Fillable Printable Loan Application for Micro Finance
Fillable Printable Loan Application for Micro Finance
Loan Application for Micro Finance
LOAN APPLICATIONFOR MICRO FINANCE
FINANCIAL ASSISTANCEUNDER MICRO CREDIT SCHEMEFOR NGOs APPLY THROUGH SCA
(AmountinRs.)
i)Nameof ApplicationOrganisation: Regn.No.
Date:
ii)CommunicationAddress & Phoneno.
iii) Area of operation:
iv) Mainactivities /objectives:
v)Compositionof its management Committee:
(Name, Address, Occupationof eachmember)
1.LENDINGPROGRAMME FOR FUNDS BEING SOUGHT FROM NHFDC
i)DIRECTLYTO BORROWERS
Name&
Address of
borrower
Age
M/F
Category
(SC/ST/
OBC/Gen/
Minority
Natureof
disability
% of
disability
Annual
income
of
borrower
Name&
address
of the
Activity
Amt.
Proposed
by the
borrower
a)Rural
b)Urban
ii)PROPOSED TO BELENDING THROUGH SHEFHELP GROUPs(SHGs)
1.Nameof the SHG :
2.Date of formationof SHG :
3.Particulars of members :
4.Nameof Bank andAccount No. of SHG :
Name&
Address of
borrower
Ag
e
M/F
Category
(SC/ST/
OBC/Gen/
Minority
Natureof
disability
% of
disability
Annual
income
of
borrower
Name&
address
of the
Activity
Amt.
Proposed
by the
borrower
a)Rural
b)Urban
2.TERMSANDCONDITIONSFOR EACH TYPE OFPROPOSED LENDINGS IN TERMS OF:
a)Rate of interestchargedandprovisionforpenal interest
b)Security/ Marginmoney,if any, takenfromthemembers
c)Repayment period; and
d)Typeof documents takenundereachcategoryfromborrower
3.BORROWI NGRAISED FROM BANKSAND OTHER ORGANISATIONS :
a)Nameof theorganizationfromwhom borrowed:
b)Amount borrowed :
c)Purpose :
d)Balanceoutstanding :
e)Whetherrepayment is maderegularly :
f)Amount defaulted :
4.FINANCIAL ASSISTANCE REQUIRED FROM NHFDC
5.DETAILS OFEXTENTION/FIELD STAFFAVAILABLE WITH NGO& SHGs FOR CREDIT
BUSINESS
a)SupervisorystaffNo.of officials
b)Fieldstaff/extension workers No. of officials
6.Following Documents areto attach :
a)Copyof registrationcertificatealong withrenewalcopyof registration .Acopyof Byelaws (with
enablingclausetoborrow/takeloan) andByelaws of SHGs(if any) with approvedcopy of MOA
authenticated bytheRegistrar of thesocieties.
b)Balancesheet, Income& ExpenditureA/C andAnnual report forthelast 3 years of NGO andsample
Balancesheets of 5 SHGs, ifany.
c)Nameof themainbankerwithAccountNumber.
d)Resolutionof Management committee, forborrowingfromNHFDC andwhetherSHGs havepassed
similar resolutions withthesignatureof allthemembers of the committee.
e)Copies of testimonials receivedfromforeigndonors/Government Departmentsetc.
DECLARATION
I ……………………………………………………………………………… (full name) Certify that the
facts andfigures furnishedinthis applicationform arecorrect andtallywiththerecords of our
organization.
Signature
Name oftheChiefExecutive
Date:……………………
