Small Business Banking

Type of Facility Rs. In Lakhs Tenure (Months) Purpose Label Code

Unsecured Product Secured Product NFB

Business Loan

Unsecured OD

Quick OD

Others

Secured OD

Cash Credit

Secured Term Loan

CGTMSE

Standup India

LCBN

Merchant Loan

Others

LC

BG

LER

Buyer Credit

Others

A. BUSINESS DETAILS (FIELDS IN RED REPRESENT MANDATORY FIELDS)

Udyog Aadhar No

Pan Card

Account No. /(s)

D D M M Y Y Y YDate of Incorporation

Office Residence Factory Permanent

Whether the MSME unit is ZED rated Yes No

Bronze Silver Gold Diamond Platinum

If yes, the gradation obtained by the MSME unit (Tick appropriate one)

Spouse Name

Existing Cust ID

Authorised SignatoryBeneficial OwnerGurantor

CKYC No.

Passport No./ Voter IDDriving Licence/Others

Passport No./ Driving Licence. Expiry Date

Mothers Maiden Name

Others (__________________)

(

(

(

(

PIO/OCI

B. INDIVIDUAL APPLICANT / CO-APPLICANT / PROPRIETOR / PARTNER / DIRECTOR / OTHER DETAILS

Individual Applicant/ Proprietor /

Relationship With Applicant

Permanent Residence Address

PAN Card

Community Hindu Muslim Christian Sikh Buddhist Zoroastrian Parsi Jain Others

(

(

(

(

CKYC No. Existing Cust ID

Passport No./ Voter IDDriving Licence/Others

Passport No./ Driving Licence. Expiry Date

Mothers Maiden Name

Others (__________________)

PIO/OCI

CO-APPLICANT - II / PROPRIETOR - II / PARTNER- II / DIRECTOR II / OTHERS II DETAILS

Community Hindu Muslim Christian Sikh Buddhist Zoroastrian Parsi Jain Others

Relationship With Applicant

Permanent Residence Address

Category

Education

Maritial Status

SC ST

Matricuate

Unmarried Married

Undergraduate

OBC

Graduate

General

Postgraduate

Others _________________

Others _________________Professional

Others Number of Dependents Person With Disability Yes No

Category

Education

Maritial Status

SC ST

Matricuate

Unmarried Married

Undergraduate

OBC

Graduate

General

Postgraduate

Others _________________

Others ____________Professional

Others Number of Dependents Person With Disability Yes No

Director I /

Proprietor/

Other - I (__________________)

Director II / Other II (__________________)Co-Applicant-II / Partner-II /

Co-Applicant -I / Partner - I/

Authorised SignatoryBeneficial OwnerGurantor

Co-Applicant / Guarantor Photograph

Co-Applicant / Guarantor Photograph

Past Year II

Past Year I

Provisional

Present Year (Estimate)

Next Year (Projections)

Year

20 - 20

20 - 20

20 - 20

20 - 20

20 - 20

Turnover (Rs. in Lacs) Profit as per P & L ( Rs. in Lacs)

C. FINANCIAL/INCOME DETAILS/ITR INCOME/ PAST PERFORMANCE/FUTURE ESTIMATES

Financial Year

D. EXISTING LOAN DETAILS / FACILITY DETAILS

Loan Bank Name Type of Loan Account No. Loan Amount EMI

Loan Opening Date Tenure

1

2

3

4

ROI Security Outstanding As on

Utilized CapacityCapital (Net Worth

in case of companies)

E. DETAILS OF ASSOCIATES/GROUP ENTITITIES (IN LAKHS) DETAILS AS ON………………………….

Name of the entitiy

Existing Customer ID (If Any)

Year Of Incorporation

Nature of Business

Net Sales/Total Income

Net Profit

Net Worth

Exposure(In Lac)

Address of Associate Concerns

Presently Banking

With

Nature of Association

Extent of Interest as a Prop./ Partner/

Director or Just Investor in Associate Concern

Cash Credit Sales Working Cycle in months

Inventory Debtors Creditors Other current assets

Promoters Contribution

Projected

Fill below details for Cash Credit limit

S. No. Name of the Bank

Branch Account Number Banking Since

F. BANKING DETAILS

1 2

Whether Complied with (select Yes /No). If not applicable then select N. A. 1. Registration under Shops and Establishment ACT Yes/ No/ NA 2. Registration under MSME (Provisional /Final) Yes/ No/ NA 3. Drug License Yes/ No/ NA 4. Latest Sales Tax Return Filed Yes/ No/ NA 5.Latest Income Tax Returns Filed Yes/ No/ NA 6.Any other Statutory dues remaining outstanding Yes/ No/ NA

G. STATUTORY OBLIGATIONS:

Statutory Obligation: Remarks( Any details in Connection with the relevant obligation to be given)

H. SECURITY DETAILS

(b) Liquid Collateral(a) Primary Security

Type of Security with Borrower

Value as on date (in lacs)

(LIP, KVP, NSC, Fixed Deposits)1.2.3.

Type of Security Value as on date (in lacs)

Stock

Book Debts

Others _______________

(c) Other Collateral

Value as on date (in lacs)

Type of Collateral

Letter of Credit (LC)

Bank Guarantee (BG)

Stand by Letter of Credit (SBLC)

Relationship

Installed Capacity

(e). In case of Term loan Requirements, the details of Assets may be given as under :

*In case of imported machine, the breakup of basic cost, freight, insurance and custom duty may be given.

Type of

Assets

Purpose for

which

required

Imported /

Indigenous

Name of

supplier

Total cost of

Assets

Contribution

made by the

promoters

Loan required

Relationship with applicant / co-applicant(Customer, supplier, Competitor)

Reference II

I . REFERENCE DETAILS ( BUSINESS REFERENCE )

Relationship with applicant / co-applicant(Customer, supplier, Competitor)

/

/

Signature of Sales Manager Sourcing Channel

(ASL/DSA/etc.)

To be handed over do the customer

ACKNOWLEDGEMENT FOR RECEIPT OF APPLICATION FORM

Axis Bank will convey its decision (within 2 weeks for credit limit up to Rs. 5 lakh and within 3 weeks for credit limit above Rs. 5 lakh and up to Rs. 25 lakh for Micro & Small enterprises borrowers) and (within 30 working days for other borrowers) from the date of receipt of the application provided the application is complete in all respects and is submitted along with all the documents as per 'check list' provided in the application for loan and/or any additional documents as may be required by the bank for proper appraisal of the application. The computation of timelines shall starts from the day on which all documents required for a proper appraisal of the application are provided by the Customer to bank.

Axis Bank has received your application for a Small Business Banking /Facility of Rs .______________

1.Last 2 years Audited /CA certified financial statement2.MOA & AOA of Company / Partnership deed of Partnership firm3.Six Months Bank statement 4.KYC Documents Note : Additional document may be required for Credit assessment

1.Executing Facility related documents2.Executing security creation documents and submitting original security documents.3.Compliance of Sanction terms and other conditions as may apply.Note : Additional documents may be required as per Sanction term

J. INFORMATION ON OTHER PRODUCTS AND OFFERINGS

INFORMATION ON SUBSIDYK.

TUFS CLCSS IDLSS FPTUFS Others _____________ Value of Asset Rs. _______________

(d) Property Collateral

Type of Security (Immovable Property)

1 2 3

Type of Property

Name of Registered owner

Relationship Borrower

Property Address

Area (in Sq. ______ )

Age of Property (in yrs)

Market value as on date (in lacs)

Name of Partners/Directors

of company/Proprietors

Complete Residence Address

Father/Spouse

DOB Aadhar No./DIN No.

PAN No. Category SC/ST/OBC/

Minority/Women

Telephone No.

(Residence)

Contact Details

Age (in years)

Profit Sharing/

Shareholding %

Academic Qualification

Experience in the line of activity

(Years)

N. DETAILS OF PARTNERS / DIRECTORS

1

2

3

4

5

L

Value of Plant & Machinery Rs.

Value of Equipment Rs.

M

Upto INR 25 lakh (Micro) Above INR 25 lakh upto INR 5 crore (Small) Above Rs. 5 crore upto Rs. 10 crore (Medium)

Upto INR 10 lakh (Micro) Above INR 10 lakh upto INR 2 crore (Small) Above Rs. 2 crore upto Rs 5 crore (Medium)

PRIORITY SECTOR CATEGORY / MSME

RA

/SB

B/A

pp. F

orm

/N

ove

mber

18 /V

ers

ion

.0

8

1 Processing Fees Upto 1.25% +Taxes applicable Upto 1.25% +Taxes applicable Upto 2.00% +Taxes applicable Upto 1.25% +Taxes applicable Upto 2.00% +Taxes applicable

2

Stamp Duty & otherstatutory document charges

As per applicable laws of stateAs per applicable laws of

stateAs per applicable laws of state

As per applicable

laws of state

As per applicablelaws of state

3

ROC ling charges Rs. 1200/- +Taxes applicable Rs. 1200/- +Taxes applicable Rs. 1200/- +Taxes applicable Rs. 1200/- +Taxes applicable NA4

Non submission of stock

statement2% +Taxes applicable of the outst

anding amount from the date of default NA NA NA NA5

Non submission of

property/stock insurance2% Additional rate of interest on the amount outstanding

2% Additional rate of intereston the amount outstanding

NA2% Additional rate of intereston the amount outstanding

NA6

Cheque book

issuance charges

First 100 leaves free (for new borrower account) and

thereafter Rs 2/- per leaf

First 100 leaves free (fornew borrower account)

and thereafter Rs. 2/- per leaf

First 100 leaves free (for new borrower account) and

thereafter Rs 2/- per leaf

NA NA7

Cheque Bounce Rs. 500/- per instance +Taxes applicable Rs. 500/- per instance +Taxes applicable Rs. 500/- per instance +Taxes applicable Rs. 500/- per instance +Taxes applicable Rs. 500/- per instance +Taxes applicable8

Penal Interest2.00% p.a. additional onexisting Rate of Interest

2.00% p.a. additional on existing Rate of interest

2.00% p.a. additional on existing Rate of interest

2.00% p.a. additional on

existing Rate of interest 2.00% p.m. on the amount of overdue installment9

10

CERSAI charges per collateral

Rs.100/- + Taxes applicable Rs.100/- + Taxes applicable Rs.100/- + Taxes applicable Rs.100/- + Taxes applicable

Sr.NO Nature of fee / charges Cash Credit Overdraft Merchant Loan Secured Term Loan Unsecured Business Loan

DETAILS OF CHARGES *

RS. 150 + Taxes applicable RS. 150 + Taxes applicable RS. 150 + Taxes applicable RS. 150 + Taxes applicable RS. 150 + Taxes applicable

Non Refundable Login Fee Rs. 5000/- + Taxes applicable Rs. 5000/- + Taxes applicable Rs. 5000/- + Taxes applicable

11 NA

NA NA

“Goods and Services tax (GST) will be charged extra as per the applicable rates, on all the charges and fees (wherever GST is applicable)"

Whether registered under GST

GST Registration

Special Economic Zone

GSTIN (Default)

GST Exemption

Address registered for GSTIN

O. GST DETAILS - BUSINESS (For Individual fill Annexure)

Y N

Single Multiple (Please fill GST Annexure for multiple GST Registration)

Y N

Same as Ofce Address Same as Factory Address As given below

SPECIFIC CUSTOMER DISCLOSURE IN RESPECTIVE OF RELATIONSHIP WITH DIRECTOR/SENIOR OFFICER OF THE BANK /ANY OTHER BANK

Y N Exemption Reason(If Yes) _____________ Exemption Valid Till :

Registration Date: D D M M Y Y Y Y

SEZ Code(If Yes) _____________________________

D D M M Y Y Y Y

SBB SM's Vistaar branches Vistaar + branches MAB Other

Signature of Sourcing Channel

Connector Digital Circle

Direct

Sampark Vistaar

Others ______ (Please Specify)

Vistaar +

Open Market MAB

Further options of Digital CircleMobile Internet Banking

Inbound customer service

Web Leads ATM TelecallingEmailSMS

ARM

Remote Banking RM.

Corporate Linked

Corporate Scheme label

FOR BANK USE ONLYDocuments Received Certified

KYC VERIFICATION CARRIED OUT BY

Emp. Name : _______________________________________________

Emp. Code : _______________________________________________

Emp. Designation : _______________________________________________

Emp. Organisation & Code : _______________________________________________

Emp. Branch : _______________________________________________

(Employee Signature)

D D M M Y Y Y YDate :

Place : ______________________

AXIS BANK LIMITED,001

/ facility

Axis Bank will convey its decision (within 2 weeks for credit limit up to Rs. 5 lakh and within 3 weeks for credit limit above Rs. 5 lakh and up to Rs. 25 lakh for Micro & Small enterprises borrowers) and (within 30 working days for other borrowers) from the date of receipt of the application provided the application is complete in all respects and is submitted along with all the documents as per 'check list' provided in the application for loan and/or any additional documents as may be required by the bank for proper appraisal of the application. The computation of timelines shall starts from the day on which all documents required for a proper appraisal of the application are provided by the Customer to bank.

1.

As per RBI guidelines, classification of accounts as NPA is done Borrower wise and not Facility wise and hence, it may be noted that in case of non-payment of dues by the customer in case of any facility availed from the Bank and consequently the account is to be classified as NPA, all other loan accounts of the Borrower/Card Holder, with the Bank also shall be classified as NPA as per the guidelines issued by RBI and it shall entitle the Bank to recall all such loans/facilities availed by the same customer from the Bank irrespective of the regular repayment in such accounts

Bank / Financial Institution other than those mentioned in above columns. 22. I/We authorize Axis Bank to verify and authenticate my/our Aadhaar number during processing my/our application for legitimate Business purposes. 23. I/We further authorise the Bank to share my Aadhaar related details/information with regulatory / statutory bodies as and when required.

address.21. It is certified that our unit has not availed any loan from any other Bank / Financial Institution in the past and I am not indebted to any other

Fulfilment Channel:

AXIS Bank Relationship Manager :

Referrer Branch Name :

Ref ID : / CRM ID

Account Opening City

Account Opening Branch Name

Account Opening Branch Sol ID

DSA Code :

DSA Name :

TL Code :

Corporate Name

P. CUSTOMER DECLARATION

Q. SOURCING DETAILS (for Official use only)

Proprietor /

Co-Applicant -I / Partner-I

Director

Co-Applicant -II

Partner II / Director II

Co-Applicant -III

Partner III / Director III Applicant Signature

7. Mudra Declaration: Axis Bank may tag the unsecured loans/facilities offered upto Rs.10Lacs to Small/Micro enterprise borrowers under Shishu, Kishor or Tarun category as per Pradhan Mantri MUDRA Yojana (PMMY) guidelines.