(APPL.FORM FEE Rs.100/-)
Maharashtra Rajay Itar Magas Vargiya Vitta Vikas Mahamandal Limited
MICRO CREDIT FINANCE SCHEME
NATIONAL
BACKWARD CLASSES FINANCE AND DEVLOPMENT CORPORATION,
New Delhi LOAN APPLICATION FORM FOR
MICRO CREDIT FINANCE No.
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1. |
Organisation Directory |
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(a) |
Name
of the Self Help Group |
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(b) |
Address |
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(c) |
State |
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(d) |
District |
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(e) |
Block |
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(f) |
Phone
No. (with STD code) |
% |
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(g) |
Fax
No. (if any) |
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(h) |
Nearest
Railway Station |
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(i) |
Registration
No. of the Self Help Group |
% |
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(j) |
Date
of Registration |
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(k) |
Date
of Renewal if any |
% |
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(l) |
Area
of operation |
% |
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(m) |
Name
of the Bank of Self Help Group |
% |
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(n) |
Account
No. |
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(o) |
Name
and Designation of Chief Functionary |
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2. |
Details of socio-economic development programmes implemented by the Self Help Group during last
3 years |
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Year |
Name of the Programme |
Funded by |
Amount received |
Achievements |
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(1) |
(2) |
(3) |
(4) |
(5) |
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Note - Please enclose a copy of your annual
reports of last three years.
For Office use only :
Code State Distt. Block Self Help Group
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3. Experience of the organization in CREDIT Activity during last
three years (Yearwise)
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Years |
Activities for which loan
given |
k No. of SHGs |
No. of borrowers |
Amount of loan disbursed |
Amount which was due for
recovery i.e. Demand |
Amount Actually Recovered |
% of Recovery to
Demand 7.6 |
Source of fund |
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(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
(8) |
(9) |
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4. Experience of the
Organisation in thrift/savings and formation of SHGs. Please give details
as below (position as on ……………………………)
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Sr. No. |
Name & Address of SHG |
Date of formation |
No. of members |
Savings Mobilised |
Loan given out of savings |
Amount Recovered |
Amount of loan outstanding |
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(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
(8) |
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Total |
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5. Proposed lending Programme in the current year
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Sr. No. |
Category of loan |
Name of Activities |
No. of SHGs |
No. of borrowers |
Average amount of loan per
beneficiary |
Total Amount Required |
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(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(5x6) |
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ST |
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MT |
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Total |
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6. Sources available with the organization
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Sr.No. |
Source |
Balance at the beginning of year |
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