LOAN APPLICATION FORM - Aditya Birla Group... · communication mode, various ABHFL loan offer schemes or loan promotional schemes or any other promotional schemes and/or any other

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LOAN APPLICATION FORMPlease fill in all the required details in BLOCK LETTERS. Tick boxes as applicable.

Co-ApplicantPlease pastepassport size

photograph herewith signature

across

ApplicantPlease pastepassport size

photograph herewith signature

across

Name

Father’s / Spouse Name

Maiden Name

Mother Name

Date of Birth

Gender

Marital Status

Citizenship

Residential status

Occupation Type

Co-Applicant / GuarantorPersonal Detail Applicant

PR EF IX F I R S T N A M E

M I D D L E N A M E

L A S T N A M E


M I D D L E N A M E

L A S T N A M E


M I D D L E N A M E

L A S T N A M E


M I D D L E N A M E

L A S T N A M E

D D M M Y Y Y Y

Male Female

Single Married

Indian Others (ISO 3166 Country Code )

Resident Individual Non Resident Indian

Foreign National Person of Indian Origin

Service ( Private Sector Public Sector

Government Sector)

Others ( Professional Self Employed

Retired Housewife Student)

Business Not Categorised

1

Application Type

KYC Number

Account Type

New Update

Normal Simplified (for low risk customers) Small

For office use only


M I D D L E N A M E

L A S T N A M E


M I D D L E N A M E

L A S T N A M E


M I D D L E N A M E

L A S T N A M E


M I D D L E N A M E

L A S T N A M E

D D M M Y Y Y Y

Male Female

Single Married

Indian Others (ISO 3166 Country Code )

Resident Individual Non Resident Indian

Foreign National Person of Indian Origin

Service ( Private Sector Public Sector

Government Sector)

Others ( Professional Self Employed

Retired Housewife Student)

Business Not Categorised

Relation with applicant

Application Form No.

Requested Loan Amount ` Tenure in Months

Purpose of Loan

Type of Loan Facility HL CP LAP-R LAP-C LRD Others

Type of Loan New Refinance Top-Up Refinance+Top-Up

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Same as Current / Permanent / Overseas Address details

Same as Correspondence / Local Address details

Address

Current Address

District

Pin / Post Code

State / U.T Code ISO 3166 Country Code

Correspondence /Local address details

Address in the Jurisdiction Details where Applicant is Resident Outside India for Tax Purposes

No. of years at current address

No. of years in current city

Current Residence

Y Y M M

Y Y M M

Self Owned Rented Other (Please specify)

Y Y M M

Y Y M M

Self Owned Rented Other (Please specify)

District

Pin / Post Code


District

Pin / Post Code


District

Pin / Post Code


District

Pin / Post Code


District

Pin / Post Code


Same as Current / Permanent / Overseas Address details (In case of multiple correspondence / local addresses, please fill ‘Annexure A1’)

Same as Current / Permanent / Overseas Address details (In case of multiple correspondence / local addresses, please fill ‘Annexure A1’)


Same as Correspondence / Local Address details

Occupation

Designation

Company / Business Name

Industry Type

Business Type

Office Address

Employment Detail Co-Applicant / GuarantorApplicant

Salaried Self Employed Professional

Trader Manufacturer Service

Pin

Salaried Self Employed Professional

Trader Manufacturer Service

Pin

TICK IF APPLICABLE RESIDENCE FOR TAX PURPOSES IN JURISDICTION(S) OUTSIDE INDIA

ADDITIONAL DETAILS REQUIRED (Mandatory only if above option is ticked)

ISO 3166 Country Code of Jurisdiction of Residence

Tax Identification Number or equivalent (If issued by jurisdiction)

Place / City of Birth

ISO 3166 Country Code of Birth

NREGA Job Card(any document notified by the central government)Others

Driving License if DL, DL expiry date

Passport No. if passport, passport expiry date

Voters ID

PAN No. UID

Proof of Identity (PoI)

Simplified Measures Account - Document Type code Identification Number

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Address Type Residential / Business Residential Business Registered Office Unspecified

Proof of Address (PoA)

Proof of Address Passport Driving Licence UID (Aadhaar)

Voter Identity Card NREGA Job Card Others

Simplified Measures Account - Document Type code

Address

City / Town / Village

District Pin / Post Code State / U.T Code ISO 3166 Country Code

No of yrs at above address no of years at current city Residence type Owned Rented Others

3

Contact Details

Tel. (Off)

Tel. (Res)

FAX

Mobile

Email ID

years years

years years

Business Constitution

Off. Ph. with STD Code

Extn. No.

Official Email ID

Total yrs in present occupation

Total Work Experience

Total Monthly Income `

Other Income `

Total `

GST

GSTIN/ UIN

GST Exemption Notification No.

Public Sector Pvt. Ltd. Partnership Proprietor

Public Ltd. Central Govt. State Govt.

Public Sector Pvt. Ltd. Partnership Proprietor

Public Ltd. Central Govt. State Govt.

Detail of Related Person (In case of additional related persons, please fill ‘Annexure B1’ )

Addition of Related Person Deletion of Related Person KYC Number of Related Person (if available)

Related Person Type Guardian of Minor Assignee Authorized Representative

Name

Applicable Not Applicable Exempted Applicable Not Applicable Exempted

NREGA Job Card(any document notified by the central government)Others



Voters ID

PAN No. UID

Proof of Identity (PoI)

Simplified Measures Account - Document Type code Identification Number

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Name Relationship If Personal Guarantor Yes NoCurrent Address Landmark CityState PINLandlineMobile

Reference 1

Instrument Type Cheque DD Instrument Date D D M M Y Y Y Y

Instrument No.

Amount (in`) Bank Name

Processing fees

Sr. No. Name of Account Holder Name of Bank Branch Account No.Current/Savings/OD(If OD Please Specify Limit)

Banking Since

1.

2.

Bank Details

Name Relationship If Personal Guarantor Yes NoCurrent Address Landmark CityState PINLandlineMobile

Reference 2

Remarks (If any)

Preferred Mailing Address Current Office Permanent

• Please refer to the Schedule of charges for the latest fees and charges updated on our website http://adityabirlahomeloans.com. Customer can also make enquiries at any branch of Aditya Birla Housing Finance Ltd. (ABHFL) or with ABHFL’s Customer service.

• Any fees and charges mentioned in the Sanction Letter are the rates applicable on the date of issue of the Sanction Letter and are subject to change from time to time.• Any Government Taxes as applicable on the fees and charges shall be payable by the Borrower.

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Declaration1. I/We hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I under take 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. 2. I /We confirm that no insolvency proceedings or suits for recovery of outstanding dues or monies whatsoever and/ or any criminal proceedings have been initiated and /or are pending against me/ us and that I/We have never been adjudicated insolvent by any court or other authority. 3. No action nor other steps have been taken or legal proceedings started by or against me/us in any court or law/other authorities for winding up, dissolutions, administration or reorganization or for the appointment of the receiver, administrator, administrative receiver, trustee or similar officer for my /our assets. 4. I/We declare that I/We have not made any payments in cash, bearer cheque or kind along with or in connection with this application to the executive collecting my/our application. I/we shall not hold Aditya Birla Housing Finance Ltd. (hereinafter referred to “ABHFL”) liable for any such payments made by us to the executive collecting this application. 5. I/we specifically authorized ABHFL and all its group/business associate companies and their agents to exchange, share or part with all or any information for any purpose including cross selling and referral. 6. I/We understand and acknowledge that ABHFL shall have the absolute discretion, without assigning any reasons (unless required by applicable law) to reject our application and ABHFL shall not be responsible in any manner whatsoever to me/us for such rejection or any delay in notifying me /us of such rejection and any costs, losses, damages or expenses, or other consequences, caused by reasons of such rejection, or any delay in notifying me/us of such rejection, of our application. 7. I/We understand and am/are aware that the processing fees collected from me/us by ABHFL, is for the purpose of ABHFL reviewing this loan application as per its own parameters and is not refundable to me/us under any circumstances whatsoever, irrespective of whether ABHFL sanctions this loan application of mine or not. 8. I/We confirm that I /we shall not use the products or the credit /loan facility(s) (or any part thereof) for any improper/illegal or unlawful purpose/ activities. 9. I/We shall inform to ABHFL regarding any changes in my /our address(s) or my employment or profession. 10. I/We hereby confirm that I/we am/are competent and fully authorized to give declarations, undertaking etc. execute and submit this application form and all other documents for the purpose of availing the loan, creation of security and for all the purposes mentioned /required to be done for this. 11. I/We confirm that I/we shall cooperate with ABHFL and furnish additional documents and/or shall execute such other documents, if necessary to enable ABHFL to abide by/comply with all other existing /further directives of the statutory /regulatory authorities/any other authority acting under any Law. 12. The Applicant(s) hereby authorizes ABHFL to disclose any information /documents relating to the Applicant(s), of the facility/ies proposed to be availed by the Applicant(s) or any obligations to be assured by the Applicant(s) in relation thereto, to National Housing Bank, Income Tax Authorities, Credit Bureau, Third Parties, Credit Rating Agencies, Databanks, Corporate(s), Banks, Financial institutions or any other Government or any Authority (Regulatory/Statutory/Judicial/Quasi-judicial) and also to obtain information from these agencies/authorities/etc with respect to the Applicant(s), so as to enable ABHFL to appraise the Applicant’s Application for grant of such facility/ies.13. I/We hereby consent to receiving information from Central KYC Registry through SMS/Email on the above registered number/email address.

Mobile No:

I Agree: Yes No I, would like to know through telephonic calls, or SMS on my mobile number mentioned in the Application Form as well as in this undertaking, or through any other communication mode, various ABHFL loan offer schemes or loan promotional schemes or any other promotional schemes and/or any other products and hereby authorize M/s Aditya Birla Housing Finance Limited (ABHFL), its employee, agent, associate and/or its group companies to do so. I confirm that laws in relation to the unsolicited communication referred in "National Do Not Call Registry" (the "NDNC Registry") as laid down by TELECOM REGULATORY AUTHORITY OF INDIA will not be applicable for such communication/calls/ SMSs received from ABHFL, its employees, agents and/or associates.

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IMPORTANT NOTE• That the receipt of your application form for the loan does not imply automatic approval of your loan by ABHFL. ABHFL may request for additional documents other than those in connections with the

application. I/We confirm that executive who collected my /our applications/ documents has informed me/us and I/we am/are fully aware: 1. That government tax as may be applicable from time to time will be charged in connection with the Loan. 2. That ABHFL will not be liable for loss or delay in receipt of the documents. 3. That incomplete/defective applications will not be processed and ABHFL shall not be responsible for any manner for the resulting delay or otherwise. 4. That the applications forms, documents/ photographs will not be returned under any circumstances once submitted to ABHFL. 5. That approval for the applications is the sole discretion of ABHFL. 6. That the quantum of the loan will be finally decided by ABHFL and ABHFL has not made any commitment to me/us regarding the same. 7. That equated installments (EMI) will be due on 1st / 5th of every month (strike out which is not applicable)

• The Most Important Terms and Conditions mentioned above are an indicative list of terms and conditions of our loan products. These Terms and Conditions are further described in our loan agreement under relevant sections / schedules and therefore should be read in conjunction with those mentioned in the loan agreement.

CENTRAL KYC REGISTRY | Instructions / Check list / Guidelines for filling Individual KYC Application Form

General Instructions:1 Fields marked with ‘*’ are mandatory fields.2 Tick ‘ ’ wherever applicable.3 Self-Certification of documents is mandatory.4 Please fill the form in English and in BLOCK Letters.5 Please fill all dates in DD-MM-YYYY format.6 Wherever state code and country code is to be furnished, the same should be the two-digit code as per Indian Motor Vehicle, 1988 and ISO 3166 country

code respectively list of which is available at the end.7 KYC number of applicant is mandatory for updation of KYC details.8 For particular section update, please tick ( ) in the box available before the section number and strike off the sections not required to be updated.9 In case of ‘Small Account type’ only personal details at section number 1 and 2, photograph, signature and self-certification required.

A Clarification / Guidelines on filling ‘Personal Details’ section1 Name: Please state the name with Prefix (Mr/Mrs/Ms/Dr/etc.). The name should match the name as mentioned in the Proof of Identity submitted failing

which the application is liable to be rejected.2 Either father’s name or spouse’s name is to be mandatorily furnished. In case PAN is not available father’s name is mandatory.

B Clarification / Guidelines on filling details if applicant residence for tax purposes in jurisdiction(s) outside India1 Tax identification Number (TIN): TIN need not be reported if it has not been issued by the jurisdiction. However, if the said jurisdiction has issued a high

integrity number with an equivalent level of identification (a “Functional equivalent”), the same may be reported. Examples of that type of number for individual include, a social security/insurance number, citizen/personal identification/services code/number, and resident registration number)

C Clarification / Guidelines on filling ‘Proof of Identity [PoI]’ section1 If driving license number or passport is provided as proof of identity then expiry date is to be mandatorily furnished.2 Mention identification / reference number if ‘Z- Others (any document notified by the central government)’ is ticked.3 In case of Simplified Measures Accounts for verifying the identity of the applicant, any one of the following documents can also be submitted and

undernoted relevant code may be mentioned in point 3 (S). Document Code Description

1 Identity card with applicant’s photograph issued by Central/ State Government Departments, Statutory/ Regulatory Authorities, Public Sector Undertakings, Scheduled Commercial Banks, and Public Financial Institutions.

2 Letter issued by a gazetted officer, with a duly attested photograph of the person.

D Clarification / Guidelines on filling ‘Proof of Address [PoA] - Current / Permanent / Overseas Address details’ section1 PoA to be submitted only if the submitted PoI does not have an address or address as per PoI is invalid or not in force.2 State / U.T Code and Pin / Post Code will not be mandatory for Overseas addresses.3 In case of Simplified Measures Accounts for verifying the address of the applicant, any one of the following documents can also be submitted and

undernoted relevant code may be mentioned in point 4.1. Document Code Description

1 Utility bill which is not more than two months old of any service provider (electricity, telephone, post-paid mobile phone, piped gas, water bill).

2 Property or Municipal Tax receipt.3 Bank account or Post Office savings bank account statement.4 Pension or family pension payment orders (PPOs) issued to retired employees by Government Departments or Public Sector

Undertakings, if they contain the address.5 Letter of allotment of accommodation from employer issued by State or Central Government departments, statutory or regulatory

bodies, public sector undertakings, scheduled commercial banks, financial institutions and listed companies. Similarly, leave and license agreements with such employers allotting official accommodation.

6 Documents issued by Government departments of foreign jurisdictions and letter issued by Foreign Embassy or Mission in India.

E Clarification / Guidelines on filling ‘Proof of Address [PoA] - Correspondence / Local Address details’ section1 To be filled only in case the PoA is not the local address or address where the customer is currently residing. No separate PoA is required to be submitted.2 In case of multiple correspondence / local addresses, Please fill ‘Annexure A1’

F Clarification / Guidelines on filling ‘Contact details’ section1 Please mention two- digit country code and 10 digit mobile number (e.g. for Indian mobile number mention 91-9999999999).2 Do not add ‘0’ in the beginning of Mobile number.

G Clarification / Guidelines on filling ‘Related Person details’ section1 Provide KYC number of related person if available.

H Clarification / Guidelines on filling ‘Related Person details - Proof of Identity [PoI] of Related Person’ section1 Mention identification / reference number if ‘Z- Others (any document notified by the central government)’ is ticked.

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Annexure A1

City / Town / Village

District Pin / Post Code State / U.T Code ISO 3166 Country Code

Address

No of yrs at above address no of years at current city Residence type Owned Rented Others

Correspondence / Local Address Details


Contact Details

Tel. (Off) Tel. (Res)

FAX Mobile

Email ID

Annexure B1Details Of Related Person

Addition of Related Person Deletion of Related Person KYC Number of Related Person (if available)

Related Person Type Guardian of Minor Assignee Authorized Representative

NamePrefix First Name Middle Name Last Name

PAN No. Aadhar No.

Voters ID



NREGA Job Card Others(any document notified by the central government)

Proof of Identity (PoI) of Related Person

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List of two - digit state / U.T codes as per Indian Motor Vehicle Act, 1988

CodeState / U.TAndaman & NicobarAndhra PradeshArunachal PradeshAssamBiharChandigarhChattisgarhDadra and Nagar HaveliDaman & DiuDelhiGoaGujaratHaryana

ANAPARASBRCHCGDNDDDLGAGJHR

HPJKJHKAKLLDMPMHMNMLMZNLOR

Himachal PradeshJammu & KashmirJharkhandKarnatakaKeralaLakshadweepMadhya PradeshMaharashtraManipurMeghalayaMizoramNagalandOrissa

CodeState / U.TPondicherryPunjabRajasthanSikkimTamil NaduTelanganaTripuraUttar PradeshUttarakhandWest BengalOther

PYPBRJSKTNTSTRUPUAWBXX

CodeState / U.T

List of ISO 3166 two - digit Country Code

AFAXALDZASAD

AOAIAQAGARAMAWAUATAZBSBH

BDBBBYBEBZBJBMBTBOBQBABWBVBRIOBNBGBFBICVKHCMCAKYCFTDCLCNCXCCCOKMCGCD

CKCRCI

HRCUCWCYCZ

DKDJDM

AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorra

AngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrain

BangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia, Plurinational State ofBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, the Democratic Republic oftheCook IslandsCosta RicaCote d'Ivoire !Côte d'Ivoire

CroatiaCubaCuracao !CuraçaoCyprusCzech Republic

DenmarkDjiboutiDominica

CountryCountry

CodeDOECEGSVGQER

EEETFKFOFJFIFRGFPFTFGAGM

GEDEGHGIGRGLGDGPGUGTGGGNGWGYHTHMVAHNHKHUISINIDIRIQIEIMILITJMJPJEJOKZ

KEKIKP

KRKWKGLALV

LBLSLR

Dominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritrea

EstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambia

GeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstan

KenyaKiribatiKorea, Democratic People's RepublicofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatvia

LebanonLesothoLiberia

CountryCountry

CodeLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, the former YugoslavRepublic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexico

Micronesia, Federated States ofMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugal

Puerto RicoQatarReunion !Réunion

RomaniaRussian FederationRwandaSaint Barthelemy !Saint BarthélemySaint Helena, Ascension and Tristan daCunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)

LYLILTLUMOMK

MGMWMYMVMLMTMHMQMRMUYTMX

FMMDMCMNMEMSMAMZMMNANRNPNLNCNZNINENGNUNFMPNOOMPKPWPSPAPGPYPEPHPNPLPT

PRQARE

RORURWBLSH

KNLCMF

CountryCountry

CodeSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi Arabia

SenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South SandwichIslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuela, Bolivarian Republic of

Viet NamVirgin Islands, BritishVirgin Islands, U.S.

Wallis and FutunaWestern SaharaYemenZambiaZimbabwe

PMVCWSSMSTSA

SNRSSCSLSGSXSKSISBSOZAGS

SSESLKSDSRSJSZSECHSYTWTJTZTHTLTGTKTOTTTNTRTMTCTVUGUAAEGBUSUMUYUZVUVE

VNVGVI

WFEHYEZMZW

CountryCountry

Code

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Loans originated, booked and serviced by Aditya Birla Housing Finance Limited. All loans at the sole discretion of Aditya Birla Housing Finance Limited. Registered Office Address: Indian Rayon Compound, Veraval,

Gujarat - 362 266. CIN - U65922GJ2009PLC083779