APPLICATION FORM FOR

(CUSTOMER SERVICE POINT-CSP)

1.Location (Village / Town) - Location, District State, PIN 2. Name (IN BLOCK LETTERS) - 3. Father’s / Husband’s Name - 4. Date of Birth & Age - 5. Gender (Please Tick) - Male Female 6. Marital Status (Please Tick) - Married Unmarried 7. Education (Please Tick) - Class X Class XII Graduate Post Graduate and above 8. Permanent Address - Mohalla/Village Post Tehsil District State Pin Code

9. Communication Address - Mohalla/Village Post Tehsil District State Pin Code

10. Telephone No. (With STD Code) – Residence Office Mobile

11. Email ID – If any - 12. Currently Banking with (Bank) - 13. Bank Account Number, if any - 14. Cheque Facility (Please Tick)- Available Not Available 15. *Proof of Name (Please Tick) - Driving License PAN Card Voter’s ID Card Passport

16. (a) *Proof of address (Please Tick) - Electricity Bill (Latest) NSC (Copy) Telephone Bill (Latest) LIC Policy (Copy)

Letter from Landlord Gas Connection

16. (b) Pan NO.

17. Present Business / Occupation, if any 18. Computer Literacy - Yes No.

19. If yes, nature of qualification 20. If you already own a business or are working your revenue / income per month including pension if any is Less than Rs. 5000 – Rs. 1000 Rs. 10000 – Rs. 20000 Rs. 20000 – Rs. 30000 More than Rs. 30000

(Please enclose copy of I.T. Return / pension payment certificate) 21. Do You have any experience in selling financial products? If yes, give details. 22. Language known (say fluent / not so fluent)

Read Write Speak

23. No. of years of stay in the town / village In town In Village 24. Do you have any police records? If yes, give details. 25. Name, address and occupation: Of two people to whom reference can be made. 26. Political Affiliation, if any: - 27. Default if any to Banks / Financial Institutions: - 28. Infrastructure available: (Office, area, location, computer, Internet, Tel No, etc) :- 29. Name of the office from which retired. :- 30. Position at the time of retirement. :-

(Plz. give brief of various positions held and role) 31 Any disciplinary action taken against you while in service

(if Yes, please give details. Please enclose a certificate of Conduct from your last the employer) 32. Particulars of liabilities: - 33. Particulars of movable property and Investment. :- 34. Particulars of Immovable property. :- Land, Village Survey/PattaNo., Area 35. Are you willing to invest in the POS/Kiosk machine and other equipment required for carrying out transactions as CSP / KO of Business Correspondents? 36. What is the cash balance you are ready to invest for making cash payments / receipt of deposits as Business Correspondent?

I certify that the above information is true to the best of my knowledge and belief. Date :-

Place :-

Signature of the Applicant

SCORING SHEET FOR CUSTOMER SERVICES POINT / SUB-AGENTS/FRANCHISEE Name of the Applicant: - Category of Applicant: - Part - A - Quantitative Assessment

Sr.

No.

Parameter Criteria Marks Max.

Marks

Marks

Scored

1 Office A

i) Non-residential

ii) Residential

iii) i/ Located at central place/prominent place at the centre

ii) Located elsewhere at the centre

5

2

5

2

5

5

2 Employer’s **

certificate submitted

(if employed in past)

i) Satisfactory conduct certificate submitted

ii) ii) Not submitted

2

1

2

3 Opinion Report of

Present Banker

bank

i) Submitted / Acceptable

ii) Not submitted / Not-acceptable

1

0

1

4 References of two

persons known to

bank

i) Submitted / Acceptable

ii) Not submitted / Not-acceptable

1

0

1

5 Distance-area of

operation

i) Distance between the place of business of

VLE& link branch in within 15 Kms.

ii) Beyond 15 Kms to 30 Kms

2

1

2

6 No. of Employees i) More than 1

ii) No. of employees / Self

2

1

2

7 Education i) Graduate and above

ii) 12thClassPass

iii) 10thClassPass

3

2

1

3

8 Infrastructure i) Owned Premises

ii) Rented Premises

2

1

2

9 Exposure to

Rural/Semi-urban

Areas

i) Has worked in rural / semi-urban area

ii) No rural / semi – urban orientation

2

1

2

TOTAL 25

DUE DILIGENCE REPORT

Name of VLE / Sub – Agent.

SL Indicative Parameters Remarks

1 Details of Incorporation

and Directors

2 Details of Management

staff including

qualification experience,

other business activities

financial status etc.

3 Particulars of employee

level expertise.

4 Type of infrastructure

available

5 Financial Position

6 Present business

relationship and their

status

7 Adherence to the

various local rules and

regulation

A Knowledge Marks Score

High Has full formal knowledge and training in

financial products and insight into local

trends. Possesses computer knowledge

5

Medium No formal training in financial products

knowledge and exposure to financial

products and local trends.

3

Low No training or exposure in financial products. No computer knowledge

2

B Willingness

High Is wiling to invest in printing visiting cards, placards. An employee is confident of money

making potential and will work full time as

CSP. Possessing financial ability to invest in

PoS/KIOSK devices and other equipments.

Ability to retain required cash balance at PoS

/ the balance in Current Account.

5

Medium Will invest some effort through self or

employees and scale up if efforts and

profitable, will work part time as CSP. How to

depend partly for outside source for investing

on PoS/KIOSK/Other equipments/security

deposits

3

Low Will invest effort full time personally but is not interested in hiring employees. Financial

resources moderate.

2

C Sales Orientation

High Has experience as an outbound sales person

and will use his/her existing network to sell as

a CSP, knows how to generate contacts and

will telephone them. Fluent in local language.

5

Medium Aware of sales methods like approaching

shops and houses (door to door) & getting

contacts from Reggistrars, Panchayts, affluent

merchants etc. for enrolling customers,

workable knowledge of local language.

3

Low Will approach shops, houses apart form

selling to people approaching him with

enquiries. Lacks fluency in local language.

2

D Scale of Commence

High Deep rooted and strong local rapport 2

Medium Moderate influence in the society 3

Low Limited influence in the society 2

E Experience in handing Cash / Accounts

High Has good experience in handing cash &

keeping of accounts

5

Medium Has some experience in hading cash /

keeping accounts

3

Low Has limited experience in handing cash /

keeping of accounts

2

TOTAL 25

• Minimum Eligible Quantitative Score : 12

APPLICANT SIGNATURE

Contact this candidate