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DPNB/28 Page 1 of 4

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DRUK PNB BANK LIMITED

Application-cum-Appraisal/Sanction Form for Personal Loan

Branch Office: _________________ Date of Application:_______________

Part – I Applicant Information

[Please read this before applying for the loan: Minimum Monthly Take Home Salary should be Nu 8500/- excluding the

proposed loan Installment and the same should be atleast 40% of the Gross Salary after including the installment of proposed

loan]

Please mention your Customer ID No here if you have any account with Druk PNB Bank

1. Applicant’s Name

2. Father’s/Husband’s Name

Photograph Here

3. Date of Birth

4. National ID Number

5. Date of Joining Service

6. Designation/Grade

7. Current Monthly Salary

(Pl attach Pay Slip)

8. Name & Address

of the Employer

………………………………………………………………………………………

……………………………………………………………………………………..

Telephone No…………………Email ID……………………PO Box No………..

9. Residential Address

………………………………………………………………………………………

………...........................................................................................................................

............................................................................................................

Telephone No……………………Email ID……………………………………..

10. Permanent Address

House No……………………………….Thram No……………………………….

Yue………………………………………Geog…………………………………….

Dungkhag……………………………….Dzongkhag……………………………..

11. Education Background

Matriculation

Intermediate

Graduation

PG/Master

Ph.D.

12. Whether relative of Staff /Director of bank

Yes

If yes, mention the Name

……………………………………

13. Marital status

Married

Unmarried

If married, please provide spouse’s details below under serial No 14

14. Spouse Information

a. Name of the spouse:

b. Address

c. Occupation/Profession:

d. Total Annual Income

e. Tax Payer No. (if applicable)

……………………………………………………………………………………

………………………………………………………………………………………

Gross………………………………Net…………………………………………

……………………………………

15. Any existing loans taken from

DPNBL and other FIs and

Banks: Loan Type:

Limit sanctioned

Present Outstanding:

Status:

Monthly Repayment:

Loan I

…………………

Loan II

…………………

Loan III

…………………

………………..

Loan IV

…………………

……………….

Name of FI

Loan A/c No

DPNB/28 Page 2 of 4

17. I request for sanction of loan of Nu…………………………..(Ngultrum…………………….………………………

...................................................................................) under Personal Loan Scheme for …………………………

……………………………………………………………………………………………………(Mention the purpose)

I declare that all the particulars and information given in the application form are true, correct and complete

and upto date in all respects and I/We have not withheld any information. I confirm that I have had no

insolvency proceedings initiated against me/us nor have I ever been adjudicated insolvent. I confirm that I had

never been awarded an adverse judgement or decree in a court case involving breach of contract, tax

malfeasance or other serious misconduct and never been a defaulter with DPNBL/other financial institution. I

authorise DPNBL or its agent to make references and enquiries relative to information in this application which

DPNBL considers necessary. I also authorise DPNBL or its agent to make information relating to me/our loan

details and repayment history information to RMA/CIB/other agencies as may be required and shall not hold

DPNBL liable for use of this information. I undertake to inform DPNBL regarding any change in my/our

residence/employment and to provide any further information that DPNBL may require.

I confirm on solemn affirmation that the above information along with the information given under

ENCLOSURE is correct. I am bound to inform the bank of any change in the details given above. I agree to

pay processing charges as applicable and charged by the bank. I have read and have been advised the terms

and conditions relating to the Personal Loan Scheme and I hereby agree to abide by these terms and

conditions or by the revised additional terms and conditions which may at any time hereafter be made while

the loan obtained by me/us is still outstanding.

I confirm that the particulars mentioned by me in the application are correct. I hereby authorize my employer

to recover the stipulated installments including interest from my salary every month. In the event of default on

my part or my leaving the service or in the other exigencies, if loan is still unpaid, I give my unqualified

consent to the Bank to adjust the loan amount outstanding against me with interest from my provident fund

balance /or gratuity payable to me and/ or any other amounts due to me.

Further, it shall my responsibility to ascertain with the concerned salary section of my department that the

stipulated monthly recoveries made from my salary has/ have remitted to bank promptly.

Yours faithfully,

(Signature and Name of Applicant)

(Enclose photocopies of documentary evidence in support of above)

16. Details of Personal Loan requested from DPNBL

a. Purpose of Loan

b. Loan Amount

c. Repayment Period (in months)

d. Monthly Installment

e. Mode of repayment

……………………………………………………………………

Nu……………………………………………………

…………………Months (Maximum is 60 Months)

Nu ……………. Per month

From Salary SI Advance Cheques

CHECK LIST OF DOCUMENTS REQUIRED

1. ID Card copy of Applicant & Surety

2. Passport Size Photograph (2 Nos)

3. Latest Pay Slip

4. Recommendation Letter from the Employer

5. Loan Clearance Certificate from other FIs

DPNB/28 Page 3 of 4

Having fully apprised myself of the particulars submitted in above personal loan application form submitted by

Dasho/Mr/Ms………………………………………………who is working in Organization/Ministry/Department as

………………..…………………………., I have decided to stand as Surety(Guarantor) for the loan applied for and

further I give my unconditional undertaking to repay the loan in case applicant fail to repay it. The information

furnished by me is true and correct to the best of my knowledge & belief.

Date:

Place: Signature of Guarantor

PART-III (Recommendation from Employer)

We hereby confirm that herein mentioned particulars of Dasho//Mrs/Ms. _____________________________of

our department / ministry/company/firm are correct. Further, he has been in the service since……….and currently

he is serving as……………………………………..(give designation). If Druk PNB Bank sanctions a loan of

Nu.________________ (Ngultrum_______________________________________________________________)

requested by him/her, we undertake to deduct the monthly loan installment regularly from his/her monthly salary

and promptly remit the same to Druk PNB Bank________________________Branch office till entire loan is fully

repaid with interest.

We further undertake that in the event of the employee leaving the service due to any reason or on account of

retirement/ resignation before the loan is fully repaid, his/her last salary/gratuity/provident fund, etc. will be paid to

the Bank towards adjustment of the loan.

We further confirm that in event of transfer of the employee to any other department/establishment, the relative

loan outstanding/stipulated installments will be mentioned in the employee’s “Last Pay Certificate”. Also the

information about the employee’s transfer will be conveyed to the Bank.

(Signature of the Recommending Official)

Name: ……………………………………..

Designation: ..…………………………….

Name of the Organization/Ministry/Department……………………………….

PART-IV (APPRAISAL & SANCTION)

For use of Druk PNB Bank

Part-II Surety (Guarantor) Information

Name

Designation

Employment Address

Permanent Address

Date of Birth (dd/mm/yy)

Customer ID No

………………………………………………………CID No……………………………..

………………………………………………

………………………………………………………………………………………………….

House No…………………… Thram No………………..Village…………………………

Geog………………………… Dungkhag……………… Dzongkhag………………….

………………………………………………………………………………………………….

………………………………. (if the guarantor is maintaining any account with DPNB)

DPNB/28 Page 4 of 4

The application submitted by___________________________________ for______________________

__________________________________________________ with Druk PNB Bank financial assistance

under Personal Loan Scheme has been appraised and qualifies/does not qualifies for sanction of loan as

detailed below:-

1. Loan Amount : ________________(30 x Monthly Net Take Home pay or Nu.

300,000 whichever is lower)

2. Interest Rate(Simple) : __________% per annum with monthly rate

3. Repayment Period : __________ months

4. Commencement of Repayment : __________ (that is one month after release of loan)

COMMENTS:………………………………………………………………………………………………

………………………………………………………………………………………………………………

Recommended/not recommended for sanction

Dealing Official Branch Incumbent(VP/AVP)

(To be signed if the sanctioning authority is beyond its power)

---------------------------------------------------------------------------------------------------------------------------

Sanctioned by:

Branch Incumbent (VP/AVP) //OR// MC/CEO/DyCEO/EVP

Sanctioned on ___________________ (Place)___________________________