Debit Card

BC Branch Code

The term “RBL Bank” or “the Bank” shall mean The Ratnakar Bank Limited.

Occupational Details

Agri-Allied: Dairy/Gotary/Fishery/Others ____________________________________________________________________________________________________

Non-Farm Sector: Manufacturing Service Trading

Area Under Cultivation: ______________________________Acres Agri Investment

Crops Name Type of InvestmentAcres AmountIrrigated (Yes/No)Sr No SI No

1 1

2 2

Financial Details

1. Source of Income of the Household(Family Income):

Annual Surplus from ActivitySr No Occupation Annual Revenue from Activity Annual Expenditure for the Activity

1

2

3

4

Primary Occupation

Other Activity-1

Other Activity-2

Activity of Other Family Members

Total

2. Present Source of Loan (Bank/Finance Cos/Commission Agents/Traders/MFI/Relatives etc.)

Source Purpose Amount Borrowed Tenure(in months) Amount O/S Status

Nominee/Guardian Address

Nomination

Title Name of the Nominee Gender Age Relationship with Borrower

Nominee Date of Birth

Guardian’s name if Nominee is Minor

Name of Business Unit

Activity No of Years Engaged

Avg Monthly Turnover in `

Goods Sold on Credit (per month)

Business Premises

Own / Rented

*Details Of Identity and Address proof (One ID & One Address Proof)

Voter ID PAN Card

Ration Card

Aadhaar Card

Electricity Bill

Driving Licence

Aadhaar Card

Sarpanch/Talati Letter

Sarpanch/Talati Letter Telephone Bill

Others____________

Others____________

Identity Proof

Address Proof

ID Proof No._________________________________________________________ Address Proof No.___________________________________________________

Family Details

Sr No Name Relationship Sex Age Occupation Educational Status

1

2

3

4

For Ratna Bachat

Nominee/Guardian Address

Title Name of the Nominee Gender Age Relationship with Borrower

Nominee Date of Birth

Guardian’s name if Nominee is Minor

For Insurance

2

6. I hereby declare that, I want to have only one signature for the account as given 'below'.

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GRT Date D M Y E A RD M

Ama~rEb ~±Ho$Mo

7. I also declare that for the purpose of account operation, a part from the below signature, I would not sign in any other manner and instruct the Bank to accept and honor all instruments/instructions issued/given by me bearing the below mentioned signature. I hereby agree and undertake to hold RBL Bank and its officers and Directors harmless and indemnified for any loss, damage, costs and charges incurred or suffered by the Bank and against any claims, suits, proceedings and actions instituted against the Bank due to acceptance of my request to honor instruments and instructions bearing the Below mentioned signature.

‘m¶mH$Sy>Z

Counter-party Checks:

1. Name, Address & Contact No:_________________________________________________________________________________________________________________

Feedback about the Client: ___________________________________________________________________________________________________________________

2. Name, Address & Contact No:_________________________________________________________________________________________________________________

Feedback about the Client:____________________________________________________________________________________________________________________

Controlling OfficeOne Indiabulls Centre, Tower 2B, 6th Floor , 841, Senapati Bapat Marg, Lower Parel (W), Mumbai - 400 013, India

Regd OfficeShahupuri, Kolhapur -416001, Maharashtra, India.

I/We Acknowledge receipt of application for loan of ` ______________on________________(Date) under Ratna Unnati Loan 'and' Ratna Bachat subject to

verification of contents and enclosures(if any). RBL Bank will endeavour to inform you about the status of your application normally within 15 days from the

date of receipt of documents/information as required from time to time and furnished by you to RBL Bank.

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(Oa Agoc Va) ImÌr Ho$cm OmB©b. Ama~rEb ~±H$ gm‘ݶnUo H$mJXnÌo {‘imë¶m VmaIonmgyZ 15 {Xdgm§À¶m AmV Vw‘À¶m AOm©da/doimodoir Ano{jV qH$dm Ama~rEb ~±H$cm Vw‘À¶mH$Sy>Z {Xcoë¶m ‘m{hVrMr

pñWVr H$idV amhrc.

Controlling OfficeOne Indiabulls Centre, Tower 2B, 6th Floor , 841, Senapati Bapat Marg, Lower Parel (W), Mumbai - 400 013, India

Regd OfficeShahupuri, Kolhapur -416001, Maharashtra, India.