always with U Odisha Gramya Bank ………………………….Branch OGB TRADERS APPLICATION FORM Passport Size Photo of the Applicant I/We here by apply for a Term Loan/Cash Credit of Rs………………. (Rupees……………………………............................only, for ……………… ……………………………, which may kindly be sanctioned. I/We furnish the details as under. Applicant’s Name Particulars of the Applicant 1 Constitution (Individuals/Proprietorship/Partnership/Company) 2 Statutory Requirements of the constitution Permanent Account Number TIN Number Corporate Identification Number (CIN) Entrepreneurs Memorandum Number 3 Key Promoters Information Name of the Individual/s / Proprietor/s / Partners / Managing Director/ Directors Sl.No Name Father/Husband’s Name Age Designation A B C D Mobile/Land line phone(with STD code) Email Permanent Account Number A C Voter ID Number A C Aadhar No (UID) A C Driving License No A C 4 Address of Residence/Regd / Admn office 5 Address of factory / unit at 6 Group to which the company belongs 7 Date of establishment / Incorporation B D B D B D B D Worth (Rs. In Lacs) 8 12 Date of commencement of commercial production/Trade Whether the factory /business premises is Owned or leased. If leased whether the Lease Agreement is in force and valid till Installed / licensed / utilized capacity Activity (State whether the above activity is covered under the “Main Objects Clause” or “Other Objects Clause” in the Memorandum of Association) Industrial classification 13 Products manufactured/Traded 9 10 11 Capacity utilization for last two years(actual), estimation for Current year , projection for next year to be furnished. 14 Capital Structure a Authorised Capital as on b Paid up Capital as on 15 Share holding pattern Name Number of shares held Face value of share hoding % of holding I ii iii iv v 16 a b c Banking Arrangements Dealing with Odisha Gramya Bank since Has the company power to borrow Present banking arrangement : (Exclusive/ Consortium/Multiple) d Leader (in case of consortium) (Incase of Consortium advances, copies of latest sanction letters of other member Banks to be furnished) e Details of credit facilities with OGB as on Name of the Branch WC-Fund based WC-Non fund based Limits i ii iii Total O/s Limits O/s Term Loans Limit O/s f Details of credit facilities with other Banks and financial institutions as on Name of the Bank/ FIs WC-Fund based WC-Non fund based Term Loans Limits O/s Limits O/s Limit O/s i ii iii Total 17 Brief History(Brief profile of the unit with Names of the promoters and their background/ their experience in the line of activity) (Separate Sheet may be attached, if necessary) 18 Technical Aspects :(Indicate the nature of process and also arrangements made for pollution control/ position regarding statutory permissions obtained from pollution control authorities) 19 Experience of Key Personnel 20 Marketing arrangements 21 Major developments, if any, that have taken place in the company/Unit 22 Areas of strength and weakness 23 Future outlook of the company/Unit 24 Present actual monthly production/sales during current year : (upto date of submission of application) Month Particulars Quantity Jan-Mar Apr-Jun Jul-Sept Oct-Dec Total Sales Value 25 Brief Financial Indicators of the Company/Firm Year ending Audit status FYAudited FYAudited FYAudited FYEstimated FYProjected Net Sales Growth in Sale Depreciation Net Profit After Tax Total Assets Fixed Assets Current Assets Intangible Assets Total Liabilities Paid up capital Reserve & Surplus Term Liabilities WC from OGB Other Current Liabilities Net working capital Current ratio 26 Security Coverage Type For existing limits Description Value Date of valuation For proposed limits Description Value Date of valuation Primary Collateral 27 Margin : The margin for existing limits and proposed limits may be considered at the following rates Facility For existing limits For proposed limits Security Margin % Facility Margin % 28 Sl 1 Particulars of the guarantors Name & Address Age/ DOB Net worth As on Date Relation 2 3 4 In case of Corporate Guarantee, necessary resolution from the Company offering guarantee shall also be furnished 29 Particulars of Associate/Group concerns dealing with Odisha Gramya Bank: (Nature of overdues, if any ,shall be discussed in detail) (Rs in lacs) Name of concern Activity Facility Limit O/S Over-dues 30 Particulars of Associate/Group concerns dealing with other Banks Name of the Name of the Particulars of credit limits O/s as on concern Bank Facility Limit Branch at which it is availed (Rs in lacs) Overdues (Furnish financial statements of associate/group concerns separately for the last three years) 31 Current Account with our Bank Name of the Branch Purpose 32 Current Accounts with other Banks Name of the Branch Purpose Whether proprietor/partner/director and guarantor has any relationship with any officials of the bank and/ or a close relative of any staff member of the bank and/or a director of any bank and / or a specified near relative of any Director of any bank. If so details may be furnished Place: Date: Signature of the applicant Unit Visit Report and Recommendation by Branch Signature of Officer (Advances) Signature of BM