MSME Loan Application
  
MSME Loan Application
Basic Information
1. Date of Application
2. Name of the Enterprise *
3. Registerd Office Address *
4. Address of Factory or Shop
5. Whether Belongs to SC/ST/OBC/Minority Community
6.Telephone No.* 7.E mail Address*
8. Mobile No.* 9. PAN Card No.
10. Constitution* 11. Date Of Establishment*
Select State->City->Branch where loan is required *
12. State 13. City 14. Branch
15. Name of Proprietors/ Partners/ Directors of Company and Their Addresses: *
Name Age Academic Qualification Residential Address Telephone No Residence Experience in the line
of Activity (In Years)
16. Activity* #If a different activity other than existing activity is proposed. Proposed#
17. Brief History (about the promoters, concern / firm / company)
Name Residential Address Telephone No Residence
18. Names of Associate Concerns and Nature of Association:
Name of Associate Concern Address of Associate Concern Presently Banking With Nature of Association Extent of Interest as a Prop./ Partner/ Director in Associate Concern
Relationship of Proprietors/ Partners/ Directors with the officials of the Bank/ Director of the Bank
19. Credit Facilities (Existing) (Rs. in Lacs)
Type of Facilities Limit (in lacs) Outstanding as on ... Presently Banking With Security Lodged with value ROI Repayment Terms
Current Account
Cash Credit
Term Loan
LC/BG
If Banking with this Bank, customer ID be given here:
It is certified that our unit has not availed any loan from any other Bnak / Financial Institution in the past and I am not indebted to any other Bank / Financial Institution other than those mentioned in 19 above.
20. Credit Facilities (Proposed) *
Type of Facilities
Amount (Rs.)
Purpose for which Required Security Offered
     Primary Security(Details with approx.
value to be mentioned)
Whether Collateral Security Offered
(Please mention yes or no)
21.In case of term loan requirements, the details of machinery may be given as under:
Type of Machine Purpose for which Required Whether Imported or Indigenous Name of Supplier Total Cost of Machine ( in case of imported machine, the breakup of basic costs, freight, insurance and customs duty may be given) Contribution being made by the promotors Loan Required
22. Details of Collateral Security Offered, if any, including third party Guarantee # (# As per RBI guidelines banks are not to take collateral security for loans upto Rs. 10 lakhs to MSME Units)
Past Performance / Future Estimates (Actual performance for two previous years, estimates for current year and projections for next year to be provided for working capital facilities. However for term loan facilities projections to be provided till the proposed year of repayment of loan)
Rs. in lacs Past Year 1 (Actual)  Past Year 2 (Actual)  Present Year (Estimate) Next Year (Projection)

Bank Finance Requirement
Loan Amount from Andhra Bank (Rs.)
Existing Customer (YES/NO)
Account No
23. Status Regarding Statutory Obligations:
Past Performance / Future Estimates (Actual performance for two previous years, estimates for current year and projections for next year to be provided for working capital facilities. However for term loan facilities projections to be provided till the proposed year of repayment of loan)
                          Whether Complied with (select Yes /No).
If not applicable then select N. A.  
 
1. Registration under Shops and Establishment ACT
2. Registration under SSI (Provisional /Final)
3. Drug License
4. Latest Sales Tax Return Filed
5.Latest Income Tax Returns Filed
6.Any other Statutory dues remaining outstanding
Security Code
Security Code
 

Application is subject to production of documentary proof of KYC requirements fixed by RBI 
i.e. Latest photographs, Proof of residence and proof of identity