citi mortgage application form for nri customers · citi mortgage application form for nri...
TRANSCRIPT
CITI MORTGAGE APPLICATION FORM FOR NRI CUSTOMERS
1
Name (Same as ID Proof) :
:
:
:
Maiden Name (If any)
Father’s/Spouse’s Name
Mother’s Name
(Please leave one space between each name)
First NameMr./Ms./Mrs./Mx. Middle Name Last Name
I confirm that the above is my current residential address and I have submitted the address proof documents for the above. In addition, I have/have not submitted a proof of my permanent address as below.
Signature
(for verification purposes only)
(for all correspondence)
Official E-mail ID
Mobile No.:
City/Town/Village:
District: Pin/Post Code:
Country:
City/Town/Village:
District: Pin/Post Code:
Country:
City/Town/Village:
District: Pin/Post Code:
Country:State/UT:
State/UT:
State/UT:
Others
Citizenship: Indian Others ___________________
Residential Status: Resident Individual Foreign National Person of Indian OriginNon Resident Indian
CKYC number (if any):
Address Type for Proof: Residential Business
Proof of Address: Passport Driving Licence UID (Aadhaar) Voter Identity Card NREGA Job Card
Others _________________________________________
Other, please specify
Passport Number Issued at Issued Date
Passport Expiry DateProof of Identity:(any one of them)
A - Passport Number
B - Voter ID Card
C - PAN Card
E - UID (Aadhaar)
F - NREGA (Job Card)
Z - Others (Other Govt ID)
(Please submit all the documents for the ID number ticked in this form).
Expiry Date
D - Driving Licence
Driving Licence Expiry Date
GST Identification number (Only for Entity):
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Name of company/concern:Doing Business As:
Designation:
Telephone:
Employee No:
Extn.:
Number of years atprevious organisation/s:
Fax:
Retirement AgeNo. of years withcurrent employer
Office Address:
City/Town/Village:
District: Pin/Post Code:
Country:State/UT:
I confirm that the above is my current residential address and I have submitted the address proof documents for the above. In addition, I have/have not submitted a proof of my permanent address as below.
Signature
Mobile No.:
City/Town/Village:
District: Pin/Post Code:
Country:State/UT:
Name (Same as ID Proof) :
:
:
:
Maiden Name (If any)
Father’s/Spouse’s Name
Mother’s Name
(Please leave one space between each name)
First NameMr./Ms./Mrs./Mx. Middle Name Last Name
Others
Citizenship: Indian Others ___________________
Residential Status: Resident Individual Foreign National Person of Indian OriginNon Resident Indian
CKYC number (if any):
Address Type for Proof: Residential Business
Proof of Address: Passport Driving Licence UID (Aadhaar) Voter Identity Card NREGA Job Card
Others _________________________________________
Other, please specify
Passport Number Issued at Issued Date
Passport Expiry DateProof of Identity:(any one of them)
A - Passport Number
B - Voter ID Card
C - PAN Card
E - UID (Aadhaar)
F - NREGA (Job Card)
Z - Others (Other Govt ID)
(Please submit all the documents for the ID number ticked in this form).
Expiry Date
D - Driving Licence
Driving Licence Expiry Date
2
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Name of company/concern:Doing Business As:
Designation:
Employee No: Number of years atprevious organisation/s:
Retirement AgeNo. of years withcurrent employer
Telephone:
Office Address:
District:
Extn.: Fax:
City/Town/Village:
Pin/Post Code:
Country:State/UT:
(for verification purposes only)
(for all correspondence)
Official E-mail ID
City/Town/Village:
District: Pin/Post Code:
Country:
City/Town/Village:
District: Pin/Post Code:
Country:
State/UT:
State/UT:
Telephone:
Address:
District:
Extn.: Fax:
City/Town/Village:
Pin/Post Code:
Country:State/UT:
3
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District:
City/Town/Village:
Pin/Post Code:
Country:State/UT:
4
Reference Rate: TBLR
:
Treasury Bill Benchmark linked Lending Rate (TBLR) which will be the reference rate for variable interest rate loans and is determined based on the 3 month Treasury Bill rate published by Financial Benchmarks India Private Limited (FBIL). The applicable date of TBLR determination will be as detailed in Schedule 1 of the loan agreement
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I consent to link my Mortgage loan account with my existing Citibank relationships listed above or internally identified by the Bank.
Consent to link Citibank facilities/accounts
Yes No
Signature /
Thumb Impression
Citibank, N.A.,
Citibank, N.A.,
Citibank, N.A.,
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I/ We understand that to help Citibank, N.A. in preventing money laundering and terrorist financing, the laws of many jurisdiction, as well as Citibank, N.A. policies, require Citibank, N.A. to obtain, verify, and record information from time to time that identifies each person/business entity who opens an account
I/We hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I/we undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it.
I/We hereby consent to receiving information from Central KYC registry through SMS/Email on the above registered number /email address.
Signature /
Thumb Impression
Signature /
Thumb Impression
Country of Jurisdiction of Residence*
Tax Identification Number or equivalent (If issued by jurisdiction)*
Place / City of Birth*
Country of Jurisdiction of Residence*
Tax Identification Number or equivalent (If issued by jurisdiction)*
Place / City of Birth*
RESIDENCE FOR TAX PURPOSES IN JURISDICTION(S) OUTSIDE INDIA
Main Applicant Joint Applicant
Address in the Jurisdiction details where applicant is resident outside india for Tax purposes
Same as Current/permanent address details Same as mailing /local address details.
Citibank, N.A.,Citibank, N.A.,
Citibank, N.A., Citibank, N.A.,
Citibank, N.A.,Citibank, N.A., Citibank, N.A.,
I hereby understand and acknowledge that as the Credit Facility to be extended by Citibank is denominated in INR (“Loan Currency”), I may be exposed to foreign exchange conversion risks if I intend to use my Gross Income (or any part thereof) which is denominated in a different currency (“Payment Currency”) to service the above Credit Facility. The conversion of the Payment Currency into the Loan Currency is also subject to foreign exchange rate fluctuations at any point of time and may be subject to foreign exchange controls under various Local ( belonging to country of loan currency )and Global regulations. In particular, adverse movements in the Payment Currency’s exchange value relative to the Loan Currency will result in: (a) me having to convert a higher amount of Payment Currency to pay the same amount of liabilities denominated in Loan Currency or (b) receiving a lower amount of Payment Currency when converted using the same amount of Loan Currency. I confirm that I understand and accept such risks.
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Senior Public Figure Declaration :
Which is defined as a senior official in the executive, legislative, administrative, military or judicial branches of a government, whether or not elected, a senior official of a
major political party, or a senior executive of a government-owned or government-funded corporation, institution or charity. A “Senior Public Figure ” also includes any
entity that has been formed by or on behalf of a Senior Public Figure, in which the Senior Public Figure is a beneficial owner of at least twenty-five per cent of the entity. In
addition, a “Senior Public Figure” includes the immediate family of a Senior Public Figure and any close associate or relative of a Senior Public Figure. A close associate is
a person who is widely and publicly known to maintain an unusually close relationship with and able to conduct financial transactions on behalf of a Senior Public Figure.
Declaration on bank director/senior officer position or relative of such position holders
I do hereby solemnly declare and state i am not
a. Director/Senior officers of Citibank and/or their Relatives and b. Directors of other bank and /or their Relatives
If answer to any of the above is a “Yes”, please provide details of relationship, position of the officer etc below:
Name of the other bank / Position with other bank
Relationship
"I declare that I am making the aforesaid declaration solemnly and sincerly believing the same to be true and in case of any change on the above I shall immediately inform the Bank of such change".
Products
Please let us know in case you are interested in any of these products
Current Account
Credit Card
Savings Account Life Insurance General Insurance Building Insurance
Investments Others __________________
Signature /Thumb Impression of Applicant Signature /Thumb Impression of Co-applicant Signature /Thumb Impression of Co-applicant in india
Declaration on Bank Director/Senior Officer position or relative of such position holders
SENIOR PUBLIC FIGURE DETAILS :
Do you or your immediate family member/joint account holder or their immediate family members currently hold/have held/are being considered for a position as
a senior public figure? Yes No
Signature / Thumb Impression of the Main Applicant Signature / Thumb Impression of the Joint Applicant
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8
Institution details:
Name:
Code:
Stamp:
Citibank employee name Citibank employee code Citibank employee designation
Location
Authorised Vendor employee name
Authorised Vendor employee designation
KYC Verification/OSR carried out by
Citibank employee/Authorised Vendor
Signature
Authorised Vendor employee code
In case of Branch/Suvidha/United Sales Force/NRIB referral please provide
Branch Name:
Branch Name/NR Location Name:
This product/service is offered by branches of Citibank, N.A. in India. © 2019 Citigroup Inc. Citi, Citibank and Arc Design are registered service marks of Citigroup Inc. or its affiliates used and registered throughout the world.
Branch/City: _____________________________________
For bank use only
Source Code:
Alternate Channel:
DSA Channel:
MGMSMDIR
EMRF
SNDR USFO XSUVRETXLCBR
INTRASBR ATOP CGAT CGRM CPHN
ONLA
AAFA
DSAO
AMGM
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(Fo
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CM
PR
/Ba
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ate
/MC
LR
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at
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Consequent upon any change in applicable CMPR/Base Rate/MCLR or TBLR of Citibank, N.A., the borrower will be notied of the revised interest rate applicable on the loan. Every such revision will apply with effect from the date specied by Citibank, N.A., India
The tenure on an individual loan will be dependant on customer risk profile, age of customer at maturity of loan, age of property at loan maturity and any other terms which may be applicable in line with Citibank N.A. mortgage credit acceptance parameters.
Citibank N.A, India does not market any product or service to individuals resident in the European Union, European Economic Area, Switzerland, Guernsey and Jersey.
This application form is not, and should not be construed as, an offer, invitation or solicitation to buy or sell any of the products and services mentioned herein to individuals resident in the European Union, European Economic Area, Switzerland, Guernsey and Jersey.
Citibank N.A, is a member of Banking Codes & Standards Board of India(BCSBI). Please visit the homepage of our website www.citibank.com/india to view the BCSBI code.
Calling Citi Phone-Banking service on the numbers provided on our website -www.online.citibank.co.in/customerservice/citiphone.