Priority Sector Advance declaration by customer availing loan

PSL Category Description / Declaration by the applicant

[Please Tick(P) as applicable]
I / we declare that the land admeasures __________________________________ (acres) at the address: ______________________
___________________________________________________________________________________________________________
o A
gri Farm Credit / Direct __ belongs to me/us and I/we herewith enclose the documents pertaining to the ownership of the same and the aforesaid loan/Vehicle
Agriculture
shall be used by me/us solely for the purpose of agriculture and/or assist the transport of agriculture input and farm products.
(Individual Farmers)

I / we are carrying out the following allied agricultural activity (as ticked below) and the aforesaid loan/Vehicle shall be used by me/us
solely for the purpose of below allied activity and/or to assist the transport of agri or allied activity input and farm products.
o A
gri Farm Credit
o Dairy o Fishery
(Allied Activities)
o Poultry o Bee-keeping
o Piggery o Sericulture (upto cocoon stage)

I / we hereby declare that I / we are running a business unit which is a Small Scale Industry engaged in manufacture / processing/
preservation of goods. I / we also declare that our investment in Plant & Machinery is less than Rs 5 Crores and the aforesaid loan/
Vehicle shall be used by me / us solely for the purpose of business.
o M
anufacturing Enterprises
I / we hereby declare that to the best of our knowledge and belief that the amount of Original cost of investment in all types of plant
and machinery used for my business ........................................................................... is around Rs............................................... lacs.
(Please fill the amount )
Enterprises engaged in providing or rendering of services and whose investment in equipment (original cost excluding land and
building and furniture, fittings and other items not directly related to the service rendered is less than 2 Crores. Below are the industries
classified within Service enterprises subject to borrower Total loan limit with Bank upto 5 Crores.
o S
mall business - I / we hereby declare that I am / we are running a small business enterprise, providing services and also declare
that the cost of equipment acquired by us for running our business is less than Rs 2 Crores and the aforesaid loan/Vehicle shall be
used by me/us solely for the purpose of business.
I/We hereby declare that to the best of our knowledge and belief that the total amount of original cost of investment in all types of
plant and machinery used for my business....................................................................... is around Rs.......................................Lacs.
(Please fill the amount )
o R
etail Trade - I / We hereby declare that I am / we are trader/traders and the aforesaid loan/Vehicle shall be used by me/us solely
for the purpose of business.
o S
ervice Enterprises I/We hereby declare that to the best of our knowledge and belief that the total amount of original cost of investment in all types of
plant and machinery used for my business....................................................................... Is around Rs.......................................Lacs.
(Please fill the amount )
o S
RTO (Small Road Transport / Taxi Operator)- I/We hereby declare that I am/we are Transport operators and will also declare the
cost of vehicles and the aforesaid loan/Vehicle shall be used by me/us solely for the purpose of transport business.
I / We hereby declare that to the best of our knowledge and belief that the total amount of original cost of investment in all types
of plant and machinery used for my business........................................................................................................... is around
Rs...........................lacs. (Please fill the amount )
o P
rofessional & Self Employed – - I / we hereby declare that I am / we are running a Profession & self employed business, providing
services and also declare that the cost of equipment acquired by us for running our business is less than Rs 2 Crores and the
aforesaid loan/Vehicle shall be used by me/us solely for the purpose of business.
I/We hereby declare that to the best of our knowledge and belief that the total amount of original cost of investment in all types of
plant and machinery used for my business....................................................................... is around Rs.......................................Lacs.
(Please fill the amount )

I/We are aware that it is on the faith of this representation, declaration and confirmation that you have agreed to consider my loan
application for financial assistance under category ___________________________________________________________(same as ticked
above) of Priority Sector Advances defined in various circulars / guidelines of Reserve Bank of India. We shall indemnify the bank to make
the loss good in the event of any loss or damage that may arise on account of false / incorrect declaration by me/us as stated above.

Borrower Name Borrower Signature

Do not sign this agreement if it is BLANK. Please ensure
all relevent sections and columns are completely filled to
your satisfactory and then only sign the agreement.
S4

Page 9 of 9