Bank of Maharashtra F157 Personal Information of the applicant / Guarantor for advances | {| | | pee Photo to be affixed Name in Full } Dt of Birth - [Bau - Caste - [Voter ID - Father's Name Shai at Residential Address PAN Permanent Present | ‘Telephone No, office! Shop Residence ‘Mobile No. Occupation / Business If in Service -— ‘Name of Employer Address Designation Present Posting at Dt of Joining Dt of Retirement] Present Gross Salary _| Rs, Present Net Salary | Rs. If in Business / Profession — ‘Name of the Firm / Company ‘Address Line of Activity Since when established Jn which capacity representing ‘Annual Income / Salary of Last Three Years 2016-17 2015-16 Rs. Rs. 2017-18 | Rs Tncome Tax Pald in Last Three Years 2015-16 2016-17 2017-18 Rs. Rs.‘Capital invested in Business as on Balance Sheet — | Dt Bs. ‘Net af Above Rs. Full detail of Other | Rs. Investments Tewellery Famiture Total of All Assets Details of Loan facilities availed Type of Loan /CC Type of Loan ‘Name of the Bank/ Branch Purpose ‘Amount ‘Dt of availment Repayment Schedule ROL Present O/s Liabilities of others , if any Others Contingent Liabilities In support of above declaration, I enclose photocopies of —PAN VOTER ID Telephone Ration Card Electricity Bill | Salary’ Employmeat | Copies LIC Bond | NSC’S | Shares/ TDR’S Certificate Title of Property/ | Vehicle RC Book | Bank A/e Pass Shop / SST Registration House /Land Book ‘Balance Sheet Tik Retims-3 Years | Form 16- 3 Years || Bank Statement of Ale - 3 Years ‘With assessenent orders Lean ‘Loan Sanction Letter / 1 Banks Certificate | Ideclare that - 1, Tam/Tam not (Tick as applicable ) a director in 2. There is no litigation against me or the firm /Co, in which I am the p: partner /# director . 3, The name of the firm /Co. or the name of the Pertners / Proprietor / ‘the Company is not on the cauition list of RBI/ CIBIL 4, The Partners /Proprietor / Director of the Company are not the Di: Bank / Co-operative Bank also declare that the above information is complete, true & correct. Date Place (In case of need ,separate sheet / paper be attached )