Enhancement request form
I/We hereby request ICICI Bank Limited (“ICICI Bank”) for enhancement of the
following existing credit facilities availed by us. I/We confirm/declare the
following:
a. Credit facility
(in `million)
Facility type Existing Amount Proposed Amount
Working Capital
(CC/OD/Others)
Working Capital
(LC/BG/Others)
Term Loan
Derivatives
b. Business details
Nature of Business Manufacturing/Service/Retail
trade/Wholesale trade
Constitution Sole/Partnership/LLP/Pvt Ltd/Public
Ltd/Society/Trust/HUF
URC*
Whether MSME unit is Zero Defect Yes/No
Zero Effect (ZED) rated (applicable
only if URC is available)
LEI no. and expiry
* I/We (“Borrower/Customer/s”) hereby authorise / give my / our consent to ICICI
Bank to classify categories of Priority Sector Lending (PSL) based on the Udyam
Registration Certificate (URC) submitted by me/us.
c. Personal details
Particulars 1 2 3 4
Name
PAN
Relationshi
p*
Email
Category$
Community
^
*Relationship can be Promoters/Partners/Directors/Guarantors/Co-applicants
$
Mention the relevant number: 1. SC / 2. ST / 3. OBC / 4. NT /5. General. Eg- 1 for
SC
^ Mention the relevant number: 1. Hindu / 2. Jains / 3. Muslims / 4. Sikhs / 5.
Christians / 6. Zoroastrians / 7. Buddhists/ 8. Others. Eg- 1 for Hindu
d. Collateral security proposed- To be filled only if additional property is
proposed.
Confirmation/Declaration:
1. I/We declare that all the particulars and information and details given/filled in
this Enhancement request form are true, correct, complete and up to date in all
respects and that I/we have not withheld any information whatsoever.
2. I/We agree and undertake to inform regarding any change in the information
/details provided by me/us to ICICI Bank and to provide any further
information/details as may be required by ICICI Bank.
3. I/We understand that the Bank, at its sole discretion, may accept or reject
my/our request for enhancement, without assigning any reason.
Authorized signatory signature
Name
Designation
