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Form NGIF/VCL/01.

APPLICATION FORM FOR GRANT OF CONVEYANCE (CAR/ SCOOTER) AND PERSONAL COMPUTER  LOAN

1.

Name _________________________ Rank _______________ No. __________

2.

Establishment/ Ship _________ Station_________ Date of Commission/

          Enrolment  ____________

3.Date of Birth ______________ Date of Retirement/ Release ________________

4.Martial Status____________ Driving License No.______________________

                                                         (enclose attested photo copy ) for vehicle loan only.

5.Permanent Home Address of the borrower :-

(a)Full name of the individual : __________________________________

(b)Father/Mother Name            : __________________________________

(c)House Number   :  __________________________________

(d)Street Number   :  __________________________________

(e)Village   :  __________________________________

(f)Post Office   :  __________________________________

(g)Telegraph Office   :  __________________________________

(h)Police Station   :  __________________________________

(j)Tehsil   :  __________________________________

(k)District   :  __________________________________

(l)State   :  __________________________________

          (m)      PIN Code   :  __________________________________

(n)Telephone Number   :  __________________________________(p)e-Mail   :  __________________________________

6.Basic Pay + Rank Pay ______________ Total/ Gross

Emoluments ________________

07.Credit Balance in DSOP/AFPP Fund ___________________________________

(Latest SE to be enclosed)

08.Amount of loan applied for Rs. ________________________________________

09.Bank Details :

(a) Bank Name :___________________________________________________

(b) A/C No. :______________________________________________________

(c) Name of Branch  _______________________________________________

(d) IFS Code :_____________________________________________________

(e) MICR Code :___________________________________________________

 Contd…2/-

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