the Customer to bank. (ASL/DSA/etc.)

1.Last 2 years Audited /CA certified financial statement

2.MOA & AOA of Company / Partnership deed of Partnership firm
3.Six Months Bank statement
4.KYC Documents
Note : Additional document may be required for Credit assessment

1.Executing Facility related documents

2.Executing security creation documents and submitting original security documents.
3.Compliance of Sanction terms and other conditions as may apply.
Note : Additional documents may be required as per Sanction term
L SPECIFIC CUSTOMER DISCLOSURE IN RESPECTIVE OF RELATIONSHIP WITH DIRECTOR/SENIOR OFFICER OF THE BANK /ANY OTHER BANK

1
2
3
4
5

M PRIORITY SECTOR CATEGORY / MSME

Value of Plant & Machinery Rs.

Upto INR 25 lakh (Micro) Above INR 25 lakh upto INR 5 crore (Small) Above Rs. 5 crore upto Rs. 10 crore (Medium)

Value of Equipment Rs.

Upto INR 10 lakh (Micro) Above INR 10 lakh upto INR 2 crore (Small) Above Rs. 2 crore upto Rs 5 crore (Medium)

N. DETAILS OF PARTNERS / DIRECTORS

Name of Complete Father/ DOB Aadhar No. PAN No. Category Telephone Contact Age Profit Academic Experience
Partners/ Residence Spouse /DIN No. SC/ST/OBC/ No. Details (in years) Sharing/ Qualification in the line
Directors Address Minority/ (Residence) Shareholding % of activity
of company/ Women (Years)
Proprietors

O. GST DETAILS - BUSINESS (For Individual fill Annexure)

Whether registered under GST
GST Registration
Special Economic Zone
GSTIN (Default)
GST Exemption
Address registered for GSTIN
Y N Registration Date: D D M M Y Y Y Y
Single Multiple (Please fill GST Annexure for multiple GST Registration)
Y N SEZ Code(If Yes) _____________________________
Y N Exemption Reason(If Yes) _____________ Exemption Valid Till : D D M M Y Y Y Y
Same as Ofce Address Same as Factory Address As given below

DETAILS OF CHARGES *
Sr.NO Nature of fee / charges Cash Credit Overdraft Merchant Loan Secured Term Loan Unsecured Business Loan

1 Processing Fees Upto 1.25% +Taxes applicable Upto 1.25% +Taxes applicable Upto 2.00% +Taxes applicable Upto 1.25% +Taxes applicable Upto 2.00% +Taxes applicable

2 Non Refundable Login Fee Rs. 5000/- + Taxes applicable Rs. 5000/- + Taxes applicable NA Rs. 5000/- + Taxes applicable NA
RA/SBB/App. Form/ November 18 /Version 8.0

Stamp Duty & other As per applicable laws of As per applicable As per applicable
3 As per applicable laws of state As per applicable laws of state
statutory document charges state laws of state laws of state
4 ROC ling charges Rs. 1200/- +Taxes applicable Rs. 1200/- +Taxes applicable Rs. 1200/- +Taxes applicable Rs. 1200/- +Taxes applicable NA
Non submission of stock 2% +Taxes applicable of the outst
5 NA NA NA NA
statement anding amount from the date of default
Non submission of 2% Additional rate of interest 2% Additional rate of interest 2% Additional rate of interest
on the amount outstanding NA NA
6 property/stock insurance on the amount outstanding on the amount outstanding

Cheque book First 100 leaves free (for new First 100 leaves free (for First 100 leaves free (for new
7 borrower account) and new borrower account) borrower account) and NA NA
issuance charges
thereafter Rs 2/- per leaf and thereafter Rs. 2/- per leaf thereafter Rs 2/- per leaf
8 Cheque Bounce Rs. 500/- per instance +Taxes applicable Rs. 500/- per instance +Taxes applicable Rs. 500/- per instance +Taxes applicable Rs. 500/- per instance +Taxes applicable Rs. 500/- per instance +Taxes applicable
2.00% p.a. additional on 2.00% p.a. additional on 2.00% p.a. additional on 2.00% p.a. additional on 2.00% p.m. on the amount
9 Penal Interest existing Rate of Interest existing Rate of interest existing Rate of interest existing Rate of interest of overdue installment
10 RS. 150 + Taxes applicable RS. 150 + Taxes applicable RS. 150 + Taxes applicable RS. 150 + Taxes applicable RS. 150 + Taxes applicable

CERSAI charges Rs.100/- + Taxes applicable Rs.100/- + Taxes applicable Rs.100/- + Taxes applicable Rs.100/- + Taxes applicable NA
11 per collateral
“Goods and Services tax (GST) will be charged extra as per the applicable rates, on all the charges and fees (wherever GST is applicable)"
P. CUSTOMER DECLARATION

address.21. It is certified that our unit has not availed any loan from any other Bank / Financial Institution in the past and I am not indebted to any other
Bank / Financial Institution other than those mentioned in above columns. 22. I/We authorize Axis Bank to verify and authenticate my/our Aadhaar number during processing my/our application for legitimate Business purposes. 23. I/We further
authorise the Bank to share my Aadhaar related details/information with regulatory / statutory bodies as and when required.

1. Axis Bank will convey its decision (within 2 weeks for credit limit up to Rs. 5 lakh and within 3 weeks for credit limit above Rs. 5 lakh and up to Rs. 25 lakh for Micro & Small enterprises borrowers) and (within
30 working days for other borrowers) from the date of receipt of the application provided the application is complete in all respects and is submitted along with all the documents as per 'check list' provided in
the application for loan and/or any additional documents as may be required by the bank for proper appraisal of the application. The computation of timelines shall starts from the day on which all documents
required for a proper appraisal of the application are provided by the Customer to bank.

/ facility

As per RBI guidelines, classification of accounts as NPA is done Borrower wise and not Facility wise and hence, it may be noted that in case of non-payment of dues by the customer in case of any facility
availed from the Bank and consequently the account is to be classified as NPA, all other loan accounts of the Borrower/Card Holder, with the Bank also shall be classified as NPA as per the guidelines
issued by RBI and it shall entitle the Bank to recall all such loans/facilities availed by the same customer from the Bank irrespective of the regular repayment in such accounts
7. Mudra Declaration: Axis Bank may tag the unsecured loans/facilities offered upto Rs.10Lacs to Small/Micro enterprise borrowers under Shishu, Kishor or Tarun
category as per Pradhan Mantri MUDRA Yojana (PMMY) guidelines.

Co-Applicant -I / Partner-I Co-Applicant -II Co-Applicant -III

Applicant Signature
Proprietor / Director Partner II / Director II Partner III / Director III

Q. SOURCING DETAILS (for Official use only)

Corporate Linked Connector Digital Circle Sampark Vistaar Vistaar +

Direct Open Market MAB Others ______ (Please Specify)
Further options of Digital Circle
SMS Email Mobile Internet Banking Web Leads ATM Telecalling
Inbound customer service Remote Banking RM.
DSA Code :
DSA Name :
TL Code :
Corporate Name Corporate Scheme label
Fulfilment Channel: SBB SM's Vistaar branches Vistaar + branches ARM MAB Other
AXIS Bank Relationship Manager :
Referrer Branch Name :
Ref ID : / CRM ID
Account Opening City
Account Opening Branch Name
Account Opening Branch Sol ID

Signature of Sourcing Channel

Documents Received Certified

FOR BANK USE ONLY

KYC VERIFICATION CARRIED OUT BY

Emp. Name : _______________________________________________

Emp. Code : _______________________________________________
Emp. Designation : _______________________________________________ (Employee Signature)
Emp. Organisation & Code AXIS BANK LIMITED,001
: _______________________________________________
Emp. Branch : _______________________________________________
Place : ______________________

Date : D D M M Y Y Y Y