Barasat Municipal Employees’ Co-Operative Credit Society Ltd.

Barasat, North 24 Parganas

Loan Application Form

To
The Secretary
Barasat Municipal ECCS Ltd.
Barasat, North 24 Parganas

Sub: Application for loan

Sir,

    I beg to apply for a loan of Rs. {{ $loan->applied_loan_amount }} (Rupees  {{ $loan->in_word }}) only subject to the bye-laws of the Society in {{ $loan->emi }} equal monthly instalments.

The particulars of mine are as follows:

  1. Sl. No. of members register : {{ $loan->member_registration_number }}
  2. Name in full (In Block letters) : {{ $loan->employee_name }} ({{ $loan->employee_id }})
  3. Father’s Name / Husband’s Name : {{ $loan->father_husband_name }}
  4. Address in full : {{ $loan->address }}
  5. Present place of posting & designation : {{ $loan->department_name}} / {{ $loan->designation_name}}
  6. Date of Retirement : {{ $loan->date_of_retirement }}
  7. Purpose of the loan : {{ $loan->purpose_of_loan}}
  8. O/S loan as on the date of application : {{ $loan->outstanding_loan_amount??0}}

Declaration:
I hereby declare that the statement given by me is true to the best of my knowledge. I must abide by the rules and regulation of the Society and I declare that the Society may deduct installment with interest from my monthly salary and also declare that, if any unpaid loan remains on the date of my retirement, the Society may deduct the unpaid amount with interest from my Gratuity, Provident Fund, and other Superannuation benefits.

Yours faithfully,

(Full Signature of member)