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PERSONAL FINANCE APPLICATION

Date: To The Consumer Lending Unit, Mega Bank Nepal Limited .................. Branch Nepal. Dear Sir/Madam, I/We hereby apply for a/an (New/Additional) Loan of NPR ................................................................................ (Nepalese Rupees ............................................................................. Only) under the Personal Finance Scheme of your Bank for the purpose of: Purchase of Consumer Goods Educational Others Purchase of Professional Equipments Social Events

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1. PERSONAL DETAILS OF THE APPLICANT(S)
Name (Mr. /Mrs./Ms) Occupation Date of Birth Citizenship No. : : : :

Permanent Residence : Present Residence :

Local Address & Contact Person (if any) : Ownership of Residence : Own: Co. provided: Mailing Address/ Work Address Grand Father's Name Father's Name Spouse's Name : : : : Children: Work: Others: 1/4 Others: Mobile: Father/Mother's name: Others: Rented:

Total Number of Dependents: Telephone No. Home:

Bank Account with MEGA BANK LTD:

Signature of the Guarantor Name: Seal: 2/4 . Shares etc): Mortgaged Properties: Amount of other guarantee commitments: I hereby certify that the information provided above is true and correct. of Dependents (for individual): Father's Name Grand Father's Name Spouse's Name Date of Birth Citizenship No. Net Worth Details: Land NPR: Liabilities (if any) Loans NPR: Annual Income: Declaration: Building NPR: : : : : : : : : : Home: Relationship with the applicant: Work: Mobile: Others (Bonds.2. DETAILS OF THE GUARANTOR Name(s) Nature of Business : : Children: Others: No. EMPLOYMENT DETAILS OF THE APPLICANT Your Occupation Name of Employer Post/Designation Terms of Service Contract Expiry/ Retirement date Previous Employer (If any) Post/Designation : : : : Years in service: Contract: Permanent : : : Years in service: 3. Mailing Address Present Residence Work Address Tel No.

........... I/We hereby authorize the Bank to disclose such information relating to my/our credit facility to such parities as deemed necessary at the sole discretion of the Bank..... I/We further agree to pay charges (if any). principal or any other dues related to this loan......... I/We hereby authorize the Bank to debit my/our account or to set-off any deposits to pay the charge ......... interest. as per the Bank's policy... with the withdrawn of the proposal after submission of this Loan Application. of ... Further....... Rental obligations Insurance Premium payments Living Expenses Education/Medical/Food/Etc.. If proven otherwise.................. I/We agree that the Bank may refer my/our name to a recognized credit or referencing agency/ies and make such references as the Bank may consider it necessary.... I/We agree to accept all the term & condition/s of the Bank that are in force including amendment thereto unilaterally by the Bank from time to time or any condition stipulated by the Regulatory Authorities............ I/We confirm that there are no insolvency proceedings against me/us nor have I/We ever been declared insolvent...Financials as at .4..... I/We agree to bear all the legal consequences... I/We understand and agree that the interest rate shall be revised annually and re-fixed by the Bank unilaterally...... Signature of the Applicant Name: Date: 3/4 .... Name(s) LIABILITIES Loans at Mega Credit Card from Mega Loans from other banks (please provide details) Credit Cards from other Banks (if any) Other Liabilities (If any) NPR NPR FOR Bank's Use ASSETS Saving/Current a/c at Mega Accounts with other banks/ Finance companies Land/building: Location: Owner's name: Vehicles/motorcycle: Other assets: (If any) NPR NPR FOR Bank's Use TOTAL TOTAL NET WORTH = NPR MONTHLY INCOME Salary Spouse's Salary Rental Income Business Income Other income (If any) TOTAL NPR NPR FOR Bank'sUse MONTHLY EXPENSES Any loan repayments/ including Credit Card exp.... Other Expenses (If any) TOTAL NPR NPR FOR Bank's Use NET INCOME = NPR Declaration: I/We hereby declare that the information giving above in this format is true and correct.. I/We acknowledge and agree that a request and demand for any information to any authority under the statutory law will be compiled by the Bank........

Bank a/c statement for 3-6 months..) Remarks/ other Info... terms.. Others... contract expiry/retirement date etc. etc. Cash.. . Bank/FI * Working Capital Loans * Term Loans * Other Loans * Non Funded facilities Total 2. FDs. (a) Please mention as appropriate: Current Assets. 10 million.. . 10 million as of date... 6. In case of mis-representation and/or the information provided is proved to be incorrect I/we assume full responsibility for any consequences thereof and agree that the Bank may prosecute me/us as per prevailing law. tenure. if any.. I/We will inform you within 15 days if the exposure crosses Rs... Salary Certificate with designation.Following are the details of credit facilities with other banks/financial Institutions: Names of other Total banks/Fls from where Limits/Outstanding credit facilities availed Date*: *(Should not be older than last quarter-end....] 4.... Land & Building. Bonds.. 4/4 . 5. Photocopy of Citizenship / Passport / Driving License [ (with the original to be sighted) for applicant & co-applicant.. Photograph of applicant (2 copies) / Photographs of co-applicant (2 copies) 2.. ... (b) Location/Plot #/ Amount/Names of guarantors. Photocopy of Office ID card (with the original to be sighted) 3.. Copy of Land ownership Certificate........ I/We confirm that the information provided above is correct.. Signature of the Applicant(s) Name: Date: KINDLY ENCLOSE THE FOLLOWING DOCUMENTS 1.. Bank/FI Grand Total Please attach additional sheets in case of insufficient space or for additional details of security and other remarks... I/We hereby declare that my/our total credit exposure in banks and financial institutions is not more than Rs. etc.. last month-end preferred) Limits Outstanding Overdue Yes/No (If yes...... etc.. Personal guarantees. Bank/FI * Working Capital Loans * Term Loans * Other Loans * Non Funded facilities Total 3........ specify date) Security Details Nature of Security(a) Details(b) (Location/ name of guarantors. 1.....