Akshay Credit Co Operative Society LTD
Application for Loan
Branch
*
Please Select
MANDSAUR
MANASA
NEEMUCH
SITAMAU
GAROTH
JAORA
RATLAM
AGAR
ALOTE
NAGDA
SHAJAPUR
Lead by
*
Please Select
Sales Executive
Advisor
Name / नाम
*
Mr.
Mrs.
Miss
Ms.
Prefix / शिर्षक
First Name / प्रथम नाम
Last Name / उपनाम
Father/Husband/Guardian Name / पिता/पति नाम
*
Mr.
Mrs.
Miss
Prefix / शीर्षक
First Name / प्रथम नाम
Last Name / उपनाम
Mobile No. / मोबाइल
*
MID / सदस्यता क्रमांक
*
Branch Email
*
example@example.com
Address / पता
*
Street Address
Street Address Line 2
City
State
Pin Code
Occupation / व्यवसाय
*
Age / उम्र
*
Police Thana / पुलिस थाना
*
Agent/Sales Name
*
Loan Category / लोन केटेगरी
*
Please Select
PRE-INTEREST LOAN
Loan Amount
*
Please Select
20000/-
30000/-
50000/-
100000/-
200000/-
300000/-
400000/-
500000/-
Loan Tenure / समय अवधि
*
Please Select
100 DAYS
200 Days
120 DAYS
Documents Required
Take Photo / आवेदक का फोटो
*
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Detail To be Filled / आवश्यक जानकारी
*
Aadhar No.
A/C No.
Bank Name
Branch Name
IFSC CODE
Cheque 1 No.
Cheque 2 No.
Cheque 3 No.
Cheque
*
Cheque 4 No.
Cheque 5 No.
Cheque 6 No.
Cheque _
*
Cheque 5 No.
अपलोड किये गए चेक कही ओर इस्तेमाल न करे |
Aadhar Card / आवेदक का आधार कार्ड
*
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Address Proof / आवेदक का पता
*
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Bank Statement / आवेदक का बैंक स्टेटमेंट
*
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only PDF file accepted with all Visible Details.
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of
Other documents
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only PDF file accepted with all Visible Details.
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of
Cheque 1
*
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अपलोड किये गए चेक कही ओर इस्तेमाल न करे |
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of
Cheque 2
*
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of
Cheque 3
*
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अपलोड किये गए चेक कही ओर इस्तेमाल न करे |
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of
Cheque 4
*
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अपलोड किये गए चेक कही ओर इस्तेमाल न करे |
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Cheque 5
*
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अपलोड किये गए चेक कही ओर इस्तेमाल न करे |
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of
Cheque 6
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अपलोड किये गए चेक कही ओर इस्तेमाल न करे |
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of
ITR
*
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Guarantors
First Guarantor / प्रथम जमानतदार
*
Name
Father's Name
MID
Occupation
Address
Contact No.
Aadhar No.
Guarantor 1 Photo (प्रथम जमानतदार का फोटो )
*
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Guarantor 1 Aadhar Card (प्रथम जमानतदार का आधार कार्ड )
*
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Guarantor 1 Address Proof ( प्रथम जमानतदार का पता )
*
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Guarantor 1 Other Documents
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Guarantor 1 Cheque
*
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Second Guarantor / द्वितीय जमानतदार
*
Name
Father's Name
MID
Occupation
Address
Contact No.
Aadhar No.
Guarantor 2 Photo (द्वितीय जमानतदार का फोटो )
*
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Guarantor 2 Aadhar Card (द्वितीय जमानतदार का आधार कार्ड)
*
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Guarantor 2 Address Proof (द्वितीय जमानतदार का पता)
*
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Guarantor 2 Other Documents
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Guarantor 2 Cheque
*
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Registration Fee
*
Registration Fee Proof
*
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of
Collection Advisor ID (Machine ID)
*
Agreement and Terms
*
By submitting this application, you authorize us to make inquires into the banking and business references that you provided.
Signature
*
ASD
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Submitted
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