AGRANI BANK LIMITED
Foreign Corporate
Branch
Motijhee C/A, Dhaka.
Date:
.......................
The
Manager
Agrani Bank Ltd.
Foreign
Corporate Branch
Sub: Purchase of Medicine
Valuing Tk. 2,00,000/-
(Taka Two Lac only)
Dear Sir,
I/We intend to
avail credit facility from Agrani Bank Limited under its “Consumers Credit
Scheme” My particulars in detail and the particulars of investment is given
below:
01. Name : Md
Al Amin
02. Father’s Name/Husband’s Name : Abdus Sobahan Molla
03. Mother’s Name : Rahima
Begum
04. Present Address : House#
11, Village- Delpara, Road# 5, Block# 1,
Delpara, Post Office- Kutubpur-
1421,
Narayangonj Sadar, Narayangonj
05. Permanent Address : Do
06. Name of Business Firm/Organization : Anwar Pharmacy
07. Business Address with Phone No. : Delpara Bazar, Pagla, Fatulla, Narayangonj.
08. Designation : Proprietor
09. Age (From 21-57 years) : 32 Years Date of Birth: 20/02/1983
10. Marital Status : Married
11. Educational Qualification :
12. Disposable Income :
|
A.
|
Monthly
Income
|
|
|
|
a. Take Home Salary
|
Tk.
|
|
|
b. Monthly Contribution from spouse
and dependents
|
Tk.
|
|
|
c. Other income
|
|
|
|
1.
Sale Proceed
|
Tk. 5,00,000/-
|
|
|
2.
|
Tk.
|
|
|
3.
|
Tk.
|
|
|
Total
Monthly Income
|
Tk. 5,00,000/-
|
|
|
|
|
|
B.
|
Monthly
Expenditure
|
|
|
|
a. Family Expenditure
|
Tk. 25,000/-
|
|
|
b. Housing
|
Tk. 15,000/-
|
|
|
c. Education
|
Tk.
|
|
|
d. Other
|
|
|
|
1.
Medicine Purpose
|
Tk. 4,10,000/-
|
|
|
2.
|
Tk.
|
|
|
3.
|
Tk.
|
|
|
Total
Monthly Expenditure:
|
Tk. 4,50,000/-
|
|
|
|
|
|
C.
|
Net Disposable Income (A-B)
|
Tk. 50,000/-
|
Contd.
Page: 02
Page
No.2
13. Spouse and
Dependents:
(Please
enclose documents relating to income and expenditure of spouse and dependents
in details)
Name Age Relation
1.
Aklima
Akter 25 Wife
2.
Nosiba
Almin 02
Daughter
3.
14. Monthly
installment (Repayment) : Tk..................................................
15.
Particulars of Credit :
Medicine Purchase
a. Name of articles Viz. Household, car,
Microbus
detail/equipment/goods Pick-
up Van
etc. with make and details of
Specification.
b.
Cost of articles : Tk. ...........................
(Please
enclose invoice)
16.
Particulars of Guarantor: (Particulars enclosed separately duly signed by
Guarantor)
Name:
Abdus Sobahan Mollah, Son of Late Hazrat Ali Mollah & Late Meherun Nessa.
17.
Declaration by the Applicant:
a. I/We
have gone through the rules of “Consumers Credit Scheme” of Agrani Bank Limited and I/We undertake to follow
these rules meticulously.
b. I/We
will use myself/ourselves and I/We will not let out/lend/transfer the possessions
of the particulars in any manner to any person.
c. I/We
declare that the information’s furnished above are true and if anything
contrary is found, the Bank shall have the right to reject my/our
application/recall the loan at any time without showing any reason.
Witness:
NAME : Md.
Sultan Ahmed
FATHER’S NAME: Late Kasem Ali
ADDRESS : 326,
Sontak Road, Kazla, Jatrabari, Dhaka.
Date:..................................
EMPLOYMENT’S
CERTIFICATE:
I here by certify that Mr. /
Mrs........................................................................................... S.O./W.O./D.O.
...........................................................................................
is serving at ...........................................................................With
effect from (Date of Joining)............................... in the rank of....................................................and
his gross salary is Tk............................................. and take
home salary is Tk................................................
I also certify
that the above information are correct to the best of my knowledge His/Her
application may be considered.
Signature
Official Seal Name:.....................................................................
Designation:...........................................................
Name
of the Organization:......................................
Date:.................................
Contd...Page:03
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