Personal Data Sheet |
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1. Name of the Applicant/Co-obligant/Guarantor |
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2. Place of Birth |
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3. Date of Birth |
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4. Educational Qualifications |
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5. Occupation/Activity |
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6. Personal Account Number (PAN) |
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7. Director Identification Number (DIN) wherever applicable |
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8. Present Residential Address |
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9. Permanent Address |
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10. Office Address |
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11. Telephone Numbers – (a) Residence (b) Office (c)
Mobile |
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12. Fax Number |
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13. Email ID |
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14. Details of Firms/Companies in which the applicant holds controlling
stake or administrative positions |
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15. Details of family members living with the applicant –
Name, their age, how related, occupation and
telephone number |
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16. Details of Movable Properties |
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(a) Cash |
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(b) Bank Balance
(mention the name of the banks in which accounts are
held) |
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(c) Vehicles –
Particulars of 2 Wheelers and 4 Wheelers to be furnished separately |
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(d) Gold in any form –
Jewellery, Coins or Biscuits |
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(e) Investments in
Shares & Bonds/Debentures (including Mutual Funds, Exchange Traded
Funds) |
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(f) Of the above, value
of listed and traded securities |
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(g) L.I.C. Policies |
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(h) Provident Fund
Balance (in case of salaried persons) |
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(i) Any other
investments and loans given to others |
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(j) Furniture, Home
Appliances and Electronic Appliances (brief
information to be given) |
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17. Details of Immovable Properties |
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(a) Agricultural Land
– Location, Extent/Area, Survey Number, Current Market Value and how
acquired
(Inherited/Gifted/Self-acquired/Jointly owned) |
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(b)
Commercial/Industrial Land - Location,
Plot/Site Number, Extent/Area, Survey Number, Current Market Value and
how acquired
(Inherited/Gifted/Self-acquired/Jointly owned) |
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(c) House Site
– Location, Plot Number, Extent/Area, Survey Number, Current Market
Value and how acquired
(Inherited/Gifted/Self-acquired/Jointly owned) |
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(d) Residential
House/Flat – Door/Flat Number, Plinth Area,
Building Name, Street/Road Name, Survey Number, Area (location),
Village/Town, District and Current Market Value and how acquired
(Inherited/Gifted/Self-acquired/Jointly owned) |
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(e) Factory
Building/Industrial Shed -
Shed Number, Block
Number, Road Name, Plinth Area, Survey Number, Area (location),
Village/Town, District and Current Market Value and how acquired
(Inherited/Self-acquired/Jointly owned) |
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(f) Commercial
Building/Complex - Door Number, Plinth Area,
Building Name, Street/Road Name, Survey Number, Area (location),
Village/Town, District and Current Market Value and how acquired
(Inherited/Gifted/Self-acquired/Jointly owned) |
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18. Details of loans availed from other sources - |
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(a) Name of the
Bank/Financial Institution |
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(b) Purpose of Borrowing |
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(c) Amount of Loan taken |
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(d) Date and Tenor |
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(e) Present Liability |
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(f) Overdues, if any |
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19. Details of Credit Cards held |
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(a) Name of the Card
Issuer |
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(b) Card Number |
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(c) Sanctioned Credit
Limit |
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(d) Present Liability |
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(e) Overdues, if any |
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20. Compliance with KYC norms |
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(a) Proof of
ID – Description of document submitted |
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(b) Proof of Residential
Address – Description of document submitted |
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21. Brief Remarks on the past dealings with the bank |
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Place: |
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Date: |
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- Format designed
by V Subramanian |
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