Please read the form carefully before filling.Fields with *are Mandatory

1.Application Sl. No.: UCOMSME886 2.Date: 13 Nov 2018
3.Name Of The Enterprise:*
4.Regd.Office Address:*
5.Address of Factory/Shop:*
6.Whether Belongs to SC/ST/OBC/Minority Community:*
7.Telephone No:* 8.E mail Address:*
9.Mobile No:* 10.PAN Card No*
11.Constitution* 12. Date Of Establishment:*
13.State* 14.Select District where loan is required:*
15.UCO branch where loan is required:*
16.Name of Porprietors/Partners/Directors of Company and their Address:*
Name Age Academic Qualification Residential Address Telephone No.(Residence) Experience in the line of activity(Years)
17.Category of Loan:*
18.Activity Existing:* 19. Proposed:
20.Name 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 proprietor/ partner/ director or just investor in associate concern
Relationship of partners/ proprietors with the officials/ director of the bank *
21.Existing Credit facilities:
Type of facilities Amount (in Lacs) Outstanding as on current date Presently Banking with Security Lodged Rate of Interest Repayment Terms
If Banking with this Bank, Customer ID be given here:
It is certified that our unit has not availed any from any other Bank/Financial Institution in the past and I am not indebted to any other bank/Financial Institution other then those mentioned in 19 above.
22.Proposed Credit Facilities :*
Type of facilities Amount (in Lacs) Purpose for which required Security Offered
Primary Security(Details with approx. valu to be mentained) Whether Collateral Security Offered. Provide details

Total Loan:(in Lacs)* (Total Loan should not exceed 100 lakh)
23.In Case of term loan requirements, the details of machienery may be given as under:
Type of Machine Purpose for which Require Whether Imported or Indigenous Name of Supplier Total Cost of Machine(in case of imported machine, the brackup of basic costs, freight,insurance and customs duty may be given) Contribution being made by the promotors Loan required
24.Past Performance and Future Estimates:
(actual performance for previous two years, estimates for current year and projections for next year to be furnished 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)
25.Status Regarding Statutory Obligation:*
Statutory Obligation Remarks(Any Details in Connection with the relevant obligaiton to be given)
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 remanining outstanding
Please Keep undernoted documents ready
  1. Copy of the title deeds of the collateral security being offered.
  2. Latest copy of income tax return/assessment order etc.
  3. Statement of account from the existing banker,if any for the last six month.
  4. Copies of relevant license,documents pertaining to the ownership/tenancy/lease agreements etc. in respect of premises where activity will be carried out.
  5. Details of Property proposed to be mortgaged.
  6. Encumberance Certificate(upto date)
  7. Photos(two copies) of applicant,guarantors
  8. Copies of Trust deeds/Memorandum and articles of association if applicable the above information furnished by me/us is true ,correct and complete to the best of my knowledge .I fully understand that mere submission of the application does not entitle me to a loan and that any loan will be considered on merits.
    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.
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