BANK:

Application No: Date

Common Application Form for Artisans Loan

(For Loan from Rs.25,000 /- to Rs.50,000/-)
The Branch Manager,
Branch:

I hereby apply for Cash Credit / Term Loan of Rs.

Name of Father’s/Husband’s
Applicant(s) Name
Constitution Individual Joint Proprietary Partnership Other

Residential Address

Business Address Rented/owned

Rented/owned
Date of Birth Sex-Male/Female

Educational Qualification Illiterate Upto10th Upto12th Graduate Professiona Others

l
KYC Documents Voter ID No. Aadhar No. License No. Any others
ID Proof
Address Proof
Telephone no. Mobile No Email
Line of Business Existing
Activity /Purpose Proposed
Annual Sales( IRE. in lakh) Proposed

Skill Certified(1) Self Skilled(2) Unskilled(3)

Experience
Social Category --- General SC ST OBC Minority
Community
Minority Buddhists Muslims Christians Sikh* Jains Zoroastrians Others
—
Term
Loan Amount Required Cash Credit: Rs Loan
Detail of Existing Type(pls. tick) Name of Bank
Accounts (If any) Branch
A/c no. If Loan A/c, amount of Ioan taken Rs.
Declaration:

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 owned 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 Mudra
Ltd., or any other agency as authorised 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.

Date:

Place: Thumb impression/Signature of

Applicant(s)(for office use only)

Acknowledgement slip No.…………………….. Loan Application No……………… Dated………………………

Received by

Place and Date Authorized Signatory(Branch Seal and sign)

…………………………………………………………..Cut Here…………………………………………………………….
Acknowledgement slip No .................... for loan application under MY(Applicants copy)

Received with thanks from Sh./Smt loan application dated for Rs

Place and Date Authorized Signatory(Branch Seal and sign)