Vous êtes sur la page 1sur 3

7/19/2016

PradhanMantriMudraYojnaOnlineapplicationformforMSMEloan

PradhanMantriMudraYojnaOnlineapplicationformforMSMEloan
#Coloredinputboxeswithsymbolacceptsonlynumericvalues
1.

NameoftheEnterprise*:

2.

RegisteredOfficeAddress:

3.

AddressofFactory/Shop

4.

Category

5.

TelephoneNo.

6.

EmailAddress:

7.

MobileNo.

8.

PANCardNo.

9.

Constitution:

10.

DateofEstablishment:

11.

State:

ANDAMAN&NICOBARISLANDS

12.

DistrictwhereLoanisrequired

PORTBLAIR

13.

BankBranchwhereLoanisrequired

PORTBLAIR,A&NISLAND

14.

BranchAddress
1STFLOOR,BJPBHAVANM.GRD,MIDDLEPOINT
NameofProprietors/Partners/DirectorsofCompanyandtheiraddresses:

General
#

DD 01

NameofProprietors/Partners/
Directors

Add

15.

Save

Age

MM 01

YYYY 2016

Academic
Qualification

ResidentialAddress

TelephoneNo
(Residence)

Experienceinthelineof
activity(Yrs)

Delete

Activity
Existing:
Proposed:

16.

NameofAssociate
Concern

Add
17.

(Ifadifferentacivityotherthanexistingactivityisproposed)

NamesofAssociateConcernsandNatureofAssociation:
AddressofAssociate PresentlyBanking
Concern
with

Save

NatureofAssociate
Concern

ExtentofInterestasaProp/
Partner/Director/orJust
InvestorinAssociateConcern

Relationshipwith
OfficialsoftheBank/
DirectoroftheBank

Delete

CreditFacilities(Existing)(Rs.inLacs)

Typeof
Facilities

Limit(inlacs)

Outstandingas
on

Presently
Bankingwith

SecurityLodged

RateofInterest

RepaymentTerms

Current
Account
Cash
Credit
TermLoan
LC/BG
IfBankingwiththisBank,CustomerIDtobegivenhere:

18.

ItiscertifiedthatourunithasnotavailedanyloanfromanyotherBank/FinancialInstitutioninthepastandIamnotindebitedtoanyother
Bank/FinancialInstitutionotherthanthosementionedin17above
CreditFacilities(Proposed)(Rs.inLacs)

Typeof
Facilities

Amount(inlacs)

Purposeforwhichrequired

http://14.140.233.81/MSMELoanApps/msme.aspx?PMMY=Y

SecurityOffered
PrimarySecurity(Detailswithapproxvalue
Whethercollateralsecurityoffered?
tobementioned)

1/3

7/19/2016

PradhanMantriMudraYojnaOnlineapplicationformforMSMEloan
No

CashCredit

Yes

No

TermLoan

Yes
No

LC/BG

Yes

19.

Incaseoftermloanrequirements,thedetailsofmachinerymaybegivenasunder:

TypeofMachine

Whether
Importedor Nameofsupplier
Indigenous

Purposeforwhich
required

Totalcostofmachine(if
importedmachine,providebreak
upofbasiccost,freight,
insuranceandcustoms)

Contribution
beingmadeby Loan
thepromoters Required(Rs.)
(Rs.)

No
Yes

Add

20.

Save

Delete

WhetherloanistobecoveredunderCGTMSE
No

Yes

DetailsofCollateralSecurityOffered,ifanyincludingthirdpartyGuarantee#(#AsperRBIGuidelinesbanksarenottotakecollateralsecurity
forloansuptoRs.10LakhstoMSMEunits)
Description

Add
21.

Value(inLacs)

Save

OwnershipDetail

Delete

PastPerformance/FutureEstimates(Actualperformancefortwopreviousyears,estimatesforcurrentyearandprojectionsfornextyeartobe
providedforworkingcapitalfacilities.Howeverfortermloanfacilitiesprojectionstobeprovidedtilltheproposedyearofrepaymentofloan)

Rs.inlacs

PastYear1(Actual)

PastYear2(Actual)

PresentYear(Estimate) NextYear(Projection)

NetSales
NetProfit
Capital(NetWorthincaseofCompanies)
22.

StatusRegardingStatutoryObligations

StatutoryObligation

WhetherCompliedwith Remarks(AnydetailsinConnectionwiththerelevantObligation)

1.RegistrationunderShopsandEstablishmentAct Yes
2.RegistrationunderSSI(Provisional/Final)

Yes

3.DrugLicense

Yes

4.LatestSalesTaxReturnFiled

Yes

5.LatestIncomeTaxFiled

Yes

6.AnyotherStatutoryduesremainingoutstanding

Yes

SelectIdentityProof:

1.Passport
ClicktoViewListofIdentityProof

IDProofNo:
SelectAddressProof:

1.RationCard
ClicktoViewListofAddressProof

AddressProofNo:
EnterTextShownBelow:

Save

http://14.140.233.81/MSMELoanApps/msme.aspx?PMMY=Y

2/3

7/19/2016

PradhanMantriMudraYojnaOnlineapplicationformforMSMEloan
Print

http://14.140.233.81/MSMELoanApps/msme.aspx?PMMY=Y

3/3