EsignDocument 6705222b3926bf86f0b6b1f5
EsignDocument 6705222b3926bf86f0b6b1f5
EsignDocument 6705222b3926bf86f0b6b1f5
`ȡȡ[jȲȯbȯͧfSHG/JLG Ǘ¡]ȯ
ĤȲBELSTAR MICROFINANCE LIMITED ȡȡKALANYNAGAR ǑȡȲ08-Oct-2024
Ǘ¡ȡȡ296117-SOJAL MAHRANA ȡȲȡȡKUSHWAH NAGAR MAIN ÈèNAYA BASERA
PRATAP NAGAR ROAD TO JAGDISH NAGAR TAK_WORD
NO 17
1. ĒǕfǓȯȡȣȡȡkȡ,
2. Ǘ¡ĤǓǓͬȡ ͬ ȡȡkȡsantosh SAHU, KARMA NAGAR INDORE MP
8. ¡ȯèȡȪ\ͬǙȯ¡ɇͩ¡¡Ʌbȧȡͧȡȣȯͩèȡͧ¡ȡȯǕǕ[ȡȧȡȢ]ǑȯȡȯɅb
ȡ[SMS/å¡ȡɪ fȨȯȡÚ ȯȯèȡ ȯbȡͩ Ȣ\Û ȲȲͬ ȯȡjȲȯ ȲȲɅȯèȡ ȯȲȢǙ¡Ȫ@
¡ȡǗȡǗɉȯ\ǕȡɅ]æȡȯ]ȡȯèȡȪȨf ff ȯȯȡ_ ȢkĐȯͫȯǑȲȡȲ ȯ]ȡ
]ȡǐĤȡȢĐȯͫȯȡ_ Ȣͪ^×ȡǑ Ǒ¡ͩ ȢȢȡȡȣȪͩ ȢȢĤȡͬȡͩ ȢȢ ȯ¢ȯ ȡ ȡȡȯ
ȯͧf\Ȣ ¡Ǔȯȯ¡ɇ@ȯȡȡĤǓȡk`Ȫ
9. ¡ ȯ¡ɇͩȲȢȪ¡ȡȯȪ]ȯͪ ȡȯɅ ¢ȡȯȯͧf¡Ʌ\Ȣ¡ ȡkȯȯĤȡȯǾɅ
fȡ Ȫ[]ȡȡȪȪĒȡkǓàͧͨɅ ȯͩ ȢȢèȡȯȧèĤȡͨĤǓȡȢ¡ȪȢ@
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ĐȡȲ ǗǓCKYC bȧ ĤȪ ȯͧ Ȳ Ȣȡ
`ȡȡ[ȡȡ ͩĐȡȡ ROI EMI \ͬ GST
Ȳ ȡͧ Ǖã ĤȢͧ
¡ȣȯ
rekha KORI READYMADE 50000.00 23.50 2740.00 23 750.00 1615.00 135.00
1
GARMENT
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ȯèȡȡ^ĐȪȡ^Ʌ ͧͧȯȯͧf
ĤȡͬǙ¡èȡ¢ȡ[ȡȡJuliet Susan George -E07124
ȡȡHead-COC
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ǑȡȲ08-Oct-2024
¡Chennai
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ɇȡȡBANK OF BARODA
ȡȡȡȡRAVI SHANKAR BRANCH
ȡȯȡĤȡSB
IFSC ȪBARB0HIGMIG
ȡȡ ȲÉȡ24558100003632
ȡȡȡȡȡrekha KORI
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1 ͩȡȡ 0.00
2 Ȫͩȡȯȡ ȡȡȡȡȡȯȡɃ 500.00
3 °ȯ 0.00
4 Ƀǐ¡
5 EB/Ȫȯȡȯ 0.00
6 ͧ¢ȡ Ȱ ȯèǗȨȯȧ 0.00
7 ͬ ͩ× ȡ 500.00
8 ȫǗȡ[ȡǕȡ 0.00
9 ȪȲ ȡȡǔȡǓ×\Û 0.00
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Ǖ [ 1000.00
Ǖ [ 12000.00
A ]ȡ Details
2 ȡĤȡ Thatched
3 [ȡĤȡ Tiles
5 ȯȢİȪ In House
6 ȫ ȡ`Þ Available
7 aȡ[ȡİȪ LPG
8 ǒȣ`Þ Yes
9 Ȣȯ Ǖͪȡ
10 fȢȢ Ǖͪȡ
B ȫǓ Ȳǔ×
2 Ǖ Others
3 ȯȣͪ Yes
4 ͩʼn Yes
5 ȨͧȲȢ No
6 AC/Ǘ No
7 ȪǑ¡ȡȡ¡ Yes
8 ȡǑ¡ȡȡ¡ No
9 èȡ[ȪÛ
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1. ȡȡͧ ͩè(EMI) ȡǕȡǓȡȣȡ` ȯ¡ȯͩȡȡȡ ȡǑ¡fȪͩÚȸ\ͬèȯȡ]ȡȢNovember
¡ȣȯ ȯǕǾ¡Ȫȯȡȯ¡¡ȣȯȧ14th ȡȣ ¡Ȱ\ͬ@
2. `ȡȡ[jȲȪȡȯȲɉȯȫȡȯèȡȯȡȡȡȡ[ɅȡǓǑ[çɅġȡͫǔȪ ȯèȡ ǙͪƨͫǔgȡBBPS/UPI g
]Ǒȡ`Ȫȯ ɮȡȡǕǕ[ȡȡ¡Ȫȡ@b ǕȫȢ\Ǔȯ¡Ȫȯȡ Ȳȯ Ʌȯèȡ\ͬǙĤǓǓͬȯ[ ȡȣ¢ȯğɅ
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ͪȯEMI ǕȡȯɅ\ [¡ɇȪ Ǘ¡ȯ\Û Ȣ`ȡȡ[jȲȪ``ȡȡ[jȲȧj ȯǕȡȡ ȡǑ¡fȪͪȯEMI ǕȡȯɅ\ [
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ȯèȡȡ^ĐȪȡ^Ʌ ͧͧȯȯͧf
ĤȡͬǙ¡èȡ¢ȡ[ȡȡJuliet Susan George -E07124
ȡȡHead-COC
¡èȡ¢
ǑȡȲ08-Oct-2024
¡Chennai
ȡ ÞȡkǕãǕã
(i) ɉɅȡ\ͬĒ
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ͪȡȯb ȫȯȯȲȡ
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4 bȧ\ͬ [¡ȣȯ 23 Month
Ǒ
5 ͩæȡÞȫȡ
7 ÝȪǑȲÞȡȯȡȯɅ\ǓǐÈȡȡȣ NA
Ȳ[Ʌ ȡ[ Ʌ ȡ[ èĤȯ \ȲǓ(%) ]ͬȡ ¡ȣȯ ȣ ȯɅ Ȳ[Ʌ ȡ[Ʌǐ[ȡ
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ȯͧf^ Ʌǐ[Ʌ
B S EPI (Rs.) No. of EPIs
- - - - - - - -
8 ǕãǕã
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i) ĤȪ ȯͧ Ȳȧ ONE TIME 750.00 NA NA
10 ]ǔèǕãȡͪ ȡǗ¡Ȫȯˏȡ
Ʌ
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Ʌ
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1 ǗȣfɅɉȧǓǕǔÈ ȯ ȲȲͬb ȫȯȡȲ NA
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6 ȯǕãǕã ǽȯɅ 2501.00
ͩè ȲÉȡ ȡȡǗ ǽȯɅ ͪĤȲͧ ǽȯɅ Þȡ ǽȯɅ ͩè ǽȯɅ
9. ȯèȡɮȡȡĤèǕȡȯkȡȡȡȪ_Ȣͪ`ȡȡ[jȲȡÚȡȣ¡Ȫȡk` Ʌ`ǔãͨȡͧȧǕƨȡk
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SMA-0 Ǒ
ȯèȡȡ^ĐȪȡ^Ʌ ͧͧȯȯͧf
ĤȡͬǙ¡èȡ¢ȡ[ȡȡJuliet Susan George -E07124
ȡȡHead-COC
¡èȡ¢
ǑȡȲ08-Oct-2024
¡Chennai
ȯèȡȪĥȧȲ 1800-102-7049
ǕȫȢ\Ǖ Ǘ Ȣ`ȡȡ[\Ǖ ȡ
ȡȡȡȡ KALANYNAGAR Ĥȯȡȡ INDORE
Èèȡȡ NAYA BASERA Đȯͫ\ͬȡȣȡȡ MOHIT BHADORIYA
Ǘ¡ȡ 296117-SOJAL MAHRANA PRATAP NAGAR Ǘ¡id 296117
`ȡȡ[ȡȡ rekha KORI `ȡȡ[ȧID 102200000000001978
bID 1022001000002315 ͪǐbȡͧ 50000.00
b ȲͪǓͬ 08 Oct 2024 ȪÊ Ȳǔ× Yes
bID : 1022001000002315
b ǕȫȢ\Ǖ Ǘ Ȣ
Ǖȡ ȯèȡȯ
ͩè Ǘȡ ǕȡȲ ȲĒ¡ȧ
Ǔȡȣ ȯǗ ͩȡȡ Þȡȯ ȲĒ¡ȧȡͧ Ȣ ȲÉȡ \ͬȡȣȯ
ȲÉȡ Ǖȡ _f]_ Ǔͬ
Þȡ ¡èȡ¢
1 14-Nov-2024 1,552.00 48,448.00 1,188.00 11,571.00 2,740.00 0.00
2 14-Dec-2024 1,807.00 46,641.00 933.00 10,638.00 2,740.00 0.00
3 14-Jan-2025 1,809.00 44,832.00 931.00 9,707.00 2,740.00 0.00
4 14-Feb-2025 1,845.00 42,987.00 895.00 8,812.00 2,740.00 0.00
5 14-Mar-2025 1,965.00 41,022.00 775.00 8,037.00 2,740.00 0.00
6 14-Apr-2025 1,921.00 39,101.00 819.00 7,218.00 2,740.00 0.00
7 14-May-2025 1,985.00 37,116.00 755.00 6,463.00 2,740.00 0.00
8 14-Jun-2025 1,999.00 35,117.00 741.00 5,722.00 2,740.00 0.00
9 14-Jul-2025 2,062.00 33,055.00 678.00 5,044.00 2,740.00 0.00
10 14-Aug-2025 2,080.00 30,975.00 660.00 4,384.00 2,740.00 0.00
11 14-Sep-2025 2,122.00 28,853.00 618.00 3,766.00 2,740.00 0.00
12 14-Oct-2025 2,183.00 26,670.00 557.00 3,209.00 2,740.00 0.00
13 14-Nov-2025 2,208.00 24,462.00 532.00 2,677.00 2,740.00 0.00
14 14-Dec-2025 2,268.00 22,194.00 472.00 2,205.00 2,740.00 0.00
15 14-Jan-2026 2,297.00 19,897.00 443.00 1,762.00 2,740.00 0.00
16 14-Feb-2026 2,343.00 17,554.00 397.00 1,365.00 2,740.00 0.00
17 14-Mar-2026 2,424.00 15,130.00 316.00 1,049.00 2,740.00 0.00
18 14-Apr-2026 2,438.00 12,692.00 302.00 747.00 2,740.00 0.00
19 14-May-2026 2,495.00 10,197.00 245.00 502.00 2,740.00 0.00
20 14-Jun-2026 2,536.00 7,661.00 204.00 298.00 2,740.00 0.00
21 14-Jul-2026 2,592.00 5,069.00 148.00 150.00 2,740.00 0.00
22 14-Aug-2026 2,639.00 2,430.00 101.00 49.00 2,740.00 0.00
23 14-Sep-2026 2,430.00 0.00 49.00 0.00 2,479.00 0.00
Ǖ 50000.00 12759.00 62759.00
¡èȡ¢
ǑȡȲ08-Oct-2024
¡Chennai
ǽ50,000.00 èȡKALANYNAGAR
ǑȡȲ08-Oct-2024
Revenue
stamp
Details Full Name Age/ DOB Gender Member ID/ Loan Occupation Relationship State/Pin code
Account No
Member rekha KORI 12/04/1987 F 1022001000002315 Forestry MP-452003
Appointee
*If Nominee is less than 18 years, Appointee is mandatory. Appointee should be more than 18 years of age
50000.00 23 1615.00
I am aware that Belstar Microfinance Limited is the holder of the life insurance Master Policy issued by ICICI Prudential Life Insurance Company Ltd for Group Micro
Insurance product and I am a member of this group.
,XQGHUVWDQGWKHIHDWXUHVRIWKLVSURGXFWDQGDJUHHZLWKWKHWHUPVDQGFRQGLWLRQVDQGKHUHE\FRQVHQWWRDYDLOWKHEHQH¿WVXQGHUWKH,&,&,3UXGHQWLDOOLIHLQVXUDQFHJURXSSROLF\
Do you wish to continue your cover till the coverage term even after you foreclose your loan or transfer your loan to another Yes No
¿QDQFLDOLQVWLWXWLRQRU\RXYROXQWDULO\VXUUHQGHUWKHJURXSPHPEHUVKLS"
Have you been hospitalized in the last 5 years or have suffered or suffer from diabetes, heart disease, cancer, HIV, AIDS or any
Yes No
major medical illness which requires regular follow up or treatment ?
Consent for allowing split payment (Applicable only for Regulated Entities for ICICI Pru Shubh Raksha Credit)
I hereby provide my consent to allow ICICI Prudential to initiate split payment of the claim amount, on the happening of any contingent event, to the extent of the outstanding
loans, in the name of Belstar Microfinance Limited. In this regard, the remaining proceeds of the claims due may accordingly be addressed in the name of the nominee.
The above declaration and other details as furnished by me, are true to the best of my knowledge.
Vernacular
I hereby declare that I have explained the contents of this application form to rekha KORI in ________________ language and have truthfully recorded the submissions provided
WRPH,IXUWKHUGHFODUHWKDWBBBBBBBBBBBBBBBBKDVVLJQHGDI¿[HGKLVKHUWKXPELPSUHVVLRQLQP\SUHVHQFH
Details Full Name Age/ DOB Gender Member ID/ Loan Occupation Relationship State/Pin code
Account No
Member RAMGOPAL KORI 01/01/1982 M 1022001000002315 Agri input MP-452003
Appointee
*If Nominee is less than 18 years, Appointee is mandatory. Appointee should be more than 18 years of age
50000.00 23 1615.00
I am aware that Belstar Microfinance Limited is the holder of the life insurance Master Policy issued by ICICI Prudential Life Insurance Company Ltd for Group Micro
Insurance product and I am a member of this group.
,XQGHUVWDQGWKHIHDWXUHVRIWKLVSURGXFWDQGDJUHHZLWKWKHWHUPVDQGFRQGLWLRQVDQGKHUHE\FRQVHQWWRDYDLOWKHEHQH¿WVXQGHUWKH,&,&,3UXGHQWLDOOLIHLQVXUDQFHJURXSSROLF\
Do you wish to continue your cover till the coverage term even after you foreclose your loan or transfer your loan to another Yes No
¿QDQFLDOLQVWLWXWLRQRU\RXYROXQWDULO\VXUUHQGHUWKHJURXSPHPEHUVKLS"
Have you been hospitalized in the last 5 years or have suffered or suffer from diabetes, heart disease, cancer, HIV, AIDS or any
Yes No
major medical illness which requires regular follow up or treatment ?
Consent for allowing split payment (Applicable only for Regulated Entities for ICICI Pru Shubh Raksha Credit)
I hereby provide my consent to allow ICICI Prudential to initiate split payment of the claim amount, on the happening of any contingent event, to the extent of the outstanding
loans, in the name of Belstar Microfinance Limited. In this regard, the remaining proceeds of the claims due may accordingly be addressed in the name of the nominee.
The above declaration and other details as furnished by me, are true to the best of my knowledge.
Vernacular
I hereby declare that I have explained the contents of this application form to RAMGOPAL KORI in ________________ language and have truthfully recorded the submissions
SURYLGHGWRPH,IXUWKHUGHFODUHWKDWBBBBBBBBBBBBBBBBKDVVLJQHGDI¿[HGKLVKHUWKXPELPSUHVVLRQLQP\SUHVHQFH