EDC  LIMITED
EDC House Dr. Atmaram Borkar Road,
Panjim, Goa - 403001,  INDIA
Tel : (0832) 227604-08 Telegrams : EDC IN Telex : 0194 304 EDC IN  Fax : (0832) 224938

(P. & B. D.)

APPLICATION FORM
Credit Facilities of over Rs. 2 Lacs & Upto Rs. 15 Lacks)

Name    : ____________________________________________________________________

Address  : ___________________________________________________________________

                ___________________________________________________________________

                ___________________________________________________________________

Date :   _____________________

To,

The Managing Director,
The EDC Limited,
EDC House. Dr. Atmaram Borkar Road,
P.B. No. 275,
PANAJI - GOA

CERTIFICATE

I/We hereby certify that  the particulars given in the  attached form are furnished for the express purpose of securing financial accommodation from the Economic development Corporation of Goa, Daman & Diu Limited and are to the best of my/our knowledge and belief true and  correct, and that no material fact has been concealed or withheld. I/We also tender  herewith Rs.______________ by cash/cheque/draft No.________________ dated ____________ drawn        on _____________________________________________________ as required, confirming that in case of rejection, closure or withdrawal of my/our application or in case I/we do not avail of the loan sanctioned, the deposit will be forfelted.

Siganuture of applicant _______________________

Name of the Applicant _______________________
(Proprietor/Partner/Director)

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