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DECLARATION OF ASSETS AND LIABIL]TIES
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Applicant's Name (in full)
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Address
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Nature of Business & Standing
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Name of Partners 3Trftl6 Rrft ftdfua srfer
Their individual Amount lnvested in
Financial worths Business
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Total
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Name of Adult Minors and
Co-Parceners their age
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Name of Karta
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Business ancestral or new
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lndividual or Proprietory Business
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Total amount of investment in business
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Has the applicant stood guarantor for
any other party : lf so, for what amount
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Other Liabilities & Borrowing
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Situation Particulars of Properties Free or Modgaged Value ln whose name the property stands Bemarks
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Name of Company No. of Shares Market Value Amount paid on Shares It any calls due Remarks
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Particulars ol other assets, such as G.P Notes, Jewellery, lnsurance Policy Etc.
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l71rVe hereby declare that the parliculars given by me / us in the torm are true and correct and that I / We hava not suprassed any inlormation from the Bank and that on the laith
ol abovs slalsmenl of mine/ours the Bank shall entertain mine/ours business I / We hold myselves / ourselves personally liable il any statement turns out to be wrong or lalse.
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Place: Signature
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Date
