Head Office: SHGB HOUSE, PLOT NO.

1, SECTOR-3, ROHTAK- 124001 (HARYANA)

CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in
DATE: 20.06.2023

LOANS & ADVANCES CIRCULAR NO. 33/2023

ALL OFFICES

In supersession of L&A Circular No. 03/2019 dated 01.01.2019.

Reg: BORROWER / GUARANTOR STATUS CUM NET WORTH REPORT.

Detailed guidelines on compilation of Confidential Reports on borrowers and co- obligants have
been circulated vide HO L&A Cir. No. 03/2019 dated 01.01.2019.

As Computation of net means and recording borrower/guarantor information is an important part

in pre-sanction appraisal stage. During review, it was observed that the extant process of
compiling confidential report requires considerable time and efforts for gathering requisite
information. Also, incomplete / inaccurate information captured results in incorrect assessment
of borrower/guarantor’s net worth, Therefore keeping in view the current market practices, The
Hon’ble Board of directors in its 70th Meeting held on 15.06.2023 has approved BORROWER /
GUARANTOR STATUS CUM NET WORTH REPORT.

The detailed guidelines, are available at Annexure-I.

All concerned are advised to go through the guidelines carefully and ensure
meticulous compliance of the same. It is advised that wherever compilation of confidential
report has been referred in various guidelines, it shall mean compilation of Status cum Net
Worth (SNW) Report.

All Inspecting Officials are advised to note the guidelines to ensure its compliance.
In case of non-compliance of above mentioned guidelines the issue of non-
compliance may be flagged / reported to the competent authority for taking further
action in the matter.

General Manager
 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in
ANNEXURE-I
GUIDELINES FOR COMPILATION OF BORROWER / GUARANTOR STATUS
CUM NET WORTH (SNW) REPORT
1. APPLICABILITY
1.1 Borrower/ Guarantor Status cum Net worth (SNW) report shall be compiled for the
following Individuals:
CONSTITUTION TO BE COMPILED FOR
Sole Proprietorship Proprietor
Partnership firm Partner(s)
Limited Liability Partner(s)
Partnership
HUF Karta and all major co-parceners
Trust Trustee(s)
Society Office bearers as per the society bye laws
AOP Members executing inter-se agreement / Memorandum of
Understanding
Company (Pvt / Promoter Director(s) of the company. In other words SNW
Public) Report for nominee and independent directors (including
professional directors) need not be compiled.

1.2 In case of Partnership firm, LLP, HUF, Company, AOP, Trust & Society, the
Tangible Net-worth (TNW) as per the latest Audited Balance Sheet or CA Certified
provisional financials for the corresponding period shall be reckoned for discussing
the Net worth of the firm / company. No separate Net-worth for firm / company
/entity is required to be compiled.

1.3 Exempted categories:

SNW report in respect of following categories of advances need not be compiled:
a. Advances against Liquid Securities (viz. Bank Deposits, Jewellery & Gold,
Postal Securities, Govt. or Trustee Securities, Life Insurance policies)
irrespective of limits.
b. Advance against primary security of Shares, Debentures, Mutual Funds and
Bonds.
c. Advances to staff members under Staff Scheme / Public Scheme

d. TOD and Adhoc

 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in

e. All Loans (including Retail Advances) upto 10.00 Lakh fully secured by IP in
the form of Primary Security / Guarantee Coverage (eg. CGTMSE / CGFMU /
CGFSEL etc.,)
f. All other limits (including Retail Advances) upto 3.00 Lakh.

2. PERIODICITY FOR COMPILATION OF SNW REPORT

2.1 SNW report should invariably be compiled at the time of appraisal of credit
facilities (i.e. at the time of fresh / renewal / enhancement / additional facilities)
and the same shall be kept with credit appraisal documents. However, In
respect of Retail advances, the SNW Report would be compiled once only i.e.
at the time of sanction.
2.2 In case of adverse development (if any), fresh SNW report may be compiled
earlier as it may provide additional information relating to the account which
may be helpful in deciding future course of action. The relevant information
sheet about the account should also be extracted from the database of CIBIL /
other Credit Information Companies as prescribed.
2.3 For Term Loan accounts having exposure of 2 Crore and above, SNW report
shall be compiled once in two years. However in case account has slipped in
SMA-2 category during preceding one year, SNW report shall be compiled at
the time of annual review.

2.4 In respect of medium term advances granted to farmers, compilation of SNW

report may not be made if the repayment instalments, interest charges etc. are
regularly being paid by the borrowers.

2.5 SNW report will be compiled by Branch / Office along with credit appraisal and
same shall be kept with credit appraisal documents.

2.6 Non-compilation of the SNW report as per the laid down guidelines exposes the
bank to risks in case of unnoticed developments in the means and financial
position of the borrower/guarantor.
 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in

3. STANDARD OPERATING PROCEDURE ( SOP) FOR OBTENTION AND

COMPILATION OF SNW REPORT

A. Branch / Office wise designated officials for obtention and compilation of

SNW Report

(i) STANDARD ACCOUNT

BRANCHES
Maker Checker
Loan Officer Branch Manager
Note: For loans above 3 lakh and upto 10 lakh (including In case of Retail Advances
,Borrower / Guarantor Status cum net worth Report shall not be required to be
compiled.

B. Process to be followed in Branches

i. Branch
For Business Loan:
a. The Borrower / Guarantor shall fill the form (SHGB 905- Revised) and shall submit
the same along with loan application and other documents required for processing
the loan.
b. In respect of Business loans, the self-declaration given by borrower / guarantor
shall be considered for arrival of net means of the Borrower / Guarantor.
For Farm Advances:
The Borrower / Guarantor shall fill the form (SHGB 539-Revised) and shall submit the
same along with loan application and other documents required for processing the
loan.

For Retail Advances:

The Borrower / Guarantor shall fill the form (SHGB 282-C-Revised) and shall submit
the same along with loan application and other documents required for processing the
loan.

ii. Common Guidelines for For Business / Farm Advances:

a. The Borrower / Guarantor status cum net worth report shall be obtained in SHGB
form 282 A where sanctioned limits above Rs. 10 Lakh & up to Rs. 50 lakh and
SHGB form 282 B where sanctioned limits is above Rs. 50 Lakh.
b. The form 282-A / 282-B (as the case may be) shall be provided to the applicant
 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in
along with the Loan Application.
c. The applicant shall fill Part A of the prescribed form (282-A / 282-B as the case
may be)
d. In respect of Form 282-B, applicant shall submit either documentary proofs or CA
certified Net-worth statement (having UDIN number) not older than 30 days prior
to date of compilation of the report which shall form the basis of arrival of net-
worth.
e. In case of form 282-A, the official shall peruse the information provided in Part A
and calculate the Net-Means of the Borrower as provided in Part B of the form.
f. In case of form 282-B, the official shall peruse the information provided in Part A
along with the documents submitted by the borrower or CA Certified Net-worth
Statement (in case of 282-B) and calculate the Net-Means of the Borrower as per
Part B of the form.
`

C. GUIDANCE NOTE
Guidance note for compiling SNW Report is provided in Annexure-II.

4. OTHER GUIDELINES
In case of Business / Farm Advances above 50.00 Lakh, it is required to corroborate
the information provided by Borrower / Guarantor with either Documentary evidence
of Assets & Liabilities or CA certified Assets & Liabilities statement not older than 30
days prior to date of report compilation. Where Borrower/Guarantor opts to submit
documentary evidence in respect of Assets & Liabilities, the following shall be
adhered:

i. IMMOVABLE PROPERTY: For verifying property ownership, in place of title deeds,

other sources like municipal receipts, revenue records, rent deeds, electricity bills,
receipts for municipal taxes paid, may also be considered.
ii. OTHER ASSETS & LIABILITIES:
Liquid assets and liabilities of an individual can be verified, with reference to Bank
Pass Books, Fixed Deposit Receipts, physical verification of cash and original
share/debenture scrips, Income Tax/Wealth Tax Assessment Orders etc. Investment
in different firms can be verified from the books of the respective firms.
 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in

5. FORMATS
The revised formats for compiling Status cum Net-worth Report for Borrower /
Guarantor are as under:
No. Description Form Annexure
i. For Business Loan above 3 lakh and up to
10 Lakh: SHGB-905
III-A
Brief SNW Report of the Borrower / Guarantor (Revised)
(Part of Loan Application)
ii. For Business Loans / Farm Advances above
10 lakh and up to Rs. 50.00 Lakh – SHGB 282-A III-B
To be compiled based on Borrower’s/
(Revised)
Guarantor’s declaration
iii. For Business / Farm Advances above
50.00 Lakh –
To be compiled based on Borrower’s/
SHGB 282-B
Guarantor’s declaration along with either
(Revised) III-C
Documentary evidence of Assets & Liabilities or
CA certified Assets & Liabilities statement not
older than 30 days prior to date of report
compilation
iv. For Retail Advances:
Brief SNW report for Individual SHGB 282-C
borrower/guarantor. III-D
(Revised)
v. For Farm Advances having limits above 3
Lakh and up to 10 Lakh: SHGB 539
Simplified SNW report for Individuals / SHGs and (Revised) III-E
others
(Part of Loan Application)

**********************
 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in
Annexure II
GUIDANCE NOTE FOR COMPILING BORROWER / GUARANTOR STATUS CUM
NET WORTH REPORT IN AGRICULTURE / BUSINESS LOANS
SHGB 282-A PART A OF REVISED FORM (ABOVE 10 LAKH and UPTO 50.00 LAKH)
1. PERSONAL DETAILS
Name: :
S/o or W/o or D/o :
Date of Birth : As declared by individual
Aadhar Number :
PAN Number : To be verified from Online PAN Verification in Non-
CBS page
Residential Address :
Mobile number :
Alternate Mobile or :
Landline number
As declared by individual
Email Address :
Name of the Firm/ Company :
Constitution of the Firm / Company :

2. DETAIL OF IMMOVABLE PROPERTY Amt in Lakh

SN Nature of the Descriptio Owner Self- Value of Whether Encumbered / un-
property (Agri / n of the Name occupied Property encumbered / Partially
Residential Property /rented encumbered. If encumbered, give
/Commercial) details regarding Loan availed

As per CERSAI search for any

As declared by the individual
encumbrance*
TOTAL VALUE OF IP Rs _ (A)
* If the Property is kept as a security, the value should be considered for CR purpose after netting
the loan amount from value of property.
3. OTHER ASSETS Amt in Lakh
As declared by the individual
TOTAL OTHER ASSETS (B)
C)TOTAL ASSETS (A+B)

4. DETAILS OF LIABILITIES @ Amt in Lakh

(*To be verified from Credit Information Report)
Description Amount Description Amount
Home Loan* Personal Loan*
Car Loan* PF Loan
Other Loans * (Please Other Liabilities
specify) (Please specify)
Total Liabilities Rs_ (D)
5. Details of Personal guarantee offered by Individual for any person / firm / company
(*To be verified from Credit Information Report)
Guarantee favouring Name of the Bank Amount of Guarantee Validity period of
person / firm / company /Institution Guarantee

$ Jewellery belonging to the women in the family by way of Istri Dhan should not be added in the list of assets. The
Gold ornaments value shall not exceed 5% of total assets to be considered.
@ The liabilities, as declared by the Individual, or as per the information obtained in Credit Information Report,
whichever is higher, shall be considered for arrival of net means.
 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in
SHGB 282-B: PART A OF REVISED FORM (ABOVE 50 LAKH)
1. PARTICULARS OF THE COMPANY / FIRM
Name of the Company / Firm :
PAN of Company / Firm :
Constitution(Proprietorship/Partnership/ HUF/ :
Trust/ Society / Company etc.,)
As declared by the Individual
Registered Office Address :
Factory Address :
Names of Directors /Partners /Proprietor / :
Guarantors/ etc., of the Company / Firm

2. PERSONAL DETAILS
Name of Promoter Director / :
Partner / Proprietor /
Guarantor /……………
As declared by the Individual
S/o or W/o or D/o :
Date of Birth :
Aadhar number :
PAN : To be verified from Online PAN Verification in Non-CBS
page
DIN (In case of Directors) : To be verified from MCA portal
(https://www.mca.gov.in/mcafoportal/showEnquireDIN.do)
Mobile Number :
Alternate Mobile or Landline :
number
As declared by the Individual
Residential Address :
Permanent Address :
Email Address :
3. DETAILS OF IMMOVABLE PROPERTY
S.N Nature of the Description Owner Name Value of Whether Self-
property of the Property Encumbered / un- occupied
(Agri / Property encumbered / /rented
Residential Partially
/Commercial encumbered. If
) encumbered, give
details regarding
Loan availed
As per CERSAI As
As provided by the individual search for any provided
encumbrance* by the
individual
TOTAL VALUE OF IP _ (A)
* If the Property is kept as a security, the value should be considered for CR purpose after
netting the loan amount from value of property.
 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in

4. DETAIL OF MOVABLE PROPERTIES Amt in Lakh

(Based on information provided by the borrower or CA certified statement not older than
30 days prior to date of CR compilation)
(A) LIFE INSURANCE POLICIES
Policy Date of Sum Branch Annual Last premium Surrender Value
Number Issuance of Assured name Premium paid date as on…………
Policy

(B) INVESTMENTS IN SHARES / DEBENTURES /MFs ETC

Name of the Total Total Amount Whether held Whether fully Current Market
Company number of in Demat form paid Value as on
Shares ……………..
/Debentures/
MFs held

(C) Term Deposits

Name of Bank & Amount Maturity Date Maturity Value Whether kept as security
Branch

(D) INVESTMENT IN GOVERNMENT SECURITIES LIKE BONDS / NSCs etc.,

Bond/ Date of Issuing Office/Post Amount Due date Maturity Value
Certificate Purchase office address
number
(E) Any other Assets such as Gold ornament (Please specify$) _ Amt in lakh

(F) TOTAL OF ALL ASSETS (A) TO (E): Amt in Lakh

5. Investment / Equity in firm / company:
S.No. Name of Firm / Company Position held % Stake in Value (Amt in Rs
Ownership Lakh)
As provided by the individual

6. DETAILS OF LIABILITIES@ Amt in Lakh

(To be verified from Credit Information Report*)
Description Amount Description Amount
Home Loan* Personal Loan*
Car Loan* PF Loan
Other Loans* (Please Other Liabilities
specify) (Please specify)
Total Liabilities (D)
7. Details of Personal guarantee offered for any person / firm / company
(To be verified from Credit Information Report*)

Guarantee favouring Name of the Bank / Amount of Guarantee Validity period of

person / firm / company Institution Guarantee

$ Jewellery belonging to the women in the family by way of Istri Dhan should not be added in the list of assets. The
Gold ornaments value shall not exceed 5% of total assets to be considered.
@The liabilities, as declared by the Individual, or as per the information obtained in Credit Information
Report, whichever is higher, shall be considered for arrival of net means.

************
 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in

ANNEXURE III-A
SHGB 905 (Revised)
BORROWER / GUARANTOR STATUS CUM NET WORTH (SNW) REPORT
(For Business Loans above Rs. 3 Lakh and up to Rs. 10 Lakh)
1. PERSONAL DETAILS
Name: :
S/o or W/o or D/o :
Date of Birth :
Aadhar Number :
PAN Number :
Residential Address :
Mobile number :
Alternate Mobile or :
Landline number
Email Address :
Name of the Firm/ :
Company
Constitution of the Firm :
/ Company
2. ASSETS AND LIABILITIES AS ON ______
Amount in Rs. Lakh
ASSETS LIABILITIES
DESCRIPTION AMOUNT DESCRIPTION AMOUNT
i. i.
ii. ii.
iii. iii.
iv. iv.
v. v.
TOTAL (A) TOTAL (B)
NET MEANS (A) – (B)

3. DECLARATION
I solemnly declare that the particulars furnished by me is complete, true and correct.

Signature / Thumb impression of Borrower / Guarantor ____________________

Witness Signature _________________________

(In case of illiterate borrower)
Name of the Witness:
Address of the Witness:
Place: Date:
 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in

ANNEXURE III-B
SHGB 282-A (Revised)
BORROWER / GUARANTOR STATUS CUM NET WORTH REPORT
FOR BUSINESS LOAN/ FARM ADVANCES ABOVE
Rs.10 LAKH and UPTO Rs.50.00 LAKH
PART A – To be filled by the Individual (Promoter Director/ Partner/ Proprietor/
Guarantor etc.,)
1. PERSONAL DETAILS

Name: :
S/o or W/o or D/o :
Date of Birth :
Aadhar Number :
PAN Number :
Residential Address :
Mobile number :
Alternate Mobile or :
Landline number
Email Address :
Name of the Firm/ :
Company
Constitution of the Firm :
/ Company

2. DETAIL OF IMMOVABLE PROPERTY Amt in Lakh

S.N Nature of the Description Owner Value of Whether Self-
property (Agri / of the Name$ Property Encumbered / occupie
Residential Property * un-encumbered / d
/Commercial) Partially /rented
encumbered. If
encumbered,
give details
regarding Loan
availed

A. TOTAL VALUE OF IP `_______________ (A)

* Description to provide details regarding House No, Plot No., Survey No (Khasra No. in case
of Agricultural Land) Door No. Town Survey No/ Village Ward/Taluk Mandal /District City/State
$
In case of Joint ownership, mention the details of ownership and percentage share
 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in

3. OTHER ASSETS Amt in Lakh

Description Value Description Value Description Value
NSC / Surrender PF & PPF Deposits with
Value of LIC Bank
Mutual Funds Gold Others (please
/Shares & Ornaments specify)
Debentures

TOTAL OTHER ASSETS ` ____________(B)

(C)TOTAL ASSETS `__________________ (A+B)

4. DETAILS OF LIABILITIES Amt in Lakh

Description Amount Description Amount
Home Loan Personal Loan
Car Loan PF Loan
Other Loans Other Liabilities*
(Please specify) (Please specify)

Total Liabilities `__________________(D)

5. INVESTMENT / EQUITY IN FIRM / COMPANY:

S.No. Name of Firm / Company Position held % Stake in Amt in Lakh

Ownership

6. Details of Personal guarantee offered by borrower / guarantor for any person / firm /
company
Guarantee favouring Name of the Bank Amount of Validity period of
person / firm / /Institution Guarantee Guarantee
company
 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in

DECLARATION:

 I solemnly declare that the particulars furnished by me is complete, true and correct.
 I undertake to furnish original /supporting documents, if needed by Bank for verification.


 I hereby declare that there is no litigation against me or the firm /company/ in which I am
the proprietor/ partner or director.

Please paste
Signature of the Borrower / Guarantor recent
Place: passport size
Date: photo

* Include taxation liability, if any.

Note: In case of insufficient space, please attach separate sheet
 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in

PART –B FOR OFFICIAL USE

CERTIFICATE:
1. As per information provided in Part A and other information, it is observed that Shri/Smt
__________________Director/ Partner / Proprietor / Guarantor /______________ of M/s

___________________is having Net Means of ` ___________ as on _________.

2. Net-means calculation:
(` in Lakh)
Value of Immovable Property as declared in Part A (A)
Other Assets (B)
Assets other than (A) and (B), if any & details thereof
S.No. Detail of Asset Amount
(i)
(ii)
Total (C)

Total Assets (D) = (A)+(B)+(C)

Less Liabilities as declared in Part A (E)
Liability other than E, if any & details thereof:
S.No. Detail of Liabilities Amount
(i)
(ii)
Total (F)
Total Liability (G) = E+F
NET MEANS (H) = (D) – (G)

3. The previous Net means* of Shri / Smt ______________ was `___________ as on

__________.

Prepared By Checked by
Name: ____________________ Name: _______________________
Designation________________ Designation___________________
PF No:____________________ PF No_______________________

Place:
Date:

* In case of major variance in net means, the reasons be mentioned.

 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in

ANNEXURE III-C
SHGB 282-B (Revised)
BORROWER / GUARANTOR STATUS CUM NET WORTH REPORT
(FOR BUSINESS LOANS/FARM ADVANCES ABOVE Rs.50.00 LAKH) –

PART A – To be filled by Individual (Promoter Director / Partner / Proprietor/

Guarantor etc.,)
1. PARTICULARS OF THE COMPANY / FIRM
Name of the Company / Firm :
PAN of Company / Firm :
Constitution(Proprietorship/Partnership/ HUF/ :
Trust/ Society / Company etc.,)
Registered Office Address :
Factory Address :
Names of Directors /Partners /Proprietor / : (1)
Guarantors/ etc., of the Company / Firm (2)
2. PERSONAL DETAILS
Name of Promoter Director / Partner / :
Proprietor / Guarantor /………………
S/o or W/o or D/o :
Date of Birth :
Aadhar number :
PAN :
DIN (In case of Directors) :
Mobile Number :
Alternate Mobile or Landline number :
Residential Address :
Permanent Address :
Email Address :
3. DETAILS OF IMMOVABLE PROPERTY (Amt in Lakh)
S.N Nature of the Description Owner Value of Whether Self-
property (Agri / of the Name $ Property Encumbered / occupi
Residential Property * un-encumbered / ed
/Commercial) Partially /rented
encumbered. If
encumbered,
give details
regarding Loan
availed

TOTAL VALUE OF IP ` _______________ (A)

 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in

* Description to provide details regarding House No, Plot No. Survey No (Khasra No. in case
of Agricultural Land) Door No. Town Survey No/ Village Ward/Taluk Mandal /District City/State
$
In case of Joint ownership, mention the details of ownership and percentage share

4. DETAIL OF MOVABLE PROPERTIES (Amt in Lakh)

(A) LIFE INSURANCE POLICIES
Policy Date of Sum Branch Annual Last Surrender
Number Issuance Assured name Premium premium Value as
of Policy paid date on…………

(B) INVESTMENTS IN SHARES / DEBENTURES /MFs ETC

Name of Total Total Amount Whether Whether Current
the number of held in fully paid Market Value
Company Shares Demat as on
/Debentur form ……………..
es/ MFs
held

(C) Term Deposits

Name Amount Maturity Date Maturity Value Whether kept as
of Bank security
&
Branch

(D) INVESTMENT IN GOVERNMENT SECURITIES LIKE BONDS / NSCs etc.,

Bond/ Date of Issuing Amount Due date Maturity Value
Certificate Purchase Office/Post
number office address

(E) Any other Assets such as Gold ornament (Please specify) _________ (Amt in `lakh)

(F) TOTAL OF ALL ASSETS (A) TO (E): _______________ (Amt in Lakh)

5. Investment / Equity in firm / company
S.No. Name of Firm / Company Position held % Stake in Amt in Lakh
Ownership
 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in

6. DETAILS OF LIABILITIES (Amt in Lakh)

Description Amount Description Amount

Home Loan Personal Loan

Car Loan PF Loan

Other Loans Other Liabilities*

(Please specify) (Please specify)
Total Liabilities `___________________(D)
7. Details of Personal guarantee offered for any person / firm / company
Guarantee favouring Name of the Bank Amount of Validity period of
person / firm / / Institution Guarantee Guarantee
company

DECLARATION:

 I enclose self-attested photocopies of relevant documents / CA Certified net worth

statement in support of information provided herein. I undertake to furnish original /
supporting documents, if needed by Bank for verification.

 I hereby declare that there is no litigation against me or the firm / company in which I am
the proprietor/ partner / director /guarantor/________ (please specify).

 I solemnly declare that the particulars furnished by me is complete, true and correct.

Please paste
recent passport
size photo

Signature of the Promoter Director /Partner / Proprietor/ Guarantor

Place:

Date:
* Include taxation liability, if any.
Note: In case of insufficient space, please attach separate sheet.
 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in

PART –B FOR OFFICIAL USE

CERTIFICATE:
1. As per information provided in the overleaf along with CA certified Net-worth Statement or
perusal of supporting documentary proofs and other information, if any, it is observed that
Shri/ Smt/ ______ Director/Partner/Proprietor/Guarantor/________ of M/s __________is
having a Net Means of `__________ as on ________________.

2. Calculation of Net means: ` in Lakh

Value of Immovable Property as declared in Part A (A)
Other Assets (B)
Assets other than (A) and (B), if any & details thereof
S.No. Detail of Asset Amount
(i)
(ii)
Total (C)

Total Assets (D) = (A)+(B)+(C)

Less Liabilities as declared in Part A (E)
Liability other than E, if any & details thereof:
S.No. Detail of Liabilities Amount
(i)
(ii)
Total (F)
Total Liability (G) = E+F
NET MEANS (H) = (D) – (G)
3. We estimate the net means* (excluding investment in Borrowing firm / company) of
Shri / Smt _________________ at ` ____________.

4. We estimate the net means (including investment in Borrowing firm / Company) of Shri/Smt
_______________ at ` ______________
5. The previous Net means** of Shri/Smt/Kum ______________ was `___________ as on
__________.
* The Net means of individual refers to net means excluding investments made by Individual in
Borrowing firm / company.
** In case of major variance in net means in comparison to previous year, the reasons be mentioned.

Prepared By Checker
Name:____________________ Name:_______________________
Designation______________ Designation__________________
PF No:__________________ PF No_________________
Place:
Date:
 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in

ANNEXURE III-D
SHGB 282-C (Revised)
BORROWER / GUARANTOR STATUS CUM NET WORTH REPORT FOR RETAIL
ADVANCES HAVING LIMITS ABOVE Rs.3.00 LAKH
1. PERSONAL DETAILS
Name: :
S/o or W/o or D/o :
Date of Birth :
Aadhar Number :
PAN Number :
Residential Address :
Office Address
Mobile number :
Email Address :
Name of the Employer (in :
case of salaried
professional)
Name of the Firm/ Company :
(In case Self Employed/
Business)
2. A. Income as per last three ITR, (wherever applicable)
(Mention the latest followed by preceding two years)
FINANCIAL YEAR INCOME (` in Lakh)
FY____:______
FY____:______
FY____:______
2.B Income as per latest Salary Slip (In case of salaried professional)

(` in Lakh)
3. ASSETS AND LIABILITIES OF BORROWER / GUARANTOR AS ON ______
LIABILITIES ASSETS
Description Amount Outstanding Loans Amount
Immovable Properties From Bank/FI: (Details
Land be provided)
Building From Employer
Movable Properties Other
Deposits with banks
Investment in Govt.
Security/LIC/NSC etc.,
Others (Please specify)
TOTAL (A) TOTAL (B)
NET MEANS OF BORROWER / GUARANTOR (B) – (A)
 Head Office: SHGB HOUSE, PLOT NO. 1, SECTOR-3, ROHTAK- 124001 (HARYANA)
CREDIT ADMINISTRATIVE DIVISION - Email: holoanshgb@shgbank.co.in

ANNEXURE III E
SHGB 539 (Revised)
BORROWER / GUARANTOR STATUS CUM NET WORTH REPORT
(For Farm Advances above Rs.3 Lakh and up to Rs.10 Lakh to
Individuals/SHGs/Others)
Office: _____________ Date: ___________

Particulars Borrower First Second

Guarantor Guarantor
1. Name
Father’s name
2. Address

3. Occupation
4. Reputation
5. Means as at_________ Amt in `
(i) Cash / Bank Balance
(ii) Stock
(iii) Live Stock
(iv) Agr. Implements
(v) Immovable Properties
(vi) Other Assets (Specify nature)
(vii)
(viii)
A. TOTAL ASSETS
6. Liabilities
(i) Sundry Creditors
(ii) Due to us
(iii) Borrowing against Immovable properties
(iv) Other loans
(v) Taxation liabilities
(vi) Other Liabilities (Specify nature)
B. TOTAL LIABILITIES
NET MEANS: (A-B)
7. Contingent Liabilities
(i)
8. Remarks
9. Details of Immovable Properties
Description Value
(i)
(ii)
10. Annual Income
From Agriculture
Other Sources
TOTAL INCOME
DECLARATION
I solemnly declare that the particulars furnished by me is complete, true and correct.
Signature / Thumb impression of Borrower / Guarantor ____________________