BANK OF BARODA
APPLICATION FORM FOR MSEs
To be submitted along with documents as per the checklist
1. NAME OF THE ENTERPRISE:
2. REGD. OFFICE ADDRESS:
3. ADDRESS OF FACTORY/ SHOP:
4. WHETHER BELONGS TO SC/ST/OBC/MINORITY COMMUNITY:
Telephone Nos E-mail Address
(Office)
Mobile No. PAN Card No.
5. CONSTITUTION: Proprietary/Partnership firm/Pvt. Ltd./Ltd. Company/Co-op. Society
6. DATE OF ESTABLISHMENT:
7. NAME OF PROPRIETOR/PARTNERS/DIRECTORS OF COMPANY AND THEIR ADDRESSES:
Academic Telephone
Experience in the
Name Age Qualifica- Residential Address No.
line of Activity
tion (Residence)
8. ACTIVITY: Existing:
Proposed:
(If a different activity other than existing activity is proposed)
9. NAMES OF ASSOCIATE CONCERNS AND NATURE OF ASSOCIATION:
Extent of Interest as a
Name of Associate Presently Banking Nature of Prop. / Partner / Director
Address
Concern with Association OR just Investor in
Associate Concern
Relationship of Proprietor/Partner/Director with the
officials of the Bank/Director of the Bank
10. CREDIT FACILITIES (EXISTING): (Rs. in lacs)
Outstanding Presently Rate of Repayment
Type of facilities Limit Security Lodged
as on banking with Interest terms
Current account
Cash Credit
Term Loan
LC/BG
If Banking with this Bank, customer No. be given here.
It is certified that our unit has not availed any loan from any other Bank / Financial Institution in the past
and I am not indebted to any other Bank / Financial Institution other than those mentioned in 10 above.
Page 1 of 4
11. CREDIT FACILITIES (PROPOSED): (Rs. In lacs)
Purpose for
Type of
Amount which Security offered
facilities
required
Whether Collateral Security
PRIMARY SECURITY
offered (Please mention yes or
(Details with approx. value
no) (If yes, then provide details
to be mentioned)
in column 12)
Cash Credit YES / NO
Term Loan YES / NO
LC/BG YES / NO
In case of term loan requirements, the details of machinery may be given as under:
Contribution
Purpose for Whether
Type of Total cost of being made Loan
which imported or Name of supplier
Machine machine (*) by the required
required indigenous
promoters
(* in case of imported machine, the break-up of basic cost, freight, insurance and customs duty may
be given)
12. Details of Collateral Security offered, if any, including 3rd party guarantee *
(* As per RBI guidelines banks are not to take collateral security for loans up to Rs. 5 lakhs to
MSME Units)
13.
PAST PERFORMANCE/FUTURE ESTIMATES:
(Actual performance for two previous years, estimates for current year and projections for next year to be
provided for working capital facilities. However for term loan facilities projections to be provided till the
proposed year of repayment of loan)
PAST YEAR - II PAST YEAR - I PRESENT YEAR NEXT YEAR
(Rs. in lacs)
(Actual) (Actual) (Estimates) (Projections)
Net Sales
Net Profit
Capital
(Net worth in case
of companies)
14. Status regarding Statutory Obligations:
Whether Complied
Remarks
with
(Any details in connection with
Statutory Obligation (Write Yes / No)
the relevant obligation to be
If Not applicable
given)
then write N.A.
1. Registration under Shops and Establishment Act
2. Registration under SSI (Provisional / Final)
3. Drug Licence
4. Latest Sales tax return filed
5. Latest Income tax returns filed
6. Any other statutory dues remaining outstanding
Page 2 of 4
SPACE FOR PHOTO
SIGNATURES OF PROPRIETOR / PARTNER / DIRECTOR WHOSE PHOTO IS AFFIXED ABOVE
Only one photo of proprietor / each Partner / Each working Director is required to be affixed. Each photo will
be certified/attested by the Branch Team with name and signatures on the photograph with Branch stamp.
The concerned staff will put his name below the signatures.
Date: Place:
I/We certify that all information furnished by me/us is true; that I/We have no borrowing arrangements for the
unit except as indicated in the application; that there is no overdue /statutory dues against me/us/promoters
except as indicated in the application; that no legal action has been/is being taken against me/us/promoters;
that 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 deemed fit and you, your representatives,
representatives of the Reserve Bank of India or any other agency as authorised by you, may, at any time,
inspect/verify my/our assets, books of account etc. in our factory/business premises as given above.
CHECK LIST (TO BE GIVEN TO THE NEW CUSTOMERS BY BRANCH) OF DATA TO BE KEPT READY
BY THE CUSTOMER
1 Proof of identity - Voter's ID Card / Passport /driving licence / PAN Card / signature identification from
present bankers of proprietor, partner or Director (if a company).
2 Proof of residence - Recent telephone bills, electricity bill, property tax receipt / passport / voter's ID
Card of proprietor, partner or Director (if a company).
3 Proof of business address
4 Proof of Minority
5 Last three years balance sheets of the units along with income tax /sales tax returns etc.
(Applicable for all cases from Rs.2 lacs and above).
However, for cases below fund-based limits of Rs.25 lacs if audited balance sheets are not available,
then un-audited balance sheets are also acceptable as per extant instructions of the bank. For cases of
Rs.25 lacs and above, the audited balance sheets are necessary.
6 Memorandum and articles of association of the Company/Partnership Deed of partners etc.
7 Assets and liabilities statement of promoters and guarantors along with latest income tax returns.
8 Rent Agreement (if business premises on rent) and clearance from pollution control board if applicable.
9 SSI registration if applicable.
10 Projected balance sheets for the next two years in case of working capital limits and for the period of the
loan in case of term loan. (For all cases of Rs.2 lacs and above)
11 * In case of takeover of advances, sanction letters of facilities being availed from existing
bankers/Financial Institutions along with detailed terms and conditions.
12 * Profile of the unit (includes names of promoters, other directors in the company, the activity being
undertaken, addresses of all offices and plants, shareholding pattern etc. (APPLICABLE FOR CASES
WITH EXPOSURE ABOVE Rs.25 LACS).
13 * Last three years balance sheets of the Associate/Group Companies (If any). (APPLICABLE FOR
CASES WITH EXPOSURE ABOVE Rs.25 LACS).
14 * Project report (for the proposed project if term funding is required) containing details of the machinery
to be acquired, from whom to be acquired, price, names of suppliers, financial details like capacity of
Page 3 of 4
machines, capacity utilisation assumed, production, sales, projected profit and loss and balance sheets
for the next 7to 8 years till the proposed loan is to be paid, the details of labour, staff to be hired, basis of
assumption of such financial details etc. (APPLICABLE FOR CASES WITH EXPOSURE ABOVE Rs.25
LACS).
15 * Review of account containing month wise sales (quantity and value both), production (quantity and
value), imported raw material (quantity and value), indigenous raw material (quantity and value), value of
stocks in process, finished goods (quantity and value), debtors, creditors, bank's
out standings for working capital limits, term loan limits, bills discounted. (APPLICABLE FOR
CASES WITH EXPOSURE ABOVE Rs.25 LACS).
16 * Photocopies of lease deeds/title deeds of all the properties being offered as primary and collateral
securities.
17 * Position of accounts from the existing bankers and confirmation about the asset being Standard with
them (In case of takeover).
18 * Manufacturing process if applicable, major profile of executives in the company, any tie ups, details
about raw material used and their suppliers, details about the buyers, details about major competitors
and the company's strength and weaknesses as compared to their competitors etc.
(APPLICABLE FOR CASES WITH EXPOSURE ABOVE Rs.25 LACS).
(The checklist is only indicative and not exhaustive and depending upon the local requirements at different
places addition could be made as per necessity)
Page 4 of 4