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SB/Loan Account No *

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Solvency Details

Solvency to be issued in favour of

Whether any solvency certificate taken during last 12 months

No Yes

Value of solvency certificate taken during last 12 months

Estimated Value of immovable properties held in personal name/firm's name (in Lakhs)

Amount or solvency certiticate requested (in Lakhs)*

Tangible Net Worth (in Lakhs)*

Value of Bank deposit (in Lakhs)*

Value of Jewellery (in Lakhs)*

Value of Other deposit (in Lakhs)*

Value of surrender value of LIC policies (in Lakhs)*

Other Liquid Security - if any (in Lakhs)*

Total amount of Loans taken (in Lakhs)*

Outstanding Amount (in Lakhs)*

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I hereby declare and confirm that I/we have no objection to the bank disclosing the information in the form of an opinion in solvency certificate

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