MUDRASHI NIDHI LIMITED

C-18, Ring Road,

Old Tempo Stand,
Kalyanpur, Lucknow
Lucknow-226022

ACC No. : GL Scheme :

Total Amount : Disbursal Date :
Interest Rate : Tenure :
Customer Code : Maturity Date :

I _________________________________ Phone/Mobile No. ________________

Occupation____________ having availed the above referred gold loan for personal purpose, do
confirm that I have received an amount of Rs. ____________ from MUDRASHI NIDHI LIMITED. I
promise to repay the amount within a period of _______ days together with an interest of _____%
p.a. and as per the term given overleaf to MUDRASHI NIDHI LIMITED.

For this loan amount received, I have pledged gold ornaments/ gold listed in the table below. I have
declared that the said gold ornaments/ gold exclusively belongs to me.

Sr. No. Item Name Nos. of Items Gross Weight Stone Weight Net Weight

Total:

I hereby nominate ____________________ my ________________ as my nominee to receive the

pledged gold ornaments on payment of full loan due in the event of death.

NOTE: You are requested to bring the original copy at the time of redeeming/ taking back of the gold
ornaments after the complete payment of the loan guaranteed to you

________________________ _________________________ ______________________

Signature of the Borrower Signature of Appraiser Signature of Branch Manager

Sign at the time of release

Received back the ornament pledged as per table above.

Date: Time:

Authorised Signatory

MUDRASHI NIDHI LIMITED

 MUDRASHI NIDHI LIMITED
C-18, Ring Road,
Old Tempo Stand,
Kalyanpur, Lucknow
Lucknow-226022

GOLD LOAN APPRAISAL MEMO

NAME :

A/C NO. :

ADDRESS :

No. of Description Gross Net Weight Carat Rate per Market

Articles Weight Gram Value

A. I hereby having pledged the above-mentioned gold jewellery for the purpose of availing gold
loan from MUDRASHI NIDHI LIMITED.

SIGNATURE OF BORROWER

B. I hereby certify that I have tested/ appraised the above and the gross weight of the articles, net
weight of gold, carat, purity of fineness, rate per gram and the market value shown against
ornaments mentioned above are to the best of my knowledge

SIGNATURE OF THE ASSAYER

C. We hereby declare that above items of jewellery/ornaments have been received by us and are
in our joint custody.

Loan Amount: Rs. _______________

Due Date: ___/___/____

Signature of Joint Custodian Signature of Branch Manager

 VALUATION CERTIFICATE
(Original)

BRANCH NAME : DATE :

CUSTOMER NO. : LOAN NO. :
CUSTOMER NAME : LOAN AMOUNT :
ADDRESS :
SCHEME NAME :
INTEREST RATE :
PROCESSING FEES :
NET DISBURSEMENT : Rs.
AMOUNT
ITEM DETAILS :

Customer Signature Manager Signature

Gold Item Receiver Employee Code

Gold Loan No. : Gold Loan No. :

Branch Name : Branch Name :

Customer Code : Customer Code :

Date : Date :

Customer Name : Customer Name :

Gold Loan Amount : Gold Loan Amount :

Address : Address :

Gross Weight : Gross Weight :

Stone Weight : Stone Weight :

Net Weight : Net Weight :

Interest Rate : Interest Rate :

 MUDRASHI NIDHI LIMITED
C-18, Ring Road,
Old Tempo Stand,
Kalyanpur, Lucknow
Lucknow-226022

BRANCH NAME:

PHONE NO.: Date:

LOAN DUE DATE INTIMATION

LOAN NO. DATE LOAN AMOUNT TOTAL AMOUNT INTEREST TILL
DUE DATE

Please refer to the terms and conditions provided by the company and accepted by you with regard
to the above-mentioned loan.

It is hereby intimated that the period of the above-mentioned loan amount expires on ___________

In the light of the above, you are requested to remit the amount required to avoid penal interest in
the above-mentioned loan on or before __________ and to avail a fresh loan.

For further details, please contact our nearest branch. You may also kindly note that for any
complaint, please feel free to contact us.

(Authorised Signatory)