PART-II
CENT LIQUID
(For Common Application Form, Guarantor’s Consent Letter & Acknowledgement-Please fill PART-I)

A. DETAILS OF SECURITIES (IN DEMAT FORM)
NAME OF THE COMPANY MARKETABLE
LOT NO OF SHARES
OFFERED AV. PRICE OF LAST 6 MONTHS
a)
b)
c)
d)
e)
f)
g)
h)

B. DEMAT ACCOUNT INFORMATION
PARTICULARS APPLICANT CO-APPLICANT
Depository’s Name
Depository Participants Name
Depository Participants I.D.Number
Applicants I.D.number

C. DETAILS OF FINANCE REQUIRED
Loan amount required Rs.
Purpose of Loan
Proposed Repayment in _________Years.
Whether Installments will be paid by applicant directly YES/NO
Whether Post dated cheques for repayment will be given YES/NO
I / we submit the following papers / documents in support of my/our above submission (Please mark tick against each)
i Original Share Certificates and other relevant documents.
ii Latest I.T.Return/I.T. Assessment order/ Form no 16.
iii Proof of Other Income.
iv Latest statement of Share Holding issued by D.P.
v Photo ID or Proof of residence in the form of
vi PAN Card
vii Election ID card
viii Pass port
ix. ID card issued by employers
x. Govt / Defence ID Card.

Further I/We make the following declarations:

a. I/We am/are the resident Indian/s
b. The amount sanctioned shall be used by me/us for the purpose as stated above only. The amount shall not be used for illegal/unlawful activities.
c. I/We undertake to execute the documents as per the requirement of the Bank from time to time and to abide by all the terms and conditions stipulated by Bank/RBI from time to time.
d. I/We also understand that the loan/overdraft sanctioned to me shall at the discretion of the Bank and the Bank is entitled to reduce the limits sanctioned or demand repayment partly or wholly at any point of time.
e. I/we authorize the Bank to debit my account with your Bank for any interest/commission and other charges as stipulated by the bank from time to time.

Signature of the Applicant Signature of the Joint-Applicant
Place
Date