DAIRY LOANS

Loan Application Form

BRANCH : ________________________
Application No.: ________________________ Year __________________

APPLICATION FORM FOR DAIRY LOAN

The Branch Head,

IDBI Ltd,
_________________

Dear Sir,

I hereby apply for a loan of Rs (Rupees

.. Only) and furnish below the necessary particulars.

Purpose of loan:
_____________________________________________________

Part A

1. Particulars of Applicant

Basis of Networth
Name of the (enclose copies/
Networth (Rs. Lakh)
Applicant separate sheets, if
required)

2. Address of applicant (With Pin Code):

3. Nature of activity :

4. Age and Sex :

5. I belong to following category/ies. Tick which ever applicable.

Hindu undivided family/ Others (Specify) Name of the Kartha, if

belonging to Hindu Undivided Family
____________________________________

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SF/ MF/ AL/ Other Farmer

SC/ ST/ BC/ Minority/ Physically handicapped

6. Background/ profile of borrower :

7. Dealings with IDBI since :

8. Details of relationships with IDBI, if any:

9. Current bank details :

10. Limits with other banks/ financial/ informal lending institutions

Name of bank/
financial/Govt./Infor Nature of Limit, if Balance
mal lending relationship any o/s
institution

11. Particulars of Land Holding, if any

Area in Acres Value
Of Source Land of
Sy.
whic of reve total
Village No
Total h irrigati nue acres
.
irrig on (Rs.) (Rs.
ated Lakh)

12. Proposed investment

Cost
Total
No./ per Remarks,
Particulars cost
Area unit if any
(Rs.)
(Rs.)
Purchase of high
yielding milch cattle
(Elaborate on the
breed, etc.)
Construction of
cattle shed

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(Elaborate on the
facility to be
created, etc.)
Purchase of dairy
equipments,
(Elaborate on the
equipments, etc.)
Expenditure
incurred for
transportation of
animals where the
animals are not
purchased locally
(Elaborate)
Transit insurance
Others
Total

13. Income from Dairy activity and Agriculture

SY SY SY SY SY SY SY
(2) (1) (0) (1) (2) (..) (n)
Annual
gross
dairy
income
(a)
Expenses
(b)
Annual
net dairy
income
(c)=(a)-
(b)
Income
from
allied
activities

Note: SY means Seasonal Year i.e. period from season to season; In case data
is available for FY or CY (Calendar Year), the same may be used.

14. Position of payment of income and wealth tax for last 3 years

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15. Specify arrangements for

Procuring cattle
Procuring of
Equipments, etc.
(Elaborate on tie-up
arrangements, if any)
Construction of cattle
shed
Procurement of Green
Fodder, Dry fodder and
Cattle Feed
Storing of fodder and
feed
Veterinary care
Marketing of produce
Transport of produce

16. Loan and interest servicing requirement

Gestation period
Installment frequency

17. Particulars of guarantors

Basis of
networth
Relationship (enclose
Networth
Name Address with copies/
(Rs. Lakh)
applicant separate
sheets, if
required)

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18. Declaration:

a) I/We hereby declare that the particulars given above are true and
correct to the best of my/our knowledge and belief.
b) It will be in order for the Bank to disqualify me/us from receiving any
credit facilities from the Bank in case it is proved that the declarations of
my/our outside borrowings made above contain misrepresentation of facts.
c) I/We hereby declare that I/we have no borrowings from any other
agency on the date of application other than those mentioned under Point No.
10.
d) I/We undertake not to borrow from any other agency without the
permission of the Bank.
e) Whether the Applicant/s, Co-obligant/s, Guarantor/s is/are related to
any Senior Officer of the Bank : Yes/No. If yes, specify the names of the
officer with designation and the branch/office working and the nature of the
relationship. Name _______________ Relationship_______________

f) I/ We certify that all the information furnished by me/us is true; that

I/we have no borrowing arrangements for the unit with any Bank other than the
facts mentioned under 10 above; that no legal action has been/is being taken
against me/us; that I/we shall furnish all the information that may be required
by you in connection with my/our application; that this may also be exchanged
by you with any agency you may deem fit, and that you, your representatives,
representative of Reserve Bank of India or any other agency as authorized by
you, at any time, inspect/verify our assets, books of accounts, etc., in our farm
factory and/or business premises.

g) I/We hereby undertake to abide by the terms and conditions that the
Bank may stipulate in sanction of this loan and inform Bank in the event of
acquiring any other assets during the tenure of the advance.

Place:
Date: Signature of
Applicant/s

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Details of Co-obligants/ Guarantor/s (separate sheet for each guarantor)

I. Address
Full Address with
Name
Name of
Sl. with Fathers
Age Occupation Village/P.O./Tq./D
No. Surna Name
ist./
me
Pin Code

II. Assets Owned

(Amount in Rs.)
Location
Present
(Specify Annual
Purchase Market
Details Door No. Income
Price (Rs.) Value
Sy.No.etc. (Rs.)
(Rs.)
)

III. Liabilities (both direct and indirect)

(Amount in Rs.)
Name of
Amo the
Present
Borrowed Amount unt Securi Borrower
Purpose Liabilit
from Availed Over ty in case of
y
due indirect
liability

IV. Net worth of Co-obligant/Guarantor [II-III] Rs._________

I/We offer to stand as Co-obligant/ Guarantor/s for the credit facilities to be

extended to _________________________.

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Declaration: I certify that all the information furnished by me/us may also be
exchanged by you with any agency you may deem fit, and that you, your
representatives, representative of Reserve Bank of India or any other agency as
authorized by you, at any time.

Place:
Date: Signature of Co-obligant/
Guarantor/s

FLOW CHART

Date of
Date of submis
Date final sion to Comments,
Sr. of complia next if any,
Particulars
No. Recei nce Delegat regarding
pt receive ed time taken
d Author
ity
At Delegated
1.
Authority 1
At Delegated
2.
Authority 2
At Delegated
3.
Authority 3

X--------------------------------Cut Here---------------------------------------X
ACKNOWLEDGEMENT

Received the Loan Application from Shri/

Smt._______________________________R/o
_______________________________ on____________________________
for the purpose of
_______________________________________________________________

For IDBI Ltd.

Place:
Date: Delegated Authority 1

Note: All application form along with the acknowledgement would be

numbered serially.