Fillable Printable Loan Application for Micro Finance
Fillable Printable Loan Application for Micro Finance
Loan Application for Micro Finance
LOAN APPLICATION FOR MICRO FINANCE
FINANCIAL ASSISTANCE UNDER MICRO CREDIT SCHEME FOR NGOs APPLY THROUGH SCA
(Amount in Rs. )
i) Name of Application Organisation: Regn.No.
Date:
ii) Communication Address & Phone no.
iii) Area of operation:
iv) Main activities /objectives:
v) Composition of its management Committee:
(Name, Address, Occupation of each member)
1. LENDING PROGRAMME FOR FUNDS BEING SOUGHT FROM NHFDC
i) DIRECTLY TO BORROWERS
Name &
Address of
borrower
Age
M/F
Category
(SC/ST/
OBC/Gen/
Minority
Nature of
disability
% of
disability
Annual
income
of
borrower
Name &
address
of the
Activity
Amt.
Proposed
by the
borrower
a)Rural
b)Urban
ii) PROPOSED TO BE LENDING THROUGH SHEF HELP GROUPs(SHGs)
1. Name of the SHG :
2. Date of formation of SHG :
3. Particulars of members :
4. Name of Bank and Account No. of SHG :
Name &
Address of
borrower
Ag
e
M/F
Category
(SC/ST/
OBC/Gen/
Minority
Nature of
disability
% of
disability
Annual
income
of
borrower
Name &
address
of the
Activity
Amt.
Proposed
by the
borrower
a)Rural
b)Urban
2. TERMS AND CONDITIONS FOR EACH TYPE OF PROPOSED LENDINGS IN TERMS OF:
a) Rate of interest charged and provision for penal interest
b) Security/ Margin money, if any, taken from the members
c) Repayment period; and
d) Type of documents taken under each category from borrower
3. BORROWI NG RAISED FROM BANKS AND OTHER ORGANISATIONS :
a) Name of the organization from whom borrowed :
b) Amount borrowed :
c) Purpose :
d) Balance outstanding :
e) Whether repayment is made regularly :
f) Amount defaulted :
4. FINANCIAL ASSISTANCE REQUIRED FROM NHFDC
5. DETAILS OF EXTENTION/FIELD STAFF AVAILABLE WITH NGO & SHGs FOR CREDIT
BUSINESS
a) Supervisory staff No. of officials
b) Field staff/extension workers No. of officials
6. Following Documents are to attach :
a) Copy of registration certificate along with renewal copy of registration .A copy of Bye laws (with
enabling clause to borrow/take loan) and Bye laws of SHGs(if any) with approved copy of MOA
authenticated by the Registrar of the societies.
b) Balance sheet, Income & Expenditure A/C and Annual report for the last 3 years of NGO and sample
Balance sheets of 5 SHGs, if any.
c) Name of the main banker with Account Number.
d) Resolution of Management committee, for borrowing from NHFDC and whether SHGs have passed
similar resolutions with the signature of all the members of the committee .
e) Copies of testimonials received from foreign donors/ Government Departments etc.
DECLARATION
I ……………………………………………………………………………… (full name) Certify that the
facts and figures furnished in this application form are correct and tally with the records of our
organization.
Signature
Name of the Chief Executive
Date: ……………………
