Complete Application - Pradhan Mantri Mudra Yojana (PMMY)

Bank & Branch where loan is required:

Loan Amount Required:

Declaration: I/We hereby certify that all information furnished by me/us is true, correct and complete... (full declaration text as per form)

Place:

Date:

Signature of Applicant(s):

Acknowledgement Slip (Applicant's Copy)

Received with thanks from Sh./Smt. a loan application for Rs. under PMMY, dated

Documents to be submitted along with the application:

Proof of Identity: Self-attested copy of Voter's ID, Driving Licence, PAN Card, Aadhaar Card, Passport, etc.
Proof of Residence: Recent utility bill (not older than 2 months), Voter's ID, Aadhaar Card, Passport, Bank passbook, etc.
Applicant's Recent Photograph (2 copies): Not older than 6 months.
Quotation of Machinery / other items to be purchased.
Proof of Identity/Address of the Business Enterprise, if any.
Proof of Social Category: Certificate for SC / ST / OBC / Minority etc., if applicable.

Important Notes:

No processing fee will be charged.
No collateral is required for the loan.
The repayment period of the loan is extended up to 5 years.
The applicant should not be a defaulter to any Bank / Financial institution.

A. For Office Use:

Enterprise Name	Application Sl. No.	Name of the Branch	Category (Shishu/Kishor/Tarun)

B. Business Information:

Name of the Enterprise
Constitution	ProprietaryPartnershipPvt. Ltd.Any Others
Current Business Address
Mobile No.		Email
Business Activity	ExistingProposed	Date of Commencement
Is Unit Registered?	YesNo	Registration No.
Social Category	SCSTOBCMinority

C. Background Information of Proprietor/Partners/Directors:

S.No	Name	Date of Birth	Sex	Residential Address & Mobile No.	Academic Qualification	Experience (Years)
1
2

S.No	ID Proof	ID Proof No.	Address Proof	Address Proof No.	PAN Card/DIN No.	Relationship with Bank Official
1
2

D. Names of Associate Concerns and Nature of Association:

Name of Associate Concern	Address	Presently Banking with	Nature of Association	Extent of Interest

E. Banking/Credit Facilities Existing:

Type of Facility	Limit Availed	Security Lodged	Asset Classification
Savings Account	N.A.	N.A.	N.A.
Cash Credit
Term Loan

F. Credit Facilities Proposed:

Type of Facility	Amount	Purpose	Primary Security Offered
Cash Credit
Term Loan
Total

G. In case of Working Capital:

Actual Sales (FY-)	Projected Sales	Inventory	Debtors	Creditors	Promoter's Contribution	Limits

H. In case of Term loan requirements:

Type of Machine	Purpose	Name of Supplier	Total Cost	Promoter's Contribution (Rs.)	Loan Required (Rs.)

Total

I. Past Performance / Future Estimates (in Rs.):

	Past Year-II (Actual)	Past Year-I (Actual)	Present Year (Estimate)	Next Year (Projection)
Net Sales
Net Profit
Capital (Net Worth)

J. Status Regarding Statutory Obligations:

Statutory Obligations	Complied (Yes/No/N.A.)	Remarks
1. Registration under Shops and Establishment Act
2. Registration under MSME
3. Drug License
4. Latest Sales Tax/Income Tax Return Filed

K. Declaration: I/We hereby certify that all information furnished by me/us is true, correct and complete. I/We have no borrowing arrangements for the unit except as indicated in the application form. There are no overdue/statutory dues owed by me/us. I/We shall furnish all other information that may be required by Bank in connection with my/our application. The information may also be exchanged by you with any agency you may deem fit. You, your representatives or Reserve Bank of India or Mudra Ltd., or any other agency as authorised by you, may at any time, inspect/ verify my/our assets, books of accounts etc. in our factory/business premises as given above. You may take appropriate safeguards/action for recovery of bank's dues.

Photo

Signature

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Signature

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Signature

Place:

Date:

Proof of identity: Self certified copy of Voter’s ID card / Driving License / PAN Card / Aadhar Card/Passport.
Proof of Residence: Recent telephone bill, electricity bill, property tax receipt, Voter’s ID card, Aadhar Card & Passport of Proprietor/Partners/Directors.
Proof of SC/ST/OBC/Minority.
Proof of Identity/Address of the Business Enterprise: Copies of relevant licenses/registration certificates.
Applicant should not be defaulter in any Bank/Financial institution.
Statement of accounts (for the last six months) from the existing banker, if any.
Last two years balance sheets of the units along with income tax/sales tax return etc. (Applicable for loans from Rs 2 Lacs and above).
Projected balance sheets. (Applicable for loans from Rs 2 Lacs and above).
Project report (for the proposed project).
Memorandum and articles of association of the company/Partnership Deed etc.
Asset & Liability statement from borrower/Partners/Directors.
Photos (two copies) of Proprietor/ Partners/ Directors.

Acknowledgement Slip (Office Copy)

Application Number	Date of Application

Name of the Applicant(s)	Loan Amt. Requested

Signature of Applicant(s)	Signature of Branch Official

Acknowledgement Slip (Applicant's Copy)

Application Number	Date of Application

Name of the Applicant(s)	Loan Amt. Requested

Signature of Applicant(s)	Signature of Branch Official