APPLICATION FOR CLEAN LOAN

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APPLICATION FOR CLEAN LOAN The Chief Executive Officer, The Andhra Bank Employees C0-operative Bank Ltd., Date : Bank Street, Koti, Hyderabad-500 195. Dear Sir, We the applicant and surety/sureties request you to sanction to the applicant, a Clean Loan of Rs.. We furnish below the personal and other details for consideration of our application. 1. Particulars: PARTICULARS APPLICANT SURETY I (Spouse of applicant) Name in full Father / Husband s name Residential Address SURETY-II (Pensioner/Employee of Andhra Bank) Phone Numbers (with STD codes) Land Line Mobile Date of Birth Staff Code No. Designation (While in service/ Existing) Admission No. While in Service While in service/ Existing Date of Retirement Details of Pension / Salary Drawing Branch Retired On Retired/due to retire on Branch Account Branch Name Code No. Name Code Acc ount No. Pension /Salary details (Enclose certificate of latest pension drawn or Salary Certificate) Basic Pension DA tal Pension (Pension Details) (Pension/Salary Details ) Gross pension/ Salary Net Pension/ Salary II. AMOUNT OF LOAN REQUIRED Rs III. REPAYABLE IN MONTHLY INSTALMENTS OF (Tick your option) III. PURPOSE OF LOAN (Housing/Medical/Ceremonial/ House hold needs) 12 18 24 30 36

: 2 : We (1) (Applicant and Pensioner) herein agree to allow the Pension Disbursing Branch of Andhra Bank to deduct from my Pension Account No. with branch of Andhra Bank, the dues of the Bank every month as per the Agreement entered into with them, (2) (Surety and Spouse of Pensioner) herein agree in the unfortunate event of death of the pensioner, to allow the Family Pension Disbursing Branch of Andhra Bank to deduct from my Family Pension Account with any branch of Andhra Bank, the dues of the Bank every month as per the Agreement entered into with them, and (3) (Surety) herein agree to allow the Bank to deduct from my Salary / Pension Account with branch of Andhra Bank the dues of the Bank, in the event of default in repayment of the loan either by the pensioner or his spouse in normal course or in the case of death of pensioner, every month as per the Agreement entered into with them. We hereby declare that the information provided above is correct to the best of our knowledge and this proposal will form the basis of the agreement between the Bank and ourselves, if the loan is sanctioned. We further agree and undertake to abide by the Rules and Regulations of the Bank in regard to the Loan in force at present or as per revised rules from time to time. Signature of Surety Signature of Surety Signature of Applicant and Spouse ---------------------------------------------------------------------------------------------------------------- Forwarded to The Andhra Bank Employees Co-operative Bank Ltd., Central Office, Bank Street, Koti, Hyderabad. The above particulars are verified and found correct. The application may be considered as per eligibility. For ANDHRA BANK Date: BRANCH MANAGER BRANCH Office Seal

DEMAND PROMISSORY NOTE Rs. Date : On Demand we jointly and severally promise to pay at Hyderabad to The Andhra Bank Employees Co-operative Bank Limited, Hyderabad or Order, the sun of Rupees together with interest on such sum from this date at percent per annum at monthly rests for value received. Re.one rev.stamp ------------------- 1.BORROWER ---------------------------- 2. SURETY ---------------------------- 3. SURETY The Chief Executive Officer, Date : The Andhra Bank Employees C0-operative Bank Ltd., Bank Street, Koti, Hyderabad-500 195. Dear Sir, With reference to our Demand Promissory Note for Rs. (Rupees dated, kindly pay the amount thereof to the borrower Sri ---------------------------- (SURETY) ----------------------------- (SURETY) On Stamp Paper

The Andhra Bank Employees Co-operative Bank Ltd., HYDERABAD SURETY LOAN BOND LOAN No The Surety Loan Bond jointly executed this day of By (1) Borrower Son/Daughter/Wife of, aged years, Pensioner of Andhra Bank, residing at (2) Surety Son/Daughter/Wife of, aged years, spouse of above borrower residing at ( 3) Surety Son/Daughter/Wife of, aged years, a permanent employee / Pensioner of Andhra Bank, residing at in favour of The Andhra Bank Employees Co-operative Bank Ltd., with its Central Office at Hyderabad, Andhra Pradesh, herein after referred to as said bank. 2. One of us namely (Borrower) has received from the said Bank, a loan of Rs. (Rupees ) for (purpose) We promise and undertake to repay the said amount with interest at per cent per annum at monthly rests in monthly instalments commencing from (each instalment being payable on or before 10 th of the month succeeding to which it relates). We undertake to repay this loan before. Should we fail to pay any instalment of loan or interest, we bind ourselves to pay extra interest of 2% per annum, over and above the normal rate mentioned above from the date of default to the date of payment. We further agree that for default of payment of an instalment of loan or interest the Bank may preclose the loan account and proceed to recover the entire amount legally with interest at percent per annum on the total amount of Principal and interest along with subsequent interest and with costs if any, the Bank may incur therefor, either from all or any of us from the Monthly Pension/Salary or terminal benefits payable to (Surety) or from properties belonging to us. 3. We agree to abide by the Bye-laws and Rules of the Bank now in force and those that may be amended or enacted hereafter from time to time. Witnesses: (Shall be Pensioners/employees of Andhra Bank) 1. Signature: Name Occupation Staff Code No. Borrower 2. Signature: Name Occupation Staff Code No. Surety 3. Signature: Name Occupation Staff Code No. Surety

IRREVOCABLE STANDING INSTRUCTIONS LETTER ( be submitted in duplicate) ================================================================== From: Mr/Ms, Staff Code No. Cadre and Grade: (at the time of retirement) & Mrs. Door No. Street. wn. District State Pincode.. The Branch Manager, Andhra Bank, Branch Dear Sir, Date : Photo of pensioner with spouse Sub: Standing Instructions (irrevocable) to recover loan instalments of the ABE Co-operative Bank Ltd., *** *** *** I, S/o. aged (Date of Birth: ) R/o the pensioner of Andhra Bank, drawing pension through my Savings Bank account No.. maintained with your branch inform that I propose to avail a Clean Loan of Rs from the Andhra Bank Employees Co-operative Bank Limited, Central Office, Hyderabad. The Bank has already sanctioned the loan amount of Rs. /- and fixed an EMI of Rs. /- I hereby authorise you to deduct loan instalment of Rs. per month from My Pension Account bearing No. with your branch and remit to the credit of my Clean Loan account availed/to be availed from them until the said Andhra Bank Employees Co-operative Bank Limited confirms to you in writing that the loan availed by me from them is repaid in full with interest and expenses. The standing instruction letter cannot be revoked by me unilaterally without the consent of the Andhra Bank Employees Co-operative Bank Limited in writing. I, W/o. (Pensioner), agree to above proposal and also authorise the Bank to deduct loan instalments from my Family Pension, in the unfortunate event of death of the Pensioner. We request you to forward the letter to the Andhra Bank Employees Co-operative Bank Limited, Central Office, Hyderabad confirming that the standing instructions are noted in your records, to enable them to disburse the loan amount. Yours faithfully, Signature of Pensioner Signature of Spouse of Pensioner

FORWARDING LETTER OF PENSION PAYING BRANCH OF ANDHRA BANK From: The Branch Manager, Andhra Bank, Branch Dear Sir, The Andhra Bank Employees Cooperative Bank Limited, Central Office, Hyderabad. Date: Re: Irrevocable standing instruction letter of Mr (Staff Code No (Pension Account No ) and Mrs..(Spouse of pensioner) ** ** ** We forward herewith a copy of irrevocable Standing Instructions letter received from the above pensioner along with spouse and confirm that the instructions are recorded in our books for remitting EMI of Rs. to you from the pension account No..maintained with our branch by above pensioner till your loan is repaid in full and communicate the same in writing to us, from the pension being credited to the account of the captioned pensioner. Yours faithfully, BRANCH MANAGER (Name: ) (Staff Code No...) Seal of the Branch

The Andhra Bank Employees Co-operative Bank Ltd. Central Office: Mithila Complex, IIIrd Floor, H.No.4-4-296/297,Bank Street. HYDERABAD-500 095 PROPERTY STATEMENT The Branch Manager, The Andhra Bank Employees Co-operative Bank Ltd., Branch Sir, Reg: Standing as Surety/Co-obligant to and /or Sanction of Credit Facilities to I have pleasure in furnishing overleaf, the particulars of movable and immovable properties. There are no encumbrances on them except those noted. I hereby undertake not to alienate, encumber or charge any of my properties without discharging the advances you have already made or may make from time to time to me or to any person/s to whom I stand as co-obligant/guarantor or guarantor for any other obligations afforded to me or to any other person/s to whom I stand as guarantor. My personal details are furnished below. 1) Full Name : 2) Father s/husband s Name : 3) Date of Birth / Age : 4) a ) Occupation : b ) Name and Address of employer: 5) Address : Business / Office Permanent Residential address Present Address 6) Particulars of family members (Spouse/Sons/Daughters/Father/Mother/Brothers) S. No. Name Date of birth / Age Relationship with applicant Occupation Permanent Address Business/ Office address 1 2 3 4 5 6 7 8 9 10

Property Statement Particulars of immovable property Location along with R.S.No Municipal Door No. Area Estimat ed Market value Income per year Is the property self acquired or joint Encumbrance on the property Particulars Amount Remarks Particulars of movable property Acquisition cost Present Market value Annual Income Remarks Other Liabilities Name of Creditor Amount of Loan Terms of payment Existing liability Rs Note: Enclose documentary evidence wherever available in support of the Properties described above. Yours faithfully, Date: Signature of applicant