Securitisation Request

Proforma for furnishing particulars to initiate Action under

Securitisation and Reconstruction of Financial Assets and Enforcement of Security Interest Act, 2002

Branch Name :		Date:

1. Name and address of the Borrower:-
	,
	,

2. Name and address of the Co-borrower:-
	,
	,

3. Name and address of the Guarantors/Sureties:-
	,
	,

4. Loan amount sanctioned:- Rs.

5. LSO No. and Date:-

6. Date of first disbursement:-

7. Present position of the account:-

	Principal Outstanding	: Rs.
	Principal Overdue	: Rs.
	Interest Overdue	: Rs.
	Penal Interest Overdue	: Rs.
	Penalty Overdue	: Rs.
	Others	: Rs.

8. Details of Securities and its present value: , Rs.

9. Name and address of the person who Mortgage of the above properties:-
	,
	,

We hereby certify that the above information is true and correct.

Asst Manager.

Branch Manager.

Note: A copy of the Ledger Sheet shall also be enclosed.