Personal loan application form

ID Information

National ID/Smart Card No.

E-TIN No.

Passport No.

Driving License No.

Birth Registration No.

Other ID Type

Contact Details

Phone No. 1

Phone No. 2

E-mail

Present Address

Area/Police Station

District/City

Post Code

Nearest Landmark

Permanent Address

Area/Police Station

District/City

Post Code

Nearest Landmark

Communication Address (Select only one)

Present AddressPermanent AddressWork Address

FAMILY INFORMATION

Spouse Information

Spouse's Name

Contact No.

Contact Address

Same as 1st Applicant or

Profession/Designation

Organization Name

Organization Address

Father Information

Father's Name

Contact Address

Same as 1st Applicant or

Mother Information

Mother's Name

Contact No.

Contact Address

Same as 1st ApplicantSame as 1st Applicant's Father or

No. of Dependents

REFERENCE (AT LEAST ONE RELATIVE REFERENCE)

1. Reference

Name

Relationship with Applicant

E-mail

Phone No. 1

Phone No. 2

Residence Address

Organization Name

Profession/Designation

Organization Address

2. Reference

Name

Relationship with Applicant

E-mail

Phone No. 1

Phone No. 2

Residence Address

Organization Name

Profession/Designation

Organization Address

FINANCIAL INFORMATION

Monthly Income

Salary (Gross)

Business Income

Rental Income

Other Income (Please specify)

Total Monthly Income

Monthly Expenses

House Rent

Loan/Installment Payment

Credit Card Payment

Family Expenses

Other Expenses (Please specify)

Total Monthly Expenses

Net Disposable Income

Assets

Cash & Bank Balance

Investments (FDR/Shares/Bonds etc.)

Land & Building

Motor Vehicle

Other Assets (Please specify)

Total Assets

Liabilities

Loan from Bank/FI

Loan from Others

Credit Card Outstanding

Other Liabilities (Please specify)

Total Liabilities

Net Worth

BANK ACCOUNT DETAILS

Bank Name

Branch Name

Account Name

Account No.

Account Type

SavingsCurrentFDROther

Date of Opening

Average Monthly Balance

Relationship with Bank

Years

Months

Any other Bank Account?

YesNo

Other Bank Account Details

Bank Name

Branch Name

Account No.

LOAN WITH BANK/FINANCIAL INSTITUTION

Do you have any loan with any Bank/FI?

YesNo

APPLIED FOR LOAN TAKE OVER

Are you applying for loan take over?

YesNo

FAMILY INFORMATION

Spouse's Name

Contact No.

Contact Address

Same as 2nd Applicant or

Profession/Designation

Organization Name

Organization Address

Father's Name

Contact No.

Contact Address

Same as 2nd Applicant or

Mother's Name

Contact No.

Contact Address

Same as 2nd ApplicantSame as 2nd Applicant's Father or

No. of Dependents

FINANCIAL INFORMATION

Monthly Income

Item	Amount (BDT)
1st Applicant's Net Income
Spouse's Net Income
2nd Applicant's Net Income
Rental Income
Interest/Other Income
Total Income

Monthly Expense

Item	Amount (BDT)
Rent & Utility
Food & Clothing
Education
Loan Repayment
Tax/Miscellaneous
Total Expense

BANK ACCOUNT DETAILS

Bank Name	Account Name	Type of Account	Account Number	Account Since

LIABILITY DETAILS

Loan

Bank Name	Type of Facility	Disbursed Amount	Outstanding	EMI	Sanction Date	To be 'Closed'	To be 'Takeover'

Personal loan application form

Loan Type

Facility Type

Application Details

Tenor

Present Address

Permanent Address

Length of Current Profession

Total Length of Profession

Work Address

Spouse Information

Father Information

Mother Information

1. Reference

2. Reference

Monthly Income

Monthly Expenses

Assets

Liabilities

Relationship with Bank

Other Bank Account Details

Monthly Income

Monthly Expense

Loan

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