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* marked fields are mandatory
Online Loan Application for Agricultural Loan: Part - A (Mandatory)
Whether maintaining a/c with the bank* Yes No
If Yes, enter Account No.* Cust-Id    
Name of the Applicant*
Date of Birth(dd/mm/yyyy) *
E-mail Id
Telephone No.
Mobile No.*
Address : State  *
Sub-District *
Town/Village *
House No.
Social Category*
If under minority category
Residential Status*
Id Proof
Id Proof No.
Issuing Authority
Date of Issue(dd/mm/yyyy)
Valid up to(dd/mm/yyyy)
Address Proof
Address Proof No.
Issuing Authority
Date of Issue(dd/mm/yyyy)
Valid up to(dd/mm/yyyy)
Whether Covered under PMJJBY/ PMSBY/ APY
Details of family members
Name of Family member Age Gender Relationship Occupation Annual Income (Rs.)
Security Key*  
Online Loan Application for Agricultural Loan: Part-B (Mandatory)
Application No.
Type of Loan required*
Amount of loan required *
Branch preference, where Loan is required
Branch Office*
Sources of income
A. Agricultural Income (Amount in Rs./ annum)
B. Other Income (specify) (Amount in Rs./ annum)
   Total Income (A+B)
Guarantors offered (if any)
Name of Guarantor Age Residential Address Telephone No./ Mobile No. Occupation Net worth
Particulars of Land Holding
Village Survey/ khasra no. Name Of Crop Title (Area in Acres) Total Area in acres Of which irrigated( in Acres) Source of irrigation Encumbrance if any
      Owned Leased Share Copper        
Particulars of existing liabilities as borrower and/or guarantor, if any other loan
Name of the Bank /Institutions Purpose of the Loan Present outstanding Rs. Of which overdue Rs. Security offered Installment Amt. Payable during the year Rs.
Particulars of assets required
Particulars of immoveable assets owned.
Immovable AssetsParticulars/ DescriptionPresent Market Values (Rs.)
Agricultural Land
House/ Building
Tractor Shed/ Farm Shed
Fishing Pond/ Tank
Particulars of moveable assets owned
Movable AssetsParticulars/ DescriptionPresent Market Values (Rs.)
Milch Cattle/ Plough Cattle
Poultry Birds
Power Tiller
Electric Motor/ Pump set
Collateral Security offered, if any If yes, details thereof:
Whether any Deposit Account already existing with any other bank:
Name of Bank
Name of Branch
Nature of Account
Declaration : The information given in the loan application is true and nothing has been concealed. The undersigned undertakes to inform the Bank any change in residence/ office address and to provide any further information that the Bank may require. The undersigned is aware of the charges/ fee to be levied by the Bank and agrees to pay upfront fee, documentation charges, etc. as applicable and charged by the Bank. The undersigned hereby agree to be bound 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. Applicant authorises the bank to contact through mobile/SMS/email for the purpose of above Loan Application. Bank reserves the right to call for any other information/documents, if necessary, and/or reject the proposal without assigning any reason thereof
Online Loan Application for Agricultural Loan: Final Submit (Mandatory)
Online Loan Application for Agricultural Loan: Final Submit (Mandatory)
Application No.
@Copy right PNB