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Application For Loan Assistance

The document is a loan application form for an individual seeking financial assistance from the National Handicapped Finance and Development Corporation. It requests loan assistance and provides applicant details like name, contact information, address, disability status, income details, project details, bank account information, and certificates. It must be submitted along with required documents like identity, residence, and disability proofs, photographs, income tax returns, and details of any existing loans.

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Tarik A R Biswas
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© © All Rights Reserved
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69 views4 pages

Application For Loan Assistance

The document is a loan application form for an individual seeking financial assistance from the National Handicapped Finance and Development Corporation. It requests loan assistance and provides applicant details like name, contact information, address, disability status, income details, project details, bank account information, and certificates. It must be submitted along with required documents like identity, residence, and disability proofs, photographs, income tax returns, and details of any existing loans.

Uploaded by

Tarik A R Biswas
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Application for Loan Assistance

To,
National Handicapped Finance and Development Corporation, Unit-11 & 12, DLF Prime
Tower, Ground Floor, Okhla phase-1, New Delhi-110020.
I/We request you to grant me/us the loan assistance as indicated below. The necessary
particulars are given as under:
PARTICULARS

1. Project Name
2. Name of applicant
3. Contact no. of applicant
4.(1) Adhar Card No.

(2) PAN Card


(Attach self attested Copy)
5. Address
(indicate district and
State clearly) Give proof of
address
6. Date of birth / Age
7. Disability type & percentage
(Attach attested copy of
certificate)
8. Caste/category
9. Sex (M/F)
10. Annual income
11. Relevant experience
12. Education/training
13. Any other Loan/Financial
Assistance received from
Central/State Govt. {Y/N}
14. If Yes, then please give
particulars of such
loan/assistance including
outstanding, if any.
15. Residence :
Owned/rented/Any other
(Please specify)
16. Project cost
17. NHFDC share
18. Repayment period
19. Moratorium period (month)
20. No. of installments
21. Installment
(Principal + Interest)
22. Repayment mode
(Monthly/Qrly)
23. Attach Project Report indicating
Revenue inflow and outflow
Continued in Page-2
1
:2:

24. Marketing Tie-up


(attach separate sheet)
25. Place of Business
(Complete address of
business to be stated)
26. Bank Account Details

i) Account No.

ii) Account Type


(SB/CC/CA/Any Other)
iii) IFS Code

iv) Branch

27. Project supported by:

28. Certificate

i) I /we certify that all information furnished by me/us is true; that

ii) I/We have no borrowing arrangements for the unit with any Bank / Financial
Institutions, except mentioned above; that

iii) No legal action has been /is been taken against me/us; that

iv) I /We shall furnish all other 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/ any other
agency authorized by you may at any time to inspect/obtain any information or
records.

I /We further certify that I /We do not have any overdue in respects of any financial
assistance I /We have availed so far.
Signature of the Applicant
(Name in Block Capital)

Signature of Guardian
(in the case of Intellectually challenged)
Place :
Date :
Note :
i) Please attach three copies of pass port size and full size photographs.

ii) Each column of the application format should be properly filled up giving
appropriate information/suitable remarks. No column should be left blank,
instead write ‘NA’ / ‘Not Applicable’ in the blank column.
***

C:\Users\user\Downloads\Annexure-IV-Loan Application_Format.doc
For Official Use only

To be submitted by Nominated Vishesh Udyami Mitra Agency

We have advised the applicant Mr. / Mrs. /Ms. ______________ S/o/D/o/W/o


______________ with regards to his /her application for loan to NHFDC, and have gone
through the details of the Project/Project report and having done so, are of the view
that the said project is viable. Also, we have verified the submitted copies of KYC
documents with the originals of the said applicant. The residential/business premise
has also been visited and verified. Having satisfied ourselves about the above, we
request that this project may kindly be considered for sanction of financial assistance.

Name , Designation &


Signature of the Organisation
handholding the Applicant with
Rubber Stamp

(Name in Block Capital)

Place :
Date :

C:\Users\user\Downloads\Annexure-IV-Loan Application_Format.doc
S. No. Mandatory Documents Tick whether
submitted

1 Copy of Disability Certificate


2 Proof of identity- Voter’s ID Card / Passport/ driving license / PAN Card / Aadhar Card
3 Proof of residence – Recent telephone bill, electricity bill, property tax receipt/ passport/
Voter ID Card
4 Photos of Applicant (Three Passport size and three Full size out of which one passport size
photo be pasted on the body of the form to be signed by the project supporting agency )

S. No. Optional Documents Tick whether


submitted
1 Electricity bill/Telephone Bill/ maintenance bill/tax paid for properties offered as collateral
security and copies of title documents of the same.
2 Latest copy of income-tax return / Assessment order etc.
3 Copies of Sales Tax / Income Tax return
4 Statement of Bank account for the last 6 months
9 Sanction letters of facilities presently being availed from existing bankers/Financial
Institutions along with detailed terms and conditions.
10 Others (As applicable)

***

C:\Users\user\Downloads\Annexure-IV-Loan Application_Format.doc

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