The work of works for which the loan is required & the estimates of the cost thereof.

The amount which it is proposed to borrow.

The fund or funds on the security of which it is proposed to borrow.

The law or laws under which the said fund or funds is or are derived received or held.

If the application is for a non-Government loan, the rate of interest at which it is proposed to borrow.

If the application is for a loan from the State Government whether the Grama Sasan undertakes to pay interest at the rate or rates which woiuld be imposed by the State Government in that behalf and if so, an undertaking to that effect from the Grama Sasan shall be enclosed to the application.

1

2

3

4

5

6

The no. of instalments in which the loan is proposed to be taken and the amount of each installment.

The no.of installment in which the Grama Sasan undertakes to repay the loan and the amount of such installment

Whether any loan was taken by the Grama Sasan previously for the same purpose and if so, the date and the amount of such loan.

Whether the Grama Panchayat is making repayments regularly in respect of Govt. loan if any, taken in the past and has furnished Utilisation Certificates and if not, the reasons for the same.

Financial position of local body

Revenue details for each of the preceding 3 years.

Expenditure details for each of the preceding 3 years.

Source from which the revenue is derived.

Amount.

Objects on which the expenditure is incurred.

Amount.

7

8

9

10

11

12

13

14

Particulars of loans taken by the Grama Sasan

Remarks

Amount paid

Amount outstanding

The normal surplus which may be expected in future.

Date of borrowing

Amount borrowed

Purpose

Of

 loan

Principal

Interest

Principal

Interest

15(a)

15(b)

15(c)

16

17

18

19

20

21