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BOTH TL AND WC APPLICATION

All Dates should be in dd/MM/yyyy format


Fields marked as * are mandatory
Application Details
* Bank / Institution Reference No.
* Bank / Institution Branch Name
Bank / Institution Branch Code

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Borrower Details
Whether borrower already assisted by bank
Outstanding Amount on date of sanction of
credit Facility
NPA
Whether Borrower Covered by CGTSI
previously
None
* Constitution
* Borrower / Unit Name

Yes
No
.................................... in Rs.
Yes

No

Yes

No

Borrower ID
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* Unit Address
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*District:
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* PIN code
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ITPAN of Firm
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Nature of Industry
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*Type of Activity
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Projected Optimum Sales Turnover ........................... in Rs.

CGPAN

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* State:

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*City

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SSI Registration Number


Industry Sector:
Number of Employees
Projected Optimum Exports

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............................in Rs.

Promoter Details
Chief Promoter's Information
* Title

* First Name

Middle Name

Name
* Gender

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ITPAN of Chief Promoter

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....................................

...................

Male
Female
Date of Birth
...............................
Social Category
Legal ID
Name ........................... Value ...........................
Other Partners / Promoter Directors

* Last Name
(Surname)
....................................

....................................

1. Name

.................................... ITPAN

.................................... Date of Birth

....................................

2. Name

.................................... ITPAN

.................................... Date of Birth

....................................

3. Name

.................................... ITPAN

.................................... Date of Birth

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Project Details- Outlay


* Collateral Security Taken

# Third Party Guarantee


Y
N
Y
N
* Collateral security is any other security offered for the said loan. For example, hypothecation of jewellery, mortgage of house,
etc.
# When the borrower furnishes the guarantee of any other person / corporate not connected with the project, it is considered as
Third Party Guarantee.
Guarantors
1. Name
Net Worth(as on date of
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....................................
sanction of facility)
2. Name
Net Worth(as on date of
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....................................
sanction of facility)
3. Name
Net Worth(as on date of
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....................................
sanction of facility)
4. Name
Net Worth(as on date of
....................................
....................................
sanction of facility)
Name of Subsidy / Equity Support Scheme
....................................

Primary Security Details


Security Name

Particulars

Value(in Rs.)

Land

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Building

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Plant and Machinery

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Other Fixed / Movable Assets

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Current Assets

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Others

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Total

in Rs.

Means Of Finance
Term Credit Sanctioned

.......................... in Rs.

Promoters Contribution
.......................... in Rs.
Subsidy / Equity Support
.......................... in Rs.
Others
.......................... in Rs.
Project Cost
.......................... in Rs.
Project Outlay

* Working Capital Limit Sanctioned


Fund Based
.......................... in Rs.
Non Fund Based
....................... in Rs. -->
Whether provided as margin
Yes
No
money under Term Loan
Promoters Contribution
.......................... in Rs.
Subsidy / Equity Support
.......................... in Rs.
Others
.......................... in Rs.
Working Capital Assessed
.......................... in Rs.
..........................
in Rs.

FacilityDetails
Scheme
Loan Type
Composite Loan

..........................
BO
N

Term Credit Details


Amount Sanctioned

in Rs.

* Credit to be Guaranteed

..........................

Amount Disbursed
* Tenure (months)

.......................... in Rs.

* Date of Sanction
Date of first disbursement if
already made
Date of last and final
disbursement if already made

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