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Small Business Banking Unsecured Product Secured Product NFB Business Loan Unsecured OD Quick OD Others Secured OD Cash Credit Secured Term Loan CGTMSE LC BG LER Buyer Credit Standup India LCBN Others Merchant Loan Others Type of Facility Rs. In Lakhs Tenure Months) Purpose Label Code A. BUSINESS DETAILS FIELDS IN RED REPRESENT MANDATORY FIELDS) Account No. /s) Udyog Aadhar No Pan Card Date of Incorporation D D M M Y Y Y Y Office Residence Factory Permanent Whether the MSME unit is ZED rated Yes No If yes, the gradation obtained by the MSME unit Tick appropriate one) Bronze Silver Gold Diamond Platinum

B. INDIVIDUAL APPLICANT / CO-APPLICANT / GUARANTOR DETAILS Individual Applicant Proprietor Spouse Name Co-Applicant / Guarantor Photograph Mothers Maiden Name Others ) PIO/OCI CKYC No. Existing Cust ID PAN Card Passport No./ Voter ID Driving Licence/Others Passport No./ Driving Licence. Expiry Date Community Hindu Muslim Christian Sikh Buddhist Zoroastrian Parsi Jain Others Permanent Residence Address Relationship With Applicant Proprietor Partner Director Category SC ST OBC General Others Education Matricuate Undergraduate Graduate Postgraduate Professional Others Maritial Status Unmarried Married Others Number of Dependents Person With Disability Yes No CO-APPLICANT - II / GUARANTOR - II DETAILS Co-Applicant / Guarantor Photograph Mothers Maiden Name Others ) PIO/OCI CKYC No. Existing Cust ID Passport No./ Voter ID Driving Licence/Others Passport No./ Driving Licence. Expiry Date Community Hindu Muslim Christian Sikh Buddhist Zoroastrian Parsi Jain Others Permanent Residence Address Relationship With Applicant Partner Director Category Education Maritial Status SC Matricuate Unmarried ST OBC General Others Undergraduate Graduate Postgraduate Professional Others Married Others Number of Dependents Person With Disability Yes No

C. FINCIAL/INCOME DETAILS/ITR INCOME/ PAST PERFORMANCE/FUTURE ESTIMATES Past Year II Financial Year Year Turnover Rs. in Lacs) Profit as per P & L Rs. in Lacs) Installed Capacity Utilized Capacity Capital Net Worth in case of companies) Past Year I Provisional Present Year Estimate) Next Year Projections) Fill below details for Cash Credit limit Projected Cash Credit Sales Working Cycle in months Inventory Debtors Creditors Other current assets Promoters Contribution D. EXISTING LOAN DETAILS / FACILITY DETAILS Loan Bank Name Type of Loan Account No. Loan Amount EMI Loan Opening Date Tenure ROI Security Outstanding As on 1 3 4 E. DETAILS OF ASSOCIATES/GROUP ENTITITIES IN LAKHS) DETAILS AS ON. Name of the entitiy Existing Customer ID If Any) Exposure In Lac) Year Of Incorporation Nature of Business Net Sales/ Total Income Net Net Profit Worth Address of Associate Concerns Presently Banking With Nature of Association Extent of Interest as a Prop./ Partner/ Director or Just Investor in Associate Concern F. BANKING DETAILS S. No. Name of the Bank Branch Account Number Banking Since 1 G. STATUTORY OBLIGATIONS: Statutory Obligation: Remarks Any details in Connection with the relevant obligation to be given) Whether Complied with select Yes /No). If not applicable then select N. A. 1. Registration under Shops and Establishment ACT Yes/ No/. Registration under MSME Provisional /Final) Yes/ No/ 3. Drug License Yes/ No/ 4. Latest Sales Tax Return Filed Yes/ No/ 5.Latest Income Tax Returns Filed 6.Any other Statutory dues remaining outstanding Yes/ No/ Yes/ No/ H. SECURITY DETAILS a) Primary Security Type of Security Stock Book Debts Others Value as on date in lacs) b) Liquid Collateral Type of Security LIP, KVP, NSC, Fixed Deposits) 1.. 3. Relationship with Borrower Value as on date in lacs) c) Other Collateral Type of Collateral Letter of Credit LC) Bank Guarantee BG) Stand by Letter of Credit SBLC) Value as on date in lacs)

d) Property Collateral Type of Security Immovable Property) 1 3 Type of Property Name of Registered owner Relationship Borrower Property Address Area in Sq. ) Age of Property in yrs) Market value as on date in lacs) e). In case of Term loan Requirements, the details of Assets may be given as under : Type of Assets Purpose for which required Imported / Indigenous Name of supplier Total cost of Assets Contribution made by the promoters Loan required *In case of imported machine, the breakup of basic cost, freight, insurance and custom duty may be given. I. REFERENCE DETAILS BUSINESS REFERENCE ) Relationship with applicant / co-applicant Customer, supplier, Competitor) / Reference II Relationship with applicant / co-applicant Customer, supplier, Competitor) / J. INFORMATION ON OTHER PRODUCTS AND OFFERINGS K. INFORMATION ON SUBSIDY TUFS CLCSS IDLSS FPTUFS Others Value of Asset Rs. To be handed over do the customer ACKNOWLEDGEMENT FOR RECEIPT OF APPLICATION FORM Axis Bank has received your application for a Small Business Banking /Facility of Rs. Axis Bank will convey its decision within weeks for credit limit up to Rs. 5 lakh and within 3 weeks for credit limit above Rs. 5 lakh and up to Rs. 5 lakh for Micro & Small enterprises borrowers) and within 30 working days for other borrowers) from the date of receipt of the application provided the application is complete in all respects and is submitted along with all the documents as per 'check list' provided in the application for loan and/or any additional documents as may be required by the bank for proper appraisal of the application. The computation of timelines shall starts from the day on which all documents required for a proper appraisal of the application are provided by the Customer to bank. Signature of Sales Manager Sourcing Channel ASL/DSA/etc.) 1.Last years Audited /CA certified financial statement.moa & AOA of Company / Partnership deed of Partnership firm 3.Six Months Bank statement 4.KYC Documents Note : Additional document may be required for Credit assessment 1.Executing Facility related documents.executing security creation documents and submitting original security documents. 3.Compliance of Sanction terms and other conditions as may apply. Note : Additional documents may be required as per Sanction term

L SPECIFIC CUSTOMER DISCLOSURE IN RESPECTIVE OF RELATIONSHIP WITH DIRECTOR/SENIOR OFFICER OF THE BANK /ANY OTHER BANK 1 3 4 5 M PRIORITY SECTOR CATEGORY / MSME Value of Plant & Machinery Rs. Upto INR 5 lakh Micro) Above INR 5 lakh upto INR 5 crore Small) Above Rs. 5 crore upto Rs. 10 crore Medium) Value of Equipment Rs. Upto INR 10 lakh Micro) Above INR 10 lakh upto INR crore Small) Above Rs. crore upto Rs 5 crore Medium) N. DETAILS OF PARTNERS / DIRECTORS Name of Partners/ Directors of company/ Proprietors Complete Residence Address Father/ Spouse DOB Aadhar No. /DIN No. PAN No. Category SC/ST/OBC/ Minority/ Women Telephone No. Residence) Contact Details Age in years) Profit Sharing/ Shareholding % Academic Qualification Experience in the line of activity Years) O. GST DETAILS - BUSINESS For Individual fill Annexure) Whether registered under GST Y N Registration Date: D D M M Y Y Y Y GST Registration Single Multiple Please fill GST Annexure for multiple GST Registration) Special Economic Zone GSTIN Default) Y N SEZ CodeIf Yes) GST Exemption Y N Exemption ReasonIf Yes) Exemption Valid Till : D D M M Y Y Y Y Address registered for GSTIN Same as Of ce Address Same as Factory Address As given below DETAILS OF CHARGES * Sr.NO Nature of fee / charges Cash Credit Overdraft Merchant Loan Secured Term Loan Unsecured Business Loan 1 Processing Fees Upto 1.5% +Taxes applicable Upto 1.5% +Taxes applicable Upto.00% +Taxes applicable Upto 1.5% +Taxes applicable Upto.00% +Taxes applicable 3 4 5 6 7 8 9 10 Non Refundable Login Fee Rs. 5000/- + Taxes applicable Rs. 5000/- + Taxes applicable Rs. 5000/- + Taxes applicable Stamp Duty & other As per applicable laws of As per applicable As per applicable As per applicable laws of state As per applicable laws of state statutory document charges state laws of state laws of state ROC ling charges Rs. 100/- +Taxes applicable Rs. 100/- +Taxes applicable Rs. 100/- +Taxes applicable Rs. 100/- +Taxes applicable Non submission of stock statement Non submission of property/stock insurance Cheque book issuance charges % +Taxes applicable of the outst anding amount from the date of default % Additional rate of interest on the amount outstanding First 100 leaves free for new borrower account) and thereafter Rs /- per leaf % Additional rate of interest on the amount outstanding First 100 leaves free for new borrower account) and thereafter Rs. /- per leaf First 100 leaves free for new borrower account) and thereafter Rs /- per leaf % Additional rate of interest on the amount outstanding Cheque Bounce Rs. 500/- per instance +Taxes applicable Rs. 500/- per instance +Taxes applicable Rs. 500/- per instance +Taxes applicable Rs. 500/- per instance +Taxes applicable Rs. 500/- per instance +Taxes applicable Penal Interest.00% p.a. additional on existing Rate of Interest.00% p.a. additional on existing Rate of interest.00% p.a. additional on existing Rate of interest.00% p.a. additional on existing Rate of interest.00% p.m. on the amount of overdue installment RS. 150 + Taxes applicable RS. 150 + Taxes applicable RS. 150 + Taxes applicable RS. 150 + Taxes applicable RS. 150 + Taxes applicable CERSAI charges 11 Rs.100/- + Taxes applicable Rs.100/- + Taxes applicable Rs.100/- + Taxes applicable Rs.100/- + Taxes applicable per collateral Goods and Services tax GST) will be charged extra as per the applicable rates, on all the charges and fees wherever GST is applicable)" RA/SBB/App. Form/ July. 17 /Version 5.0

P. CUSTOMER DECLARATION address.1. It is certified that our unit has not availed any loan from any other Bank / Financial Institution in the past and I am not indebted to any other Bank / Financial Institution other than those mentioned in above columns. 1. Axis Bank will convey its decision within weeks for credit limit up to Rs. 5 lakh and within 3 weeks for credit limit above Rs. 5 lakh and up to Rs. 5 lakh for Micro & Small enterprises borrowers) and within 30 working days for other borrowers) from the date of receipt of the application provided the application is complete in all respects and is submitted along with all the documents as per 'check list' provided in the application for loan and/or any additional documents as may be required by the bank for proper appraisal of the application. The computation of timelines shall starts from the day on which all documents required for a proper appraisal of the application are provided by the Customer to bank. / facility As per RBI guidelines, classification of accounts as NPA is done Borrower wise and not Facility wise and hence, it may be noted that in case of non-payment of dues by the customer in case of any facility availed from the Bank and consequently the account is to be classified as NPA, all other loan accounts of the Borrower/Card Holder, with the Bank also shall be classified as NPA as per the guidelines issued by RBI and it shall entitle the Bank to recall all such loans/facilities availed by the same customer from the Bank irrespective of the regular repayment in such accounts Co-Applicant / Guarantor - I Signature Co-Applicant / Guarantor - II Signature Co-Applicant / Guarantor - III Signature Q. SOURCING DETAILS for Official use only) Corporate Linked Direct Digital Circle Connector Open Market MAB Sampark Vistaar Vistaar + Others Please Specify) Further options of Digital Circle Email SMS Inbound customer service Internet Banking Mobile Remote Banking RM. Web Leads Telecalling ATM DSA Code : DSA Name : TL Code : Corporate Name Corporate Scheme label Fulfilment Channel: SBB SM's Vistaar branches Vistaar + branches ARM MAB Other AXIS Bank Relationship Manager : Referrer Branch Name : Ref ID : / CRM ID Account Opening City Account Opening Branch Name Account Opening Branch Sol ID Signature of Sourcing Channel FOR BANK USE ONLY Documents Received Certified KYC VERIFICATION CARRIED OUT BY Emp. Name Emp. Code Emp. Designation Emp. Organisation & Code AXIS BANK LIMITED,001 Emp. Branch Place : Date : D D M M Y Y Y Y Employee Signature)