8/6/2019 HDFC Appl Form

1/2

INDIVIDUAL OANAPPLICATION ORMFOR APPLYINGTHROUGI{ DSAS (DIRECTELLTNGGENTS)PERSONAL AND EMPLOYMENT DETAILS

Wilh ou , ight hroughRegd. fiicu Ramon ous,TParekh ars, 69, ackbayedamalion,Cuhrchgale,ombai40020. hones:6316000,2820282.axtDU-2n11205,2

FirslName i,liddle ame FirstName l\,liddleame

LandMark: Landvlark:PinCode: State: PinCode: State:Self wned ! Rented n

LOANREOUESTEDAmount s. Term:rs.- - _--Yourmonthly xpenditures.lnstalmentouand o-applicant(ifany) anpayo HDFCermonthRs.

A99 _Y.|!, ! N4!J! lvarried ! Other n SingleOthersAge Yrs. trM !

Leased/Provided applicant:

! Marrjed I OtherOthershildren

Fax:Pin ode: ___ State:Ext. Yrs. Retirement

LOANFYPE Annual !! Fixed ! Adjustablen Combination! HomeExtensionoan ! LandPurchaseoan! NonResidentialremises oans ! Short ermBridging oa! HomeEquity oanLOAN DETAILS

FATHER's/HUsBAND'sA[4ECunnelt/Penueuerur*RESTDENTTALDDRESS'(lfPermanentAddresss d lerntk ndly lve ela n he ox rovidedllhebollom f hspage.)cuinili niiroerCiiPHoNE o. wTHSTD CoDEE-MALD- - , ^UATE FEIRTH/SEXMARITALTATUS

OccuPATloNQuALlFrcATroNsDEStGNATtoNMoNTHLyNcoltEOtten ucorr.reilPLotEBliiEisNA[4E ND DDRESS(Pleaseentionheaddressof he oflice ouarebased t)PH0NE o. wTHSTD CoDEYRs. NPRESENTccupATtoN

PinCode:_ - _ State:

Yrs. Retirementqe Yrs.

! Self mployed

to meetHDFC. Landost Rs.

2. Totalurchaserice/constructionostRs.3. Incidentalostsifany) Rs.e.g.Stamp uty,Registrationharges.tc.4. Otherostspleasepecify) Rs.5. l\4arketaluefproperty(forHome quityoan) Rs.

F- - - - - - - - - - - -_ - ' 1t l r - - - - - - - - - - - - - -1t lt lr l

7. LoanequestedromFixedRateAdjustable ate8. Savingsrom ank9. Disposalf nvestments(fixedepositsshares,tc.)'10.Amountlreadypentsource _ )11.Providentundrefundable/non+efundable)

Rs.Rs.Rs.Rs.Rs.Rs.Rs.Rs.6. Loan utstandingfor efinance) Rs.Rs. 12 ,OtherspecifyA. Total of funds B. Estimaie f sources f fundsNote;A'whichs he otal equirementf unds,hould qual stimatefsources.B'whichndicateshesourcesromwhereheIt s mportanthatyou ndicaten detail hesourcesrbmwhere he costwilibemet n order o helD s processouraol willbemet.ion aster

Land\4ark: Phone o.:Pin ode: _,__ State:

To be filled by the Customer onlyDateSubmissionfAool.: __ _SUbmitted to(Fxeculiveare)

Customeriqrature

DSAExecutive:Location:

PASTE ECENTPHOTOGRAPHFAPPLICANTWITHSIGNATURE

Cheque o.:Bank:ASTE ECENTPHOTOGRAPHFCO.APPLICANT

SIGNATURE FROM DFC OTHEDSAHDFC xecutive: lnitialsDate fAcceptance- _ FileNo.

l r . r ll r r r Il t t t !l r t t I

8/6/2019 HDFC Appl Form

2/2

SAVINGS,NVESTMENTS,TC.ParticularsLOANSVAILED/ROPOSEDlmportanl:on isclosurefalse eclaraiionaneadocancellationfyouroanApplicant(Rs.) Co-applicant(Rs.) applicalion.Sourceof LoanApplicant:EmployerBankCredit ocietyOthersCo-applicant:EmployerBankCredit ocietyOthers

OutstandingAmountRs.) Monthlynstallment al. ermPayableRs.) (Months)avingsnBanklmmovableropedyithurrentaluespecify)2.CurrentalancenProvidentund alanceother ssetsspecify).1 .

(yourhare)__-._,-,._,_

2.Life nsuranceolicy(ies)Sum ssuredMaturityates(pLEAsEEfiT|or{ ErAtLsFyouR ALARyccour{TNRoy{}

NamefAccount older Namef Bank Branch A/c peratedinceAccountlo.(s)1 .z .

OF PROPERTY Fo BEPURct{AsED/coNsrRUcrEDixrEl{DEoirpRovED/oFFEREDs sEcuRtty) pLEAsEoMpLETEsAppLtcABLE)Address: entionwellingnit o., treet,ity,nearestandmarkndDin ode.lf notselected,entionntendedocation:

AreafLand:_.,__,Sq.m. uilt-uprea: Sq.m.Stage f constructionextensionimprovement

State PinCode:

! Y ! N. Y ! N. Y ! Nt ] Y | ] N! Y ! N

lf propertyot electedouldou ikeHDFC ealtyo assistou?Do ou roposeo enthedwellingni tAre ou hesole wner f hedwelltngnitls he egalitleo hedwellingnit learWillHDFC eableoobtainirstmortgagef hedwellingni tJAppLTGABLEo applrcANr AND o-AppltcaNr0FANy)l

appliedo HDFC ora loan?lf yes,File LoanA'./c o.

2.Have ou ryour pouseiven uarantee(s)foranybonower/s f HDFC?lf yes, a) File Loan JcNo.b) Name f borrower/s3.When ouldouprefer ouroano be:

f Y ! N

! Y L - N

a) Sanctioned Dare)b) Disbursed {oate)

4.What ther ecurity i l lyoubeable o provide5.Pleaseelecthemode f epaymentonvenientoyou:(Notapplicableoremployedpplicants, hose mployersaveadeduction t source rrangementithHDFC)Tick y') againstheappropriateox.a) Deductionfmonthlynstallmentyyour mployerb) Post ated heouesc) Standingnstructionso bankers

Ar eyo ua cit izen(s)f lndia?J Yes No.Status! Residentndian Non-Residentndian.oyoubelongo j SC ST tr NA .

HDFCHomeLoan ProtectionPlanfrom HDFCSLIC? il Yes NoProductsftered y HDFC ank?f] SavinosankAccounl-redilard olher oans from HDFCERGOGeneral! YAs !

NAMES NDADDRESSESFTWOREFEREES HOARENOTRELATEDO YOU)HDFCma ymake uchenquiries rom thereferees f it deemsnecessary

1 ?,.,,.Email:mail :

Tel: O) (R) Tel: O) (R)

Applicant'signature Co-applicant'signature