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                              Preliminary Consumer Loan Application
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APPLICANT COAPPLICANT GUARANTOR
NAME  
DATE OF BIRTH [YYYY/MM/DD]*
MOBILE NO*  
E-mail ADDRESS*        
MARITAL STATUS*  
NO OF DEPENDANTS*  
Select OCCUPATION:*      
PHONE NO. OF OFFICE/BUSINESS WITH EXTENSION NO. IF ANY
NO. OF YEARS OF SERVICE/BUSINESS*  
GROSS INCOME FROM SALARY/BUSINESS P.A.*  
NET INCOME FROM SALARY/BUSINESS P.A.*  
OTHER INCOME IF ANY
PAN NO.*  
ESTIMATED NET WORTH*  
IMMOVABLE ASSETS [Land and bldg.]
[Specify Address]*
 
MOVABLE ASSETS [VEHICLES]
[Brand, make and Regn. no.]*
 
INVESTMENTS*  
LIABILITIES
[Existing Bank Borrowings if any]
Whether repayment by deduction of installment from salary by employers
Present Bankers Bank-*  
  Select Branch:*
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