PERSONAL FINANCE APPLICATION

Date: To The Consumer Lending Unit, Mega Bank Nepal Limited .................. Branch Nepal. Dear Sir/Madam, I/We hereby apply for a/an (New/Additional) Loan of NPR ................................................................................ (Nepalese Rupees ............................................................................. Only) under the Personal Finance Scheme of your Bank for the purpose of: Purchase of Consumer Goods Educational Others Purchase of Professional Equipments Social Events

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1. PERSONAL DETAILS OF THE APPLICANT(S)

Name (Mr. /Mrs./Ms) Occupation Date of Birth Citizenship No. : : : :

Permanent Residence : Present Residence :

Local Address & Contact Person (if any) : Ownership of Residence : Own: Co. provided: Mailing Address/ Work Address Grand Father's Name Father's Name Spouse's Name : : : : Children: Work: Others: 1/4 Others: Mobile: Father/Mother's name: Others: Rented:

Total Number of Dependents: Telephone No. Home:

Bank Account with MEGA BANK LTD:

2. EMPLOYMENT DETAILS OF THE APPLICANT

Your Occupation Name of Employer Post/Designation Terms of Service Contract Expiry/ Retirement date Previous Employer (If any) Post/Designation

: : : : Years in service: Contract: Permanent

: :

Years in service:

3. DETAILS OF THE GUARANTOR

Name(s) Nature of Business

: : Children: Others:

No. of Dependents (for individual): Father's Name Grand Father's Name Spouse's Name Date of Birth Citizenship No. Mailing Address Present Residence Work Address Tel No. Net Worth Details: Land NPR: Liabilities (if any) Loans NPR: Annual Income: Declaration: Building NPR: : : : : : : : : : Home:

Relationship with the applicant:

Work:

Mobile:

Others (Bonds, Shares etc):

Mortgaged Properties: Amount of other guarantee commitments:

I hereby certify that the information provided above is true and correct.

Signature of the Guarantor Name: Seal: 2/4

4.Financials as at ...................................................... of ................................................ Name(s)

LIABILITIES
Loans at Mega Credit Card from Mega Loans from other banks (please provide details) Credit Cards from other Banks (if any) Other Liabilities (If any)

NPR

NPR
FOR Bank's Use

ASSETS
Saving/Current a/c at Mega Accounts with other banks/ Finance companies Land/building: Location: Owner's name: Vehicles/motorcycle: Other assets: (If any)

NPR

NPR
FOR Bank's Use

TOTAL

TOTAL

NET WORTH = NPR MONTHLY INCOME Salary Spouse's Salary Rental Income Business Income Other income (If any)
TOTAL

NPR

NPR
FOR Bank'sUse

MONTHLY EXPENSES Any loan repayments/ including Credit Card exp. Rental obligations Insurance Premium payments Living Expenses Education/Medical/Food/Etc. Other Expenses (If any)
TOTAL

NPR

NPR
FOR Bank's Use

NET INCOME = NPR

Declaration:
I/We hereby declare that the information giving above in this format is true and correct. If proven otherwise, I/We agree to bear all the legal consequences. I/We agree to accept all the term & condition/s of the Bank that are in force including amendment thereto unilaterally by the Bank from time to time or any condition stipulated by the Regulatory Authorities. I/We confirm that there are no insolvency proceedings against me/us nor have I/We ever been declared insolvent. I/We understand and agree that the interest rate shall be revised annually and re-fixed by the Bank unilaterally. I/We hereby authorize the Bank to debit my/our account or to set-off any deposits to pay the charge , interest, principal or any other dues related to this loan. I/We further agree to pay charges (if any), as per the Bank's policy, with the withdrawn of the proposal after submission of this Loan Application. I/We agree that the Bank may refer my/our name to a recognized credit or referencing agency/ies and make such references as the Bank may consider it necessary. I/We hereby authorize the Bank to disclose such information relating to my/our credit facility to such parities as deemed necessary at the sole discretion of the Bank. Further, I/We acknowledge and agree that a request and demand for any information to any authority under the statutory law will be compiled by the Bank.

Signature of the Applicant Name: Date:

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Following are the details of credit facilities with other banks/financial Institutions:
Names of other Total banks/Fls from where Limits/Outstanding credit facilities availed Date*: *(Should not be older than last quarter-end; last month-end preferred)
Limits Outstanding

Overdue Yes/No (If yes, specify date)

Security Details Nature of Security(a) Details(b) (Location/ name of guarantors, etc.)

Remarks/ other Info.

1. ................... Bank/FI * Working Capital Loans * Term Loans * Other Loans * Non Funded facilities Total 2. ................... Bank/FI * Working Capital Loans * Term Loans * Other Loans * Non Funded facilities Total 3. ................... Bank/FI

Grand Total
Please attach additional sheets in case of insufficient space or for additional details of security and other remarks, if any. (a) Please mention as appropriate: Current Assets, Land & Building, Personal guarantees, FDs, Bonds, Cash, Others, etc. (b) Location/Plot #/ Amount/Names of guarantors, etc.

I/We confirm that the information provided above is correct. In case of mis-representation and/or the information provided is proved to be incorrect I/we assume full responsibility for any consequences thereof and agree that the Bank may prosecute me/us as per prevailing law. I/We hereby declare that my/our total credit exposure in banks and financial institutions is not more than Rs. 10 million as of date. I/We will inform you within 15 days if the exposure crosses Rs. 10 million.

Signature of the Applicant(s) Name: Date: KINDLY ENCLOSE THE FOLLOWING DOCUMENTS
1. Photograph of applicant (2 copies) / Photographs of co-applicant (2 copies) 2. Photocopy of Office ID card (with the original to be sighted) 3. Photocopy of Citizenship / Passport / Driving License [ (with the original to be sighted) for applicant & co-applicant.] 4. Salary Certificate with designation, terms, tenure, contract expiry/retirement date etc. 5. Copy of Land ownership Certificate. 6. Bank a/c statement for 3-6 months.

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