Here is a Loan / Salary advance application form used in many of he companies

SECTION I- TO BE FILLED BY THE EMPLOYEE

• Employee Name: _________________________________ Employee Code : _______________

• Designation: _____________________________________ Date of Joining: ________________

• Loan / Advance Details ( Kindly provide the relevant details)

Types of loan/advance requested Amount applied for No. of installments( for payment)

• Purpose of Personal Loan
o Education
o Children’s education
o Holidays/Travel
o Medical expenses
o Investments
o Consumer durable purchases
o Marriage in family
o Home improvement/Renovation of home or office
o Loan transfer
o Purchase of equipment
o If any other, Please specify: __________________________________________________________________________

__________________________________________________________________________

• List of documents attached with the application

__________________________________________________________________________

__________________________________________________________________________

• Do you have any outstanding loan prior to this loan? If so please provide the following details

1. Type of loan:________________________________________________________________
2. Amount Outstanding : _______________________ Date on which availed : _____________
I have read all the provisions of Company Policy on Loans/Advances and undertake to comply by them. I authorize the company to recover any outstanding amount under this policy from my salary / full and final settlement as the case may be.
__________________________ Recommended / Not recommended
Employee Signature & Date Manager’s name, signature and date

SECTION II- TO BE FILLED BY HR Department

• Amount of Loan/advance approved:_____________________________

• Date: __________________

________________________

Authorized Signatory

SECTION III- TO BE FILLED BY FINANCE

Approval Received on: __________________________________________________________

Documentation completed by employee on ___________________________________________

Previous loan outstanding checked on _______________ by ____________________________

The amount of loan/advance given: _________________________________________________

First installment due: ____________________________________________________________

No of installments to payoff loan/advance: ___________________________________________

The source of transfer is

o Check Cheque No.__________________ Dated______________________

o Bank Transfer Account No. __________________Bank Name _________________

______________________

Authorized signatory

Date: ____________________