VIJAYA BANK
Branch :
APPLICATION FOR BANK FINANCE UNDER “VIJAYA WHEELS”
 
Photo
[to be stapled]
Sl No Details Information
1. Name  
2. Age  
3. S/O, W/O, D/O  
4. PAN / GIR Number  
5. Residential address with phone number
a. Present address Address :

Phone No :
b. Permanent address Address :

Phone No :
6. SB / C.A/c No :
Date of Opening :
7. Particulars of other deposits / accounts held with Vijaya Bank / Any other Bank
Nature & Number of deposit Depositor’s name Relation with the applicant Due date Balance (Rs)
         
         
8. Existing liabilities
Lender’s name Nature of facility Amount outstanding Security offered
       
       
9. Name & address of two references not related to the applicant 1.


2.

 
10. In case of salaried persons
a. Name of institution, where the applicant is working Amount outstanding
b. Address of the institution  
c. Name of Salary disbursing Authority with his / her designation & phone number
Name : ________________________
Designation : ________________________
Phone No : ________________________
d. Monthly salary [Attach latest pay slip] Rs.
11. In case of non-salaried persons
a. Occupation Amount outstanding
b. Annual income Rs.
c. Net worth as per enclosed Statement of Assets & Liabilities (2-26(a)) – [Applicable in case of Non-IT assessees]  
d. Year up to which IT returns are filed [Attach a copy]  
e. Year up to which assessment is done [Attach a copy]  
f. Office address with phone number Address :


Phone No :
12.
Purpose of the loan:




For purchase of new / second hand /used

Motor Vehicle for private / business use as per details furnished.		 Two Wheeler / Motor Car  
New / Used  
Model / year of mfg:  
Make:  
Type:  
Invoice / Purchase price:  
Total Accessories’ price:  
Dealer’s / Vendor’s Name:  
Registration Expenses:  
Expected delivery date:  
IN CASE OF USED VEHICLE
Market value / value as per Valuation report :
Name of the valuer : 		 
Vehicle for private use/ profession / business use as described above.  
 
13. Securities offered & value 1. Hypothecation of the above said vehicle.
2.
14. Amount of loan sought Rs.
15. Instalments sought [Maximum of 60 months]  
16.
Guarantor/s I Guarantor II Guarantor
a. Name    
b. Age    
c. Son / Wife / Daughter of    
d. Occupation    
e. Annual income [Attach Salary Certificate / Copy of IT assessment order] Rs. Rs.
f. Net worth as per enclosed Statement of Assets & Liabilities (2-26(a)) – [Applicable in case of Non-salaried persons] Rs. Rs.
g. I agree to stand as a guarantor for the above applicant. The information furnished above by me is true and correct to the best of my knowledge and belief.



GUARANTOR/S

Date:
17. Declaration / Authorisation:
I have read the rules of the scheme, understood the contents and agree to abide by. The information furnished above is true and correct to the best of my knowledge. I hereby request and authorise you to remit the proceeds of the loan directly to the dealer/vendor collecting margin money from my account. All the instalments, interest and / or other charges may be debited to my above account/s




APPLICANT

Place :
Date:
18. SPACE FOR PROCESSING / FORWARDING REMARKS (including gist of credit reports from the Banks & market reports)





OFFICER / MANAGER / SENIOR MANAGER
 
19. Finally I do sanction the following :
Sanction No:  
Rate of interest _________ % p.a.
Terms of repayment/EMI  
Facility  
Amount Rs.
Security with margin  
Other conditions  
Date  






SANCTIONING AUTHORITY

NAME:
DESIGNATION: