Uttar Bihar Gramin Bank

Head Office: Kalambagh Chowk, Muzaffarpur ( Bihar )

Format for hypothecation of Receivables

01. Asset Type: Movable

(a) Security Interest Type: Hypothecation

(b) Type of Security : Receivables

(c) Description of Security : ……………..

(d) Registration No. of Security: …………….

02. BORROWER ::

(a) Borrower Type :: Company /Co-operative Society /HUF/Individual /Limited Liability

Partnership /Partnership Firm /Proprietorship Firm/Trust

(b) Property owner :: Yes /No

(c) Name :: Mr./Mrs./MS/DR……………………………………………..

(d) Date of Birth :: …………………………………………

Address for correspondence

(a) Plot/Khesra/Survey/Shop/Flat/House No. :: ……………………………………….

(b) District :: ………………………….. (c) State:: ……………………………………..

(d) Pin Code :: ……………………. (e) PAN No. :: ……………………………..

(f) Corporate Identity No. ( for Company ):: ………………………………….

(g) Registration No. ( for Co-operative society ):: ……………………………………..

03. THIRD PARTY ::

(a) Is this a third party mortgage :: Yes /No

(b) Third party Type :: Company /Co-operative Society /HUF/Individual /Limited Liability
Partnership /Partnership Firm /Proprietorship Firm/Trust

(c) Property owner :: Yes /No

(c) Name :: Mr./Mrs./MS/DR……………………………………………..

(d) Date of Birth :: …………………………………….

Address for correspondence

(a) Plot/Khesra/Survey/Shop/Flat/House No. :: ……………………………………….

(b) District :: ………………………….. (c) State:: ……………………………………..

(d) Pin Code :: ……………………. (e) PAN No. :: ……………………………..

(f) Corporate Identity No. ( for Company ):: ………………………………….

(g) Registration No. ( for Co-operative socirty ):: ……………………………………..

04. NATURE OF SECURITY INTEREST ::

(a) Joint security interest :: Yes /No
(b) Consortium Finance :: Yes /No

05. SECURITY INTEREST HOLDER::

(a) Security Interest holder name :: UTTAR BIHAR GRAMIN BANK

(b) BSR Code :: ……………………..

(c) Branch Name :: …………………………….. ( c) District :: ……………………………

(d) State :: ……………………………………… (e) PIN Code :: ………………………..

06. PROPERTY DOCUMENT ::

(a) Evaluated price of asset :: ……………………………………………

(b) Security interest creation date within bank :: ……………………………………………

(d) Specific Document Type :: Letter of Hypothecation dated ………………………

(e) State :: …………….……….

(f) PIN Code :: ……………………………

07. LOAN ::

(a) Nature of facility :: DL/TL/LAP/CC/OD/BG/BILLS

(b) Loan A/c No. :: …………………..…… (c) Loan amt. :: …………….……….

(d) Date of disbursement /Loan sanction date :: ……………………………

(e) Rate of interest :: (%)…………………..……

(f) Repayment period ( months) :: …………….……………...

Regional Manager/Branch Manager