This document is an integral part of loan / facility application form (To be obtained on letter

head on best effort basis, if applicable. To be submitted mandatorily for all New, Renewal as
well as Enhancement cases at the time of login)

Declaration cum undertaking

We hereby confirm that we are maintaining current account for our business and details of the
same are as below –

Sr. Bank Name Branch Name A/c number

No
1
2
3
4
5
6
7

We understand that, if Axis bank grants us loan / credit facility, then we need to close all these
current accounts within 30 days from disbursement and ensure that all business transactions
are being routed through our Axis Bank account.

We further confirm that, our total borrowing as on _________ is Rs._______ Cr and details of the
same are as below –

Sr. Facility Type Sanction Limit Bank / Lender & Branch

No (CC/OD/TL/FDOD/ Name
Pledge Finance / Bill
Discounting / LC / BG,
etc.)
1
2
3
4
5
6
7
Total

We will ensure to take written permission from Axis Bank before availing any additional loan /
credit facility and will undertake to adhere the regulatory conditions about maintaining /
continuation of current account.

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 Legal Entity Identifier (LEI) Declaration

I/we confirm that the total banking exposure of our firm/company after availing the
proposed loan / credit facility is Rs.50 Crore or above. The Legal Entity Identifier (LEI) is
applicable to our firm/company and the details of the same are as under:

1) LEI No.:
2) LEI Issuer:
3) LEI Issuance Date: (DDMMYYYY)
4) LEI Expiry Date: DD (DDMMYYYY)

I/we confirm that the total banking exposure of our firm/company after availing the
proposed loan / credit facility is between Rs.5 Crore to < Rs. 50 Crore. We will endeavour to
apply for the LEI and agree to provide the LEI details to Axis Bank once we obtain the same.

I/we confirm that the total banking exposure of our firm/company after availing the
proposed loan / credit facility is below Rs. 5 Crore. The Legal Entity Identifier (LEI) is not
applicable to us.

I/We declare that the particulars and information given above are true, correct and up to
date in all aspects.

Stamp (if applicable) & Signature

Date -

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