Central Bank of India
______________ Branch
Borrower’s / Guarantor’s Profile
(To be used in case of Individual Borrowers / partners / Directors / Members of HUF
/ Guarantors)
Name and Address of Borrowal Account:
Affix Recent
Passport
Size Photo & sign
Across
Account Number (If any)
1. Full Name (Shri / Smt / Kum)
2. Father’s / Husband’s Name
3. Nationality
4. Age & Date of Birth & Place of
Birth
5. Sex ( Male / Female)
6. Educational Qualifications
7.A. Employment Particulars
i) Name & Address of Employer
ii) Designation
iii) Date of Joining
iv) Number of years of service
v) Gross Emoluments (Per annum, copy
of latest salary slip to be enclosed)
7.B. Occupation Particulars
i) Nature of Business
ii) Established since
iii) Place of Business
iv) Name of sister concerns / Associates
and address thereof
1
8.a. Present Address
i) Flat /Door / Block No.
ii) Name of Premises / Building
iii) Road / Street / Lane
iv) Area / Locality
v) Town / City / District
vi) Pin code
vii) Telephone / Fax No.
8.b. Whether the above premises is
rented or owned?
9.a. Permanent Address
i) Flat /Door / Block No.
ii) Name of Premises / Building
iii) Road / Street / Lane
iv) Area / Locality
v) Town / City / District
vi) Pin code
vii) Telephone / Fax No.
8. b. Whether the above premises is
rented or owned?
10. E-mail Address
[Link] of family members
Name Relationship Age Marital status Addresses (Res
& Off)
i)
ii)
iii)
iv)
2
12. Income tax Permanent Account No.
(Please enclose copy of last Income-tax
and Wealth-Tax returns)
Ward / Circle
13. (i) Ration Card No.
ii) Issuing Authority
iii) Date of issue
iv) Card Holder’s Name
v) Address as given in the Card
(If different from the address given
above, reasons thereof) (Copy of Ration
card to be enclosed)
14. Election Commission Identity card
No.
Issuing Authority and Date
15. (i) Passport Number
(ii) Date and Place of issue
(iii) Period of validity
(Copy of relevant pages enclosed)
16. (i) Driving Licence No.
(ii) Valid Up to
(iii) Issued by RTO at
( Copy enclosed)
17. (i) Credit Card No.
(ii) Name of the Bank / Institution
(iii) Valid up to
18. Liabilities / Loans
(i) Self / as a partner / co-parcener /
ers
Name under Sources Amount Purpose Security Terms of
which (Bank or (Rs) Repayment
borrowed financial
institutions)
3
As a Guarantor
(i) Self / as a partner / co-parcener /
ers
Name of Sources Amount Purpose Security Terms of
Principal (Bank or (Rs) Repayment
borrower financial
institutions)
19. Details of Existing Bankers (Name &
Address)
Type of Account & Existing Balance
(Specify if pledged & details thereof)
20. List of moveable properties
a) Vehicles (Copy of RC Book enclosed)
i) Description (Two / Three / Four
wheelers
ii) Make
iii) Registration No.
iv) Year and Model
b) Shares / NSCs / Bonds / Debentures /
Bank Deposits / Units / LIC Policies
Nature of Name of the Total No. of Face Value Maturity Terms of
security Company / Security Value (For Deposits (in
(share / Bank / FI / Bonds / months)
Bond etc) Others Debentures)
b) List of immoveable properties
4
1. Name of Owner
2. Details of Property
3. Market Value of the Property
4. Desires Sale Value
c. Any other e.g. Jewellery etc (Please
specify)
Means / Capital
Proprietor’s Capital
Partners’ Individual capital
1) Rs.
2) Rs.
3) Rs.
4) Rs.
Total Rs.
In case of Companies:
CAPITAL
Authorized Issued Subscribed Paid up Firm
underwriting
commitments
if any in case
of fresh issue
5
We enclose
i) 3 copies of Audited balance sheet and P/L a/c each for the year ended
___________.
ii) 3 copies of provisional Balance sheet and P/L a/c for the year ending
___________.
iii) Copy of partnership deed
Borrowing Powers:
We enclose
i) Certified copy of Resolution of General Body meeting held on ________
( Annexed hereto ) and
ii) Three copies of Memorandum and Articles of Association of the Company
(in case of new accounts)
We confirm that Memorandum and Articles provide powers to
i) Borrow up to Rs.___________
ii) Create mortgage, charge etc____________
Place: Yours faithfully
Date:
