HP Financial Corporation

Phones: No. 2624642 Telegram: FINCORP
FAX No.2623027

HIMACHAL PRADESH FINANCIAL CORPORATION,
NEW HIMRUS BUILDING CIRCULAR ROAD
SHIMLA-171001

APPLICATION FOR FINANCIAL ASSISTANCE TO TRANSPSORT OPERATORS

The Managing Director,
HP Financial Corporation,
New Himrus Building,
Shimla-171001.

Dear Sir,

I/we hereby beg to apply for a transport term loan of Rs. ______________ (Rs. __________________________________________) and submit the following information in this regard:

S. No.

Description

To be filled in by the Borrower

1

Name of the Borrower

2

Correspondence Address:

a) Telephone No. if any

3

Permanent Address

Telephone No. if any

4

Place of domicile

5

Constitution

6

Date of establishment

7

Name(s) and Address(es) of Sole Prop

Partners/Directors etc

8

In case of Partnership, please indicate whether it is registered as a firm under Partnership Act and/or under Income Tax Act

9

Brief history of the Borrower giving his experience in the business

10

Type of vehicle to be purchased

11

Date of issue of permit/permission letter Of the State Transport Authority for plying the vehicle

12

Expiry date of permit/permission

13

Issuing Authority of permit

14

Area where the vehicle will be plied

15

Permission for Inter-state operation of

Vehicle required. Its detail be submitted.

16

Public conveyance Permit/Badge No.

17

Average earnings per month Indicating the basis thereon

18

Name of the Bankers together with full particulars of facilities enjoyed for and Other activities, if any.

19

Total original investment in vehicles/Other existing business as per the Books (this will exclude vehicles to be purchased.

20

Particulars of vehicles (such as make, model, retail price of the vehicle)

21

Details of total cost of the vehicle proposed to be purchased

Cost of chassis

Cost of body fabrication

Insurance pre4mium for one year

22.

Purpose of the loan and when the loan is expected to be availed of

23.

How is it proposed to finance the vehicle(s) to be acquired (Please indicate amount to be invested by the borrower and the amount to be borrowed.

24.

Seating and/or carrying capacity of the vehicle to be purchased.

25.

Places where the vehicle(s) will be operated.(Please indicate area of operation, routes, etc and whether permission from requisite authorities has been obtained for the proposed operations)

26.

Repayment period of loan

27.

Terms of repayment of proposed term loan.

28.

Nature and value of collateral security to be offered. Please indicate whether the assets are free from all encumbrances. Full particulars to be given.

29.

Name & address of the Guarantor(s)

30

Name & address of two references

31.

General (Any remarks not covered by above items such as regarding income-tax assessment, annual turnover etc)

I/We declare that the information supplied above is correct to the best of my knowledge and belief and that this proposal will form the basis of the agreement between the Corporation and myself/ourselves, if the loan is granted.

If the loan is granted to me/us, I/we hereby agree to produce the vehicle(s) for inspection at your Head Office or Branch Office in every six months or ay shorter intervals required by the Corporation.

Yours faithfully,

( )

Place:
Dated:

Note: The application form should accompany processing fee @ Rs.300/- per lac or part thereof.

S. No.	Description	To be filled in by the Borrower
1	Name of the Borrower
2	Correspondence Address: a) Telephone No. if any
3	Permanent Address Telephone No. if any
4	Place of domicile
5	Constitution
6	Date of establishment
7	Name(s) and Address(es) of Sole Prop Partners/Directors etc
8	In case of Partnership, please indicate whether it is registered as a firm under Partnership Act and/or under Income Tax Act
9	Brief history of the Borrower giving his experience in the business
10	Type of vehicle to be purchased
11	Date of issue of permit/permission letter Of the State Transport Authority for plying the vehicle
12	Expiry date of permit/permission
13	Issuing Authority of permit
14	Area where the vehicle will be plied
15	Permission for Inter-state operation of Vehicle required. Its detail be submitted.
16	Public conveyance Permit/Badge No.
17	Average earnings per month Indicating the basis thereon
18	Name of the Bankers together with full particulars of facilities enjoyed for and Other activities, if any.
19	Total original investment in vehicles/Other existing business as per the Books (this will exclude vehicles to be purchased.
20	Particulars of vehicles (such as make, model, retail price of the vehicle)
21	Details of total cost of the vehicle proposed to be purchased Cost of chassis Cost of body fabrication Insurance pre4mium for one year
22.	Purpose of the loan and when the loan is expected to be availed of
23.	How is it proposed to finance the vehicle(s) to be acquired (Please indicate amount to be invested by the borrower and the amount to be borrowed.
24.	Seating and/or carrying capacity of the vehicle to be purchased.
25.	Places where the vehicle(s) will be operated.(Please indicate area of operation, routes, etc and whether permission from requisite authorities has been obtained for the proposed operations)
26.	Repayment period of loan
27.	Terms of repayment of proposed term loan.
28.	Nature and value of collateral security to be offered. Please indicate whether the assets are free from all encumbrances. Full particulars to be given.
29.	Name & address of the Guarantor(s)
30	Name & address of two references
31.	General (Any remarks not covered by above items such as regarding income-tax assessment, annual turnover etc)