E. S. I. C. (MEDICAL) EMPLOYEES' DELHI CO-OPERATIVE THRIFT & CREDIT SOCIETY LTD.
Regd. 478 (u) • E. S. I. Hospital, Ring Road, Basai Dara Pur, New Delhi-110015
APPLICATION FOR LOAN
| 1. Name: | 8. Society Account No.: |
| 2. Official Address: |
| 3. Residential Address: |
| 4. Employee I.D. No.: | 9. Designation: |
| 5. Bank Name & A/C No.: | 10. (a) Date of Birth: |
| 6. IFS Code / MICR No.: | 10. (b) Date of Retirement: |
| 7. Phone No.: | 11. No. of Shares Held: |
| 12. Basic Pay: ₹ | 13. Amount of Loan Required: ₹ |
| 14. No. of Installments: | 15. Purpose of Loan: |
16. Full Name of Guarantors with Account Nos.:
1. Name:
A/C No.: |
________________________
Signature of Guarantor 1 |
2. Name:
A/C No.: |
________________________
Signature of Guarantor 2 |
________________________
Signature of Applicant
(FOR OFFICE USE ONLY)
| Entry made in the Cash Book on Page: ___________ |
Accountant: ____________________ |
| Balance of Previous Loan if any: ___________ |
Date on which Last Loan Cleared: ___________ |
| M. C. L. of the member: __________________ |
Amount for which he is guarantor: ___________ |
SECRETARY / TREASURER
PRESIDENT
"SURETY BOND"
I
8. Society Account No.:
a member of the above named society have this
_________ day of ____________ 201___ Received Subject to the bye laws of the society, LOAN of Rupees
________________________________________________________________________ (in words Rupees
___________________________________________________________________________________________)
only bearing interest at the rate of 12% per annum which I hereby to repay in full by
___________ monthly instalments commencing from the next month of ____________ 202___ with interest
due thereon each instalment being payable on or before 7th of each month.
If I fail to pay in instalment or and instalment of the principal loan on the due date, the whole loan shall become immediately due and payable with interest, In case of default I further undertake to pay additional interest at 3% per annum on all overdue instalments from the date of default. I also undertake to deposit the instalments of principal loan with interest if not deducted from my salary for any reason.
I also agree to furnish one/two ____________ sureties in respect of this loan or fresh sureties in addition to or in place or those furnished below, should the Managing Committee of the society require me to do so.
I further agree that the loan will be expended for __________________________________________________ within one month from this date. If it is not so applied undertake to repay the money with interest within one month from this date. If it is not so applied undertake to repay the money with interest together with such additional interest as may be levied in accordance with the bye-laws of the society.
Under the provision of Section 52 of Delhi Co-operative Societies Act 2003 I authorise D. (M) D. & M.S.E.S.I New Delhi (my employer) to deduct from my salary or other money payable to me such amount on account of instalments due on this loan as may be furnished to him by Secretary of the Society from time to time and pay the sum direct to the said society in satisfaction of this loan
I further authorise D. (M) D. & M.S.E.S.I.C., New Delhi (My employer) in the event of my death or termination of my service from any cause what ever before this loan and the interest due thereon have been fully repaid to deduct from the moneys due to me or standing to my credit or due to my estate or any gratuity leave encashment Deposited or pension to which may become entitled, Such amount as will sufficient to liquidate the balance of this loan and interest thereon to date of payment and to pay same direct to said society in satisfaction of this loan.
Under the above condition I execute this bond after having duly RECEIVED the fully sum Rs. ______________________ (in words Rupees ___________________________________________________________________________________________________).
Signature of Witness:
1. _______________________________
Address: _______________________________
2. _______________________________
Address: _______________________________
_______________________________
Signature of Borrower (In Full)
Account No:
Office:
SURETIES / GUARANTORS UNDERTAKING:
Wehereby undertake to be jointly and severally liable to the above mentioned society for due repayment of this loan with interest in accordance with the above conditions and bye-laws of society and we hereby agree that our liability as sureties under this agreement shall not be impaired or discharged by reason of any time or other indulgence granted by the society of the said __________________________________________________ or by agreement entered into or composition accepted by the society modifying by operation of law or otherwise their and remedies under the above agreement.
1. Surety Signature: _______________________________
Name:
Account No.:
Office:
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2. Surety Signature: _______________________________
Name:
Account No.:
Office:
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