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CGTMSE – Form for First Instalment of Claim
Credit Guarantee Fund Trust for Micro & Small Enterprises
Application for Invocation of Guarant ee Cover and Preferment of Claim under CGS
In terms of Clause 10 of Credit Guarantee Fund Scheme for Micro and Small Enterprises (CGFSMSE), we prefer the claim 1. Online Claim Application Ref. No
2. Details of Operating Office & Lending Branch:
3. Borrower’s / Unit’s Details:
4. Status of Account(s):
a) Date on which a/c was classified as NPA 5. Details of Legal Proceedings:
a) Forum through which legal proceedings were initiated against borrower (Please tick one)
Civil Court/DRT/Lok Adalat/Revenue Recovery Authority/ Securitisation Act, 2002 (SRFAESIA)/ ____________________________________________________________________ CGTMSE – Form for First Instalment of Claim
g) Whether recovery proceedings have concluded? 6. Term Loan (TL) / Composite Loan Details:

(All amounts to be in Rs.)
#- Mention only Principal and interest outstanding 7. Working Capital (WC) Limit Details:
(All amounts to be in Rs.)


$- Mention amount including interest
Date of Release of WC (in case of new borrowers):
8. Security & Personal Guarantee Details
(All amounts to be in Rs.)
Networth of Reasons for reduction in the CGTMSE – Form for First Instalment of Claim
9. Recoveries made from Borrower / Unit after a/c classified as NPA
(All amounts to be in Rs.)

@- Please indicate mode such as sale of security, subsidy received after date of NPA, One Time Settlement (OTS) etc.

If recovery is done through OTS, indicate the date of seeking approval of CGTMSE for OTS
_________________
10. Total amount for which guarantee claim is being preferred:
(All amounts to be in Rs.)
Principal amount outstanding in the account as on the date a/c was classified as NPA after netting off any repayment / recovery made under the a/c after date of NPA the TL / Composite Loan covered under the CGS Outstanding amount including interest in the account as on the date a/c was classified as NPA after netting off any repayment / recovery made under the a/c after date of NPA CGTMSE – Form for First Instalment of Claim
Declaration and Undertaking by MLI (Bank / Institution)
(To be signed by the officer not below the rank of Assistant General Manager of Bank or of equivalent rank) Declaration – We declare that the information given above is true and correct in every respect.
We further declare that there has been no fault or negligence on the part of the MLI or any of its
officers in conducting the account. We also declare that the officer preferring the claim on behalf of MLI is having the authority to do so. We hereby declare that no fault or negligence has been pointed out by internal / external auditors, inspectors of CGTMSE or its agency in respect of the account(s) for which claim is being Undertaking – We hereby undertake:
a) To pursue all recovery steps including legal proceedings b) To report to CGTMSE the position of outstanding dues from the borrower on half-yearly basis as on 31st March and 30th September of each year till final settlement of guarantee claim by c) To refund to CGTMSE the claim amount settled along with interest thereof at 4% over and above the prevailing bank rate, if in the view of CGTMSE we fail or neglect to take any action for recovery of the guaranteed debt from the borrower or any other person from whom the d) On payment of claim by CGTMSE, to remit to CGTMSE all such recoveries, after adjusting towards the legal expenses incurred for recovery of the amount, which we or our agents
acting on our behalf, may make from the person or persons responsible for the administration of debt, or otherwise, in respect of the debt due from him / them to us. 1) CGTMSE reserves the right to ask for any additional information, if required. 2) CGTMSE reserves the right to initiate any appropriate action / appoint any person / institution etc to verify the facts as mentioned above and if found contrary to the declaration, reserves the right to treat the claim under CGTMSE invalid. CGTMSE – Form for First Instalment of Claim
Check List

Please ensure following prior to lodging Claim:

Please ensure following prior to lodge Claim:
1. Ensure that the guarantee is in force as on date of claim and the MLI/borrower has paid the Guarantee Fee (GF) and Annual Service Fees (ASF) regularly. MLI has to pay Annual Service Fee till the issue of 1st instalment of the claim to keep guarantee in force. 2. Ensure that the Lock in period of 18 months from the date of last disbursement or the date of issuance of guarantee cover, which ever is later, is completed. 3. The borrower account is classified as NPA as per norms. 4. Date of issue of Recall Notice is furnished. 5. Ensure that Legal Proceedings has been initiated and furnished the relevant details such as date of initiation of legal action and legal authority such as DRT / Revenue Recovery Authority / SARFASI etc to which the legal application is filed. In case of SARFASI, please follow the guidelines as per our Circular No. 43. 6. Ensure that The Declaration & Undertaking duly signed by Asst. General Manager of MLI or an officer of equivalent rank is enclosed with the Claim Application Form. 7. Details of subsidy (amount & date of credit) received after date of NPA, if any, availed by

Source: http://www.cgtmse.com/files/ClaimFormNew.pdf