THE H.P.

STATE COOPERATIVE BANK LTD;

HEAD OFFICE THE MALL SHIMLA-171001.
Latest
The Manager Pass Port Size
H.P. State Co-op. Bank ltd., Photograph
Branch Office……………..

Reg:- APPLICATION FOR TERM LOAN FOR PURCHASE OF VEHICLE

Please sanction a term loan of Rs……………… in my favour for purchase of vehicle. All the requisite particulars
are submitted hereunder for your perusal.

1. Personal data :

i) Name of the applicant :……………………………………..

ii) Business address :…………………………………….
iii) Constitution : …………………………………….
iv) Experience : …………………………………….

Name(s) of proprietor/partners/office : Age ……………………………

bearers of Coop. Society

(v) If already owning vehicles,

Details (like type, year : …………………………………….
of manufacture, cost price,
present estimated value, income
there from, if a loan has been taken
against them, details). : …………………………………….
(vi) Whether the vehicle will be : …………………………………….
driven by the applicant.
(vii) Staff employed : …………………………………….
(viii) In the case of owner drivers : …………………………………….
(a) Number of dependents in the : …………………………………….
family.
(b) Minimum sustenance amount : …………………………………….
required for the family.
(c) Present monthly income : …………………………………….
(d) Whether belonging to : …………………………………….
scheduled caste/tribe
(e) If owning land, its size : …………………………………….

2. Data of the vehicle proposed :

to be purchased
(i) Type, make and year of
manufacture : …………………………………….
(ii) Fuel used : …………………………………….
(iii) Dealer’s name and address : …………………………………….
(iv) Cost:
(Performa invoice to be enclosed).
i) Chassis : Rs. …………………………………….
ii) Body Building : Rs. …………………………………….
iii) Others ( ) : Rs. …………………………………….
Total = : Rs. …………………………………….

Applicant’s contribution (%) : …………………………………….

Loan required : Rs. …………………………………….

(v) If a working capital loan is required,

Details relating to purpose (enclos-
ing estimates/invoices, where appl- …………………………………….
icable) amount involved etc. : …………………………………….

(vi) Amount of working capital required : …………………………………….

3. Operational viability :
(i) Carrying capacity of the vehicles
(Persons/load) : …………………………………….
(ii) Route on which or area where the
vehicle will operate. : …………………………………….
(iii) Position relating to the obtaining of
the necessary licence/permit. : …………………………………….
(iv) Anticipated monthly earnings. :Rs. …………………………………
(v) Factors which ensure the applicant
of achieving the above earnings and
of a successful business in his area of
operation. : …………………………………….
(vi) Particulars of Sales-tax & Income-tax
assessments. : …………………………………….
4. Repayment

(i) Start-up period required : …………………………………….

(ii) Monthly repayment towards : Rs. ………………………………
existing Bank loan

Monthly repayment towards proposed: Rs. ………………………………

Bank loan
Monthly repayment towards :Rs. …………………………………
other borrowings (to be specified).
: …………………………………….
Total = ………………………………(A)
Anticipated net cash accruals
as per enclosure : …………………………………(B)
Debt service ratio : B:A : …………………………………….

5. Security : …………………………………….

6. Any other remarks : …………………………………….

Date:………..

Place: ……… : …………………………………….

( Signature of Borrower)
 UNDERTAKING

I, ______________________ S/O, D/O, W/O Shri/Smt. _______________Aged _______ years permanent

resident of Village ____________ Post Office ______________________ Tehsil __________ District
_____________ H.P. do solemnly affirms and take on oath as under:-

1. That I am working in ______________ department /institutions for the last ______ years as __________
and is a regular/ confirmed employees.

2. That I have applied to H.P. State Cooperative Bank limited, Branch Office ________ for sanction of a
vehicle loan amounting to Rs. __________ (Rupees __________________) only, for purchase of
___________(make of vehicle)

3. That I have not availed any loan from any Bank/Financial Institutions including H.P. State Co-operative
Bank for purchase of vehicle as on date of this undertaking.

4. That to facilitate repayment of the loan applied, I have authorised my D.D.O to deduct my monthly salary
equal to the amount of instalment as fixed by the Bank, if sanctioned and to remit the same to the H.P. Sate
Cooperative Bank. Accordingly an undertaking from my D.D.O. (Shri ________________ Designation
_____________) has been submitted.

5. I, ___________________ s/o of Shri ______________________, working as regular employee in the

________________________________ department/institution for the last ______ years and holding the
post of ____________ solemnly affirm and undertake on oath as under :-

6. That as per last month’s salary certificate, against my gross salary of Rs. _________________ per month, I
am drawing net salary of Rs. Per month which comes to _____% of my gross salary.

7. That my date of superannuating is ______ and as such the remaining service is for _______ years _______
months.

8. That I hereby authorise my DDO in terms of section 46 (1) of the H.P. State Cooperative societies Act,
1968 to deduct the loan instalments from my monthly salary for remitting into my loan account with the
_____________ Cooperative T&C Society. I hereby also declare that this authority shall not be revoked by
me till fully liquidation of loan amount or written consent of the society.

9. That I further authorise my DDO that in case of my death, resignation, termination, superannuation, the
dues payable to me shall be appropriated for liquidating the loan of the society and I shall not claim any
relief in this regard as may be provided under any Act in force.

10. That I further nominate/authorise my DDO to receive the payment, if any, in case of my death or disability
under Janta Insurance Scheme, Group Insurance or any other insurance schemes as purchased by me from
time to time, for crediting the proceeds to the loan account with the society.

11. That as a proof of non-availing any vehicle loan from other Banks/Institutions I have submitted no
objection certificate (NOC).

Certified that the undertaking as detailed above is true and nothing has been concealed there from. If any
contrary fact is found, I shall be responsible and suitable action may be taken against me by the Bank /
Department / Institution.

(Signature of Undertaker)
Name: _______________
Place: ________ Address for correspondence: -
_________________________
Date: ________ _________________________
 Annexure “D”

GUARANTOR’S UNDERTAKING WITH THEIR DDO’S CERTIFICATE UNDER SECTION

46OF H.P. CO-OPERATIVE SOCIETIES ACT. 1968.

I__________________________s/o,d/o,w/oShri____________________Working as
________________(Designation) for the last ___________Years with __________________________
(Name of department) drawing a net monthly salary of Rs. __________/-
(Rupees______________________________ ____________only), hereby stand as guarantor for the
repayment of loan of Rs. _________________being raised from the H.P. State Cooperative Bank ltd.; by
Shri ____________________ S/O, D/O, W/O Shri _________________________ together with interest
to be accrued thereon till total liquidation of the loan.
I further authorise my DDO to deduct my salary in case of default made in repayment by Shri
________________________ (Borrower) on written demand of the aforesaid Bank to remit the same into
the loan account of the above said borrower till total liquidation of the loan with interest accrued.

Date: _________ Signature of Guarantor

Place: _________ Name and Designation
___________________
___________________
___________________
Countersigned by DDO
Of the Guarantor

Name(DDO)______________________ Designation _______________________

Dispatch No. _____________________________________Dated_____________
 Annexure “C”
Employer/DDO Undertaking under section 46 of
H.P. State Coop. Societies Act, 1968

As per authorisation and request made by Shri/ Smt. / Miss __________________________ S/O,
W/O, D/O, Shri ______________________, it is certified that he/she is in the regular service of this
Deptt. i.e. __________________________(Name of Department) holding a post of
____________________. He /She is in the regular service of this Deptt. for the last ______ years and is
due to retire from the service of this Deptt. on_________.
I hereby undertake to recover the agreed loan installments every month from the salary
bill of the aforementioned employee and to remit the amount by issuing of cheques/demand draft in
favour of the H.P. State Coop. Bank Ltd. Branch Office _____________ or by depositing cash through an
authorised person of the Department to the credit/deposit of his/her loan account with the said Bank till
the entire loan together with interest is fully repaid.

In case of he/her death, resignation from and/or termination of the service of the aforesaid
employee from the Department / Institution, the total outstanding loan amount with interest shall be
recovered from the terminal benefits payable to him/her and shall be deposited with the Bank.

Dispatch no. ___________ Signature of DDO/Employer

Dated: ________________ Designation______________

Department _______________
Seal of Dept.
 Annexure “B”

A) Name of Deptt. / Institution _____________________________________

S/No. Name & designation Place of Remaining Monthly Net Monthly Vehicle
of applicant borrower posting services gross salary drawn to be
in years Salary Purchased __________
1 2 3 4 5 6 7

_______________________________
Cost of Margin Amount
Vehicle Money applied
8 9 10