CBD-23 BANK OF INDIA

Rev. - 2006 Abids Branch

BORROWER’S/GURANTOR’S PROFILE
The Branch Manager,
Bank of India
Abids Branch
Hyderabad-500 001

I hereby declare that the information provided below by me is true and correct and I undertake that if at any point of time
hereinafter it transpires that any information provided/to be provided by me is found to be incorrect/false, the Bank shall
be at liberty to recall the advance forthwith, irrespective of the contracted terms of the loan I would repay forthwith, the
entire loan outstanding then together with interest/penal/additional interest and other charges. I undertake to provide any
further information as Bank may ask from me time to time. I also undertake to execute necessary documents for
guaranteeing the loan. I further declare insolvency proceedings have been initiated againdt me or pending in any court.

1. Name: (Shri/Smt./Kum)
T O L W A L A S A N J A Y K U M A R
(Surname) (Name) (Middle Name)
2.Resident Status:
Resident Non-Resident Indian Foreign Resident
3.Father’s Name/Husband’s Name
L A T E S R I T R I B H U V A N D A S
4.Present Address: 5. Permanent Address
4 - 1 - 9 3 2 4 - 1 - 9 3 2
T I L A K R O A D T I L A K R O A D
A B I D S A B I D S

CITY CITY
H Y D R A B A D H Y D E R A B A D
T E L A N G A N A T E L A N G A N A
TELEPHONE TELEPHONE
6 6 7 7 3 7 4 7 6 6 7 7 3 7 4 7
MOBILE EMAIL
9 8 8 5 2 9 2 8 2 4 9 8 8 5 2 9 2 8 2 4
Premises : Owned BY RANGA REDDY Premises: Owned BY RANGA REDDY
Duration of Stay: 100 YEARS Duration of Stay: 100 YEARS
6. Age & DOB: 51YEARS, 03/05/1968 7. Nationality: INDIAN
8.Sex: Male/Female MALE 9.Educational Qualification: 10TH PASSED
10.Occupation: Service/Business/Retired (Last employment with) SELF EMPLOYED
A. If in Service
Address________________________________________________________Tel
NA No._____________________________
NA
Service Since ______________________Post
NA Held ________________________Date
NA of Retirement_________________
NA
B. If in Business: Name of the Company: DNT POWER (UNDER INCORPORATION)
Address/Tele: 4-1-932, TILAK ROAD, HYDERABAD 500 001
Line of Activity/Experience: FUEL LESS POWER GENERATION AND 20YEARS EXPERIENCE

Establish
City Since: 23/11/2018 Position: PROPERITORYSHIP
 11. Annual Income: 2.95 LACS 12. PAN No. A 0 J P K 3 9 3 2 L
13. Identification: (Enclose Copy)
Driving licence Identity Card Passport Credit card Ration Card
No. PAP1674432000460
Valid Upto NA
Date & Place issue 06/02/2006

14. Detail of Bank Accounts:

Sl. Bank Name Branch Name Account Type Account No. Current Balance Last six
No. mnths avg.
BANK OF BARODA ABIDS S/A 0511010000 RS.33000 RS.30,000
0017

15. Details of Assets:

A. IMMOVABLE PROPERTY As on 31.03.2015
Particulars Ownership Area in Free Hold Location / Address Purchase Present Whether
Sq.mtrs or Lease Cost Value encumbered
Hold Amount in Amount in (Give details)
Rs. Rs.
OPEN JOINT 416 FREE BODUPPAL 750 2.40 CR FREE
PLOT HOLD

B. MOVABLE PROPERTY
i. Insurance Policies (Amount in Rs.)
Name of the Company & Policy No. Date of Sum Assured Surrender Annual Premium paid
Branch Issue Value Premium upto what
period

NA NA NA NA NA NA NA

NA NA NA NA NA NA NA

NA NA NA NA NA NA NA
ii. Shares/Debentures/Mutual Fund etc. (Amount in Rs.)
Name of the Company & Branch No. of Certification Scheme Whether Current
Shares No./Account No. fully paid Market
Demat Account No. (Yes/No) Value
NA NA NA NA NA NA
 NA NA NA NA NA NA

NA NA NA NA NA NA

iii. Term Deposits: (Amount in Rs.)

Term Deposit Receipt Bank/Branch Name Type Amount & date Maturity Maturity
No. of receipt Date Amount

NA NA NA NA NA NA

NA NA NA NA NA NA
iv. Investment in Govt. Securities like Bonds/PPF/NSC/KVP/IVP etc (Amount in Rs.)
Bond/Certificat Nature of Secutity Date of Issuing Office/ Face Value Due Date Maturity
e No. Purchase Post Office Amount

NA NA NA NA NA NA NA
v. Vehicles (Amount in Rs.)
Type of Registration Model Year of Cost at the time RC Book Present Value
Vehicles No. Make of Purchase Details

NA NA NA NA NA NA NA

NA NA NA NA NA NA NA

NA NA NA NA NA NA NA

NA NA NA NA NA NA NA
vi. Jewellery: (Amount in Rs.)
Particulars Quantity Valuation (Approx)* Details of Shridhan, if any
GOLD 30 90,000 NA
SILVER NA NA NA
OTHERS NA NA NA
(* Attach Valuation Certificate, if available)
16. LIABILITIES:
i. As Borrower (Amount in Rs.)
Borrowed from Purpose of Loan Amount of Loan Security Repayment Terms Outstanding
Balance
NA NA NA NA NA NA
NA NA NA NA NA NA
ii. As Guarantor (Amount in Rs.)
Name of the person Name of the Guarantee Present status of Outstanding balance
whom Guaranteed Bank/Financial Institution Amount account
NA NA NA NA NA
17. Legal Heirs/Family Particulars
Name Occupation Relation Age Marital Status Address
SHARAD KUMAR BUSINESS BROTHER 50 MARRIED TILAK ROAD
18. Any other relevant particulars (If needed then add separate sheet)

In support of any declaration, I enclose:

Place: HYDERABAD
Date: 18/04/2019 ________________________________
(Signature of Borrower/Guarantor)
Worth assessed as per market report and the details In case of Guarantor, signature verified
provided by the proponent Rs. (Bank (by the Borrower)
Official)
Verified the documents (With the original)
by………………..
________________________ ________________________
Signature & Code Borrower’s Signature
Date: