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Application to the Committee for a Corrective Action Plan under
Revival & Rehabilitation of MSME

(For Existing Loan Exposure up to Rs.10 Lakh)

Branch Details Section:
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A.Brief Profile of the Enterprise:
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B.Details of Proprietor/ Partners/ Directors:
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Name of Proprietor/ Partners/ Directors * Designation * Residential Address with Contact No * PAN No./ DIN No. * Net Worth as on date
(Amount in Rs.)

C. Details of Associate Concern / Sister Concern: (Amount in Rs.)
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Name of Associate Concern/ Sister Concern Business Activity Banking With Loan Limit
Financials as on
FB NFB Gross Sales PAT TNW

D. Social Category:
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E. Details of Existing Liabilities with the Bank: (Amount in Rs.)
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Sl. No. Nature of Facility Limit
O/s Bal as on
Over Dues
1. Fund Based
A. Working Capital
B. Term Loan
Total (1)
2. Non Fund Based
A. Working Capital
B. Term Loan
Total (2)
3. Grand Total (1+2)

F. Details of Other Liabilities: (Amount in Rs.)
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Details of Statutory dues remaining outstanding with State Government or Central Government * Details of Unsecured Creditors. (Furnish reason for incurring liability) *

G. Past Performance & Future Estimates: (Actual performance for two previous years,
estimates for current year and projections for next two years to be provided for additional
working capital facilities)(Amount in Rs.)
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Past Year-II (Actual) Past Year-I (Actual) * Present Year (Estimate) * Next Year-I (Projection) Next Year-II (Projection)
Net Sales
Net Profit
Capital (Net Worth of the Enterprise)
Current Ratio
Debt Equity Ratio

H. In case of additional Working Capital: (Amount in Rs.)
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Actual Sales Projected
FY- FY- Sales Working Cycle in Months Inventory Debtors Creditors Promoter’s Contribution

I. For additional term loan facilities projections to be provided till the proposed year of repayment of loan.

J. (a) Details of Existing Security: (Amount in Rs.)
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Particulars of Primary Security * Nature of charge Date of Valuation Value *
Particulars of Collateral Security * Nature of charge Date of Valuation Value *

(b) Details of Proposed Additional Security to be offered:
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Particulars of Primary Security offered * Particulars of Collateral Security (where applicable) *

K. (a) Details of Existing Guarantors: (Amount in Rs.)
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Name of the Guarantors * Age Occupation * Annual Income * Net Worth

(b) Details of Proposed Guarantors: (Amount in Rs.)
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Name of the Guarantors * Age Occupation * Annual Income * Net Worth