ANNEXURE - II
BORROWERS BASIC FACT SHEET
FOR INDIVIDUALS / CONSUMERS
PRESCRIBED UNDER PRUDENTIAL REGULATIONS R-8
1. BORROWER’S PROFILE: Date:_____________
NAME ADDRESS
PHONE NUMBERS FAX MOBILE NUMBER
OFFICE. RES.
NATIONAL IDENTITY CARD NUMBER NATIONAL TAX NUMBER
FATHER’S NAME FATHER’S IDENTITY CARD NUMBER
2. REFERENCES:
NAME ADDRESS
PHONE NUMBERS FAX MOBILE NUMBER
OFFICE. RES.
NATIONAL IDENTITY CARD NUMBER NATIONAL TAX NUMBER
3. REFERENCES:
NAME ADDRESS
PHONE NUMBERS FAX MOBILE NUMBER
OFFICE. RES.
NATIONAL IDENTITY CARD NUMBER NATIONAL TAX NUMBER
4. NATURE OF BUSINESS / PROFESSION:
INDUSTRIAL COMMERCIAL AGRICULTURAL SERVICE ANY OTHER
5. EXISTING LIMITS AND STATUS:
AMOUNT EXPIRY STATUS
DATE
REGULAR AMOUNT AMOUNT RESCHEDULED/
OVERDUE RESTRUCTRED
(if any) (if any)
FUND BASED
NON-FUND
BASED
6. REQUESTED LIMITS:
AMOUNT TENOR
FUND BASED
NON-FUND BASED
7. DETAILS OF PAYMENT SCHEDULE IF TERM LOAN SOUGHT.
8. LATEST INCOME TAX / WEALTH TAX FORM TO BE SUBMITTED BY THE BORROWER.
CERTIFY AND UNDERTAKE THAT THE INFORMATION FURNISHED
ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE.
____________________________________ ____________________________________
AUTHORISED SIGNATURE & STAMP APPLICANT SIGNATURE & STAMP
(Bank’s Authorized Official