UNION BANK OF INDIA

______________ BRANCH

APPLICATION CUM PROCESS NOTE FOR CLEAN OVERDRAFT (STAFF)

1. Employee Number :

2. Name of applicant :

3. Designation :

4. Date of Joining :

5. Date of birth :

6. Date of Retirement :

7. Residential Address :

8. (a) Name of the nominee for PF/ :

Relationship
(b) Name of the nominee for gratuity/ :
Relationship
9. Amount of overdraft sought :

10. Salary Particulars

Basic Pay Rs.

Dearness Allowance Rs.

House Rent Allowance Rs.

City Compensatory Allowance Rs.

Other Allowances Rs.

Gross Salary Rs.

MONTHLY DEDUCTIONS

(Please attach copy of the latest salary slip)

A) P.F.Contribution Rs. B) Housing Loan Rs.

LIC Premium Rs. P.F.Loan Rs.

Income Tax Rs. Festival Adv Rs.

Professional Tax Rs. Vehicle Loan Rs.

Others Rs. Co-operative Society Rs.

 Others Rs.

Sub Total (A) Rs. Sub-Total (b) Rs.

C) Notional Monthly Interest on Clean Overdraft : Rs

(Assuming that the limit will be fully utilized)

D) AGGREGATE DEDUCTIONS (A+B+C) :

Percentage of D to Gross Monthly Salary :

I have fully understood the terms and conditions for grant of Clean Overdraft and shall
abide by them. The facility will be utilized by me from time to time for the various purposes
as detailed in the scheme. I declare that the particulars mentioned by me hereinabove are
true and correct.

Yours faithfully,

Branch/Office ( )

FOR OFFICE USE

1) Amount of overdraft applied : Rs

2) Eligible Amount : Rs

3) Amount Sanctioned : Rs

Branch Manager’s Comments / Recommendations:

Total monthly deductions including monthly interest component or Overdraft Limit do not
exceed 60% of gross salary.

Certified that no disciplinary action, legal proceedings are initiated / pending / contemplated
against Shri/Smt/Kum ____________________________

RECOMMENDED SANCTIONED

(DESIGNATION) (COMPETENT AUTHORITY)

Date : Date :
 ANNUAL REVIEW

Certified that all terms of sanction are complied with, account is in order and
documents are in force. Certified further that no disciplinary action, legal
proceedings are initiated / pending / contemplated against
Shri / Smt / Kum._______________________.

RECOMMENDED SANCTIONED

(DESIGNATION) (COMPETENT AUTHORITY)

Date : Date :
 PROPRIETORSHIP/INDIVIDUALS

DATE:___________

Rs._______________

ON Demand , I _____________________________________ promise to

pay UNION BANK OF INDIA or order sum of Rupees

_________________________________ together with interest on such

sum from this date at the rate of _______ % over Union Bank of India’s

Base Rate or such other rates as my be prescribed by the Bank from time

to time with a minimum of _______ % per annum with _____________

rests for value received.

SD-21 I
UNION BANK OF INDIA

_________________ Branch

Dear Sirs,

I/We beg to enclose a Demand Promissory Note Dated ________ for Rs____________
(Rupees ____________________________) signed by me/us which is given to you as
security for the repayment of amounts outstanding with respect to credit limits in my/our
name or in the name of either of us and also for the repayment of any loans and advances
to the extent of Rs_____________ (Rupees____________________________) which I/We
or either of us may avail of hereafter and the said Promissory Note is to be security to you
for the repayment of the ultimate balance or sum remaining unpaid with respect to any loan
or advance drawn under the credit limits sanctioned and I am/We are to remain liable on
the said Promissory Note.

Yours faithfully

Full Names Signature

__________________ ___________________

__________________ ___________________

__________________ ___________________

__________________ ___________________
 ANNEXURE – I
LETTER OF AUTHORITY
(to deduct/interest from salary)

Place :
Date ;
To:
UNION BANK OF INDIA
___________________

Dear Sir/Madam,

Overdraft Facility of Rs. granded to me

1. At my request vide my application dated ________ the Bank has sanctioned

me the captioned OD facility/limit on terms and conditions contained in Staff
Circular No.5902 dated 05.09.2012 and I hereby undertake to abide by the said
terms and conditions.

2. Vide my declaration/undertaking dated __________ I have designated the

captioned Overdraft Account for the credit of my monthly salary. In this
connection, I hereby further authorize you to appropriate the monthly interest
accrued on the captioned overdraft account from my monthly salary credited to
the captioned overdraft account. I fully understand that by this authorization, my
monthly salary shall automatically get reduced by the extent of accrued interest
debited for appropriation.

3. I hereby declare that I shall not revoke the letter of authority so long as I remain
indebted under the captioned Overdraft facility availed by me.

Yours faithfully,
WITNESS:
1. signature :
Name :
Address :

2. signature :
Name :
Address :
 ANNEXURE – II
DECLARATION/UNDERTAKING
(From Staff Members)

To:
UNION BANK OF INDIA
___________________

Dear Sir/Madam,

Overdraft Facility of Rs. granded to me

I______________________________, Employees No.___________ presently

working at _________________ Branch/Office, do hereby solemnly and sincerely
declare, say and undertake as follows:

At my request vide my application dated ________ the Bank has sanctioned me the
captioned OD facility/limit on terms and conditions contained in Staff Circular
No.5902 dated 05.09.2012 and I hereby undertake to abide by the said terms and
conditions.

I do hereby declare and undertake that so long as I continue to be indebted or liable

to the Bank under the captioned OD facility granted to me by the Bank, I shall not
avail any loans from any outside sources except Staff Credit Societies. In the event
of availing loans from outsiders, I shall do so only after obtaining prior permission in
writing of the Bank. Even in the event of obtaining any loan from an outside source
with the specific permission of the Bank, I hereby undertake that I shall not charge
my monthly salary or any other monitory benefit recoverable by me from the bank as
security for repayment of such loan. I further undertake not to request the Bank to
deduct and remit installments from my salary to such external lending agencies.

I do hereby designate my Over Draft Account for credit of my monthly salary.

Yours faithfully,
 ANNEXURE –III
Unstamped Undertaking from nominee to appropriate Terminal Benefits
(Provident Fund)
Date ____________
The Trustees,
UNION BANK OF INDIA
Employees’ Provident Fund
Mumbai

Dear Sir/Madam,

Provident Fund No._________

In consideration of Union Bank of India having agreed to grant Clean

Overdraft of Rs.____________ (Rupees__________________________________)
to Mr./Mrs._________________________ (Applicant’s Name) a member of Union
Bank of India Employees’ Provident Fund and Mr./Mrs._____________________
(Nominee’s Name), the nominee under the Provident Fund Account of the said
Mr./Mrs._____________________ (Applicant’s Name) hereby authorize you to
register the lien of Union Bank of India on the Provident Fund of the said
Mr./Mrs.__________________ till the entire Clean Overdraft of Rs.___________
(Rupees _____________________________________________ ) with interest
accrued thereon is repaid by us.

In the event of failure on the part of either or both of us to repay the said loan
with interest accrued thereon and in the event of any claim made by the said Union
Bank of India, the Trustees will be entitled at all times to pay forthwith any amount
which the Bank may claim under the aforesaid loan without any reference to either of
us.

It is understood and agreed on our part that any demand so made by the
Bank will be conclusive evident of such non-payment of the said loan or balance
thereof by us.
Yours faithfully,

MEMBER

NOMINEE UNDER THE PF ACCOUNT

SIGNATURE OF NOMINEE
 ANNEXURE –IV
Unstamped Undertaking from nominee to appropriate Terminal Benefits
(Gratuity Fund)
Date ____________
The Trustees,
UNION BANK OF INDIA
Employees’ Gratuity Fund
Mumbai

Dear Sir/Madam,

Gratuity Account of _________

In consideration of Union Bank of India having agreed to grant Clean

Overdraft of Rs.____________ (Rupees__________________________________)
to Mr./Mrs._________________________ (Applicant’s Name) a member of Union
Bank of India Employees’ Gratuity Fund and Mr./Mrs._____________________
(Nominee’s Name), the nominee under the Provident Fund Account of the said
Mr./Mrs._____________________ (Applicant’s Name) hereby authorize you to
register the lien of Union Bank of India on the Gratuity Fund of the said
Mr./Mrs.__________________ till the entire Clean Overdraft of Rs.___________
(Rupees _____________________________________________ ) with interest
accrued thereon is repaid by us.

In the event of failure on the part of either or both of us to repay the said loan
with interest accrued thereon and in the event of any claim made by the said Union
Bank of India, the Trustees will be entitled at all times to pay forthwith any amount
which the Bank may claim under the aforesaid loan without any reference to either of
us.

It is understood and agreed on our part that any demand so made by the
Bank will be conclusive evident of such non-payment of the said loan or balance
thereof by us.
Yours faithfully,

MEMBER

NOMINEE UNDER THE PF ACCOUNT

SIGNATURE OF NOMINEE