I.D.

10008

CORPORATION BANK CORP HOME

(A GOVT. OF INDIA ENTERPRISE) APPLICATION CUM APPRAISAL
HEAD OFFICE : MANGALORE
.
1. Please fill all the columns in the application invariably & no columns shall be Affix recent passport Affix recent passport
left blank, If any information is not applicable mark as NA. size size
2. Wherever space is not sufficient, separate sheet may be used. Photograph Photograph
3. Corporation Bank reserves the right to reject any application. of Applicant of Applicant
4. Please tick whichever is applicable. with signature with signature
5. Applicant should submit duly filled application along with all relevant documents.

To:
The Branch Manager,

Sagar BH Road Branch Branch

Dear Sir,
I/We hereby apply for a Housing Loan of Rs 5,00,000.00 (Rupees Five Lakhs only).

To enable you to consider my/our application for loan, I/we furnish the following details.

PERSONAL DETAILS

FIELD DESCRIPTION APPLICANT CO-APPLICANT

01. NAME IN FULL Mrs Sharadamma M Mr K M SANTOSHKUMAR

02 FATHER’S/HUSBAND’S NAME . .
03. DATE OF BIRTH 01/01/1963 09/03/1985
04. GENDER Female Male
05. MARITAL STATUS Widowed Married
06. NO. OF DEPENDENTS CHILDREN OTHERS CHILDREN OTHERS
07. RELIGION ............... ...............
09. EDU. QUALIFICATION ............... ...............
IF PROFESSIONAL ............... ...............
09. A. STATUS ............... ...............
B. CATEGORY
............... ...............
10. PAN NO NOPAN DJHPS8706J
11. PASSPORT NUMBER NO ............... ISSUED BY ............... NO ............... ISSUED BY ...............
VALID TILL ............... VALID TILL ...............
12. VOTER ID NUMBER ............... ...............
13. DRIVING LICENCE NO. ............... ...............
14. RESIDENTIAL ADDRESS Khaira Grama Achapura Post Sagar Taluk khaira grama achapura post, sagar taluk shimoga
sagar,madhya pradesh - 577412 karnataka
577412
. .

15. PERMANENT ADDRESS.

16. OCCUPATION ............... ...............

17. NET WORTH RS. RS.

Note: Full details to be furnished in the Statements of Assets and Liabilities by the applicant & co-applicant/s. Please refer to Annexure-90.
 EMPLOYMENT DETAILS

FIELD DESCRIPTION APPLICANT CO-APPLICANT

01. EMPLOYER NAME Agirculturist Hubli Dharwad BRTS Company Limited

02. EMPLOYER TYPE ............... ...............
03. EMPLOYER ADDRESS:
............... ...............
(Mention the address of the Office presently you are based at)

04. WORKING SINCE ............... ...............

05. WHETHER THE JOB IS TRANSFERABLE ............... ...............
............... ...............
06. REMAINING SERVICE ............... Years ............... Years
07. DESIGNATION & DEPARTMENT ...............,............... ...............,...............
09. DETAILS OF PREVIOUS EMPLOYMENT IF ANY(Please
...............0 Years 0 Months ...............0 Years 0 Months
mention Name of the employer,no of years of service etc.)

09. INCOME DETAILS APPLICANT CO-APPLICANT

1. Gross Salary Rs 20000.00 Rs 21600.00

2. Other income (specify: ) Rs 0.00 Rs 0.00
3. Total Income (1+2) Rs 20000.00 Rs 21600.00
4. Statutory Deductions (PF+Tax+SSS,etc ) Rs 0.00 Rs 0.00
5. Other Deductions (LIC direct payment etc) Rs 0.00 Rs 1858.00
6. Net Income (Enclose Income Proof) Rs 20000.00 Rs 19742.00

DETAILS IN CASE APPLICANT/CO APPLICANT IS SELF EMPLOYED / PROFESSIONAL /BUSINESSMAN PROPRIETORSHIP / FIRM /COMPANY/ HUF/ INSTITUTION

1. BUSINESS NAME ...............

2. DATE OF ESTABLISHMENT ...............
3. NATURE OF CONSTITUTION Self employed [ ] Professional [ ] Institution [ ] Trust [ ] HUF [ ]
Proprietorship [ ] Partnership [ ] Company [ ] Others [ ]
4. NATURE OF BUSINESS/PROFESSION ...............

5. BUSINESS ADDRESS ……………………………………… Phone: Mobile Fax: Email:

6. REGISTRATION NUMBER ...............
7. SALES TAX NO /VAT NO ...............
9. PAN NUMBER ...............
9. BUSINESS PERFORMANCE FOR THE ( Amount in lacs)
LAST 3 YEARS (Enclose the proof)
Years Turnover Gross Income /Profit Net income/
Profit

First ............... ............... ...............

Second ............... ............... ...............

Third ............... ............... ...............

10. PARTICULARS OF PROPRIETOR /PARTNERS / DIRECTORS /TRUSTEES/ ETC

Name & Address Age Qualification Net Worth Net Income Phone No.

A. ... ............... ............... ............... ...............

B. ... ............... ............... ............... ...............

C. ... ............... ............... ............... ...............

D. ... ............... ............... ............... ...............

Note : Full details to be furnished in the Statements of Assets and Liabilities separately by the proprietor/partners/directors etc.
 ADDITIONAL INFORMATION FOR ALL CATEGORY OF BORROWERS

PRESENT BANKERS APPLICANT CO -APPLICANT

NAME OF THE BANK/S & BRANCH ........................................ ........................................

DEALING WITH SINCE ........................................ ........................................
CREDIT FACILITIES ENJOYED, IF ANY. A/C NO. LIMIT (in lacs) Bal.O/S(in lacs) EMI(Rs) A/C NO. LIMIT (in lacs) Bal.O/S(in lacs)
Whether any relative is working in our Bank? [ ] Yes [ ] No. If yes, his/her details: ................ [ ] Yes [ ] No. If yes, his/her details: .......

OTHER INFORMATION APPLICANT CO APPLICANT

No Savings[ ] PPF/NSC/Pension fund [ ] Bank Deposit/Mutual fund/others[ ] No Savings[ ]PPF/NSC/Pension fund[ ] Bank Deposit/Mutual fund/others[ ]
Saving habits

Borrowing history Loans/Credit Cards [ ] Credit Card only [ ]No loans /Credit Cards[ ] Loans / Credit Cards [ ] Credit Card only [ ]No loans/Credit Cards[ ]

Family Medical History Critical illness in family [ ] No illness [ ] Critical illness in family [ ] No illness [ ]
No Critical illness require regular treatment [ ] No Critical illness require regular treatment [ ]

Method of repayment Post dated cheques [ ] Salary deduction [ ] Standing instructions [ ] Post dated cheques [ ] Salary deduction [ ] Standing instructions [ ]

Projected Income Stable Income[ ] Irregular/varying Income[ ] Stable Income [ ] Irregular/varying Income [ ]
Decline in Income [ ] No much variation [ ] Decline in Income [ ] No much variation [ ]

Two references (To be provided by the Name:....................................Phone:................... Name:....................................Phone:...................

borrower) How do you know............................................ How do you know............................................
Know since...................................................... Know since......................................................

Name:....................................Phone:................... How Name:....................................Phone:................... How

do you know............................................ Know do you know............................................ Know
since...................................................... since......................................................
ADDITIONAL DETAILS IN CASE OF NON RESIDENT INDIAN (NRI)

PASSPORT /VISA DETAILS APPLICANT CO-APPLICANT

VISA VALID UP TO ........................................ ........................................

VISA PARTICULARS ........................................ ........................................
PASSPORT NUMBER ............... ...............
PASSPORT ISSUED BY ............... ...............
DATE OF ISSUE & EXPIRY Issued on: ............... Exp on: ............... Issued on: ............... Exp on: ...............
OVERSEAS ADDRESS ................................. .................................
DETAILS OF EMPLOYMENT CONTRACT

CONTRACT VALID UP TO
........................................ ........................................
BALANCE PERIOD OF CONTRACT
........................................ ........................................
TERMS OF CONTRACT
........................................ ........................................
NATURE OF EMPLOYMENT
........................................ ........................................
PROVISION FOR RENEWAL
Yes : ( ) No: ( ) Yes : ( ) No: ( )
RENEWAL DETAILS
........................................ ........................................
WORK PERMIT NO OR LABOUR CARD NO
........................................ ........................................
DATE OF ISSUE
........................................ ........................................
ISSUING AUTHORITY
........................................ ........................................
VALID UP TO
........................................ ........................................
TERMS OF PERMIT OR LABOUR CARD
........................................ ........................................
 LIST OF COPIES OF DOCUMENTS TO BE SUBMITTED

VISA Yes [ ] No [ ] EMPLOYMENT CONTRACT Yes [ ] No [ ]

PASSPORT Yes [ ] No [ ] Salary slip for the last 3 months Yes [ ] No [ ]

IDENTITY CARD Yes [ ] No [ ] One year NRE bank account Pass Sheet Yes [ ] No [ ]

WORK PERMIT Yes [ ] No [ ] Receipt for advance payment if any Yes [ ] No [ ]

Declaration to the effect that the proposed house /flat will be used for self occupation only, on return to India and not for any other purpose.Yes[ ] No[ ]

Declaration to the effect that margin money to be paid by remittances from abroad through normal banking channels or out of funds in the borrower’s
NRE/FCNR/NRO account in India. Yes [ ] No [ ]

Declaration: Where NRI - applicant is a principal borrower, with resident close relative as co applicant/ guarantor or where land is owned jointly by NRI
borrower with the resident close relative, margin money and repayment of loan instalment /interest is to be paid by NRI borrower.Yes [ ] No [ ]

PURPOSE OF LOAN Construction [ ] Purchase [ ] Purchase of Site & construction of house [ ]

Foreclosure/takeover from other Banks/ FIs / Employer [ ] Repair
/Renovation/Extension [ ]

PROJECT COST OWN CONTRIBUTION (MARGIN) LOAN AMOUNT

Rs. 750000.00 Rs. . Rs. 500000.00

TYPE OF INTEREST SOUGHT REPAYMENT PERIOD REPAYMENT HOLIDAY

Floating [ ] Fixed [ ] ........................ Years/Months .........................Months

Full address /location of the property (Survey No/ ...................................................

Door No/ Flat No/House No/ Road , Village, ...................................................
Taluk, District, State) ...................................................
Prominent land mark/s if any.

NAME & ADDRESS OF THE SELLER /BUILDER/OR ..................................................................................................................................................................

CO-OP HOUSING SOCIETY
........................................................................................................
Phone.......................... Mobile..................................Email..........................................

PROPERTY PROFILE Location Metro [ ] Urban [ ] Semi Urban [ ] Rural [ ]

Ownership Single [ ] Joint [ ]

Is the land Freehold [ ] Leasehold [ ] Un expired lease period ...........years

Age of the house /flat: ..................... Years ( for ready built house/flat only)

PROPOSED LOAN SOUGHT IS FOR PURCHASE/ First house [ ] Second house [ ] Third OR.......... house(indicate number) [ ]
CONSTRUCTION OF
First floor [ ] Second floor [ ] Third OR.......... floor (indicate number) [ ]

Particulars of Permission /Licence/ Plan Approval ................

obtained from the Competent Authority.
 DETAILS OF PROJECT COST

(A) FOR CONSTRUCTION (C) FOR REPAIR /RENOVATION/EXTENSION

Purchase price of land * Rs.............................. Original value of Land & Building. Rs.................................

Add: Rs............................. Proposed cost of repair/renovation extension etc. Rs...........................

Stamp duty + Registration charges Rs............................. Age of the building ............................Years.

Add: Rs............................. Built up area of extension Whether the building Yes [ ] No [ ]

was originally constructed as per approved plan ?
(enclose a copy of original approved plan)

Estimated Cost of construction ................................. Particulars of repair/renovation/extension .......................................

/improvement etc.(Briefly furnish the details) .

Project cost (Total of above) ................................. .......... ..........

Total area of Land ................................. .......... ..........

Proposed built up area (in sq. ft.) ................................. ................................. .................................

Cost per sq,ft. ................................. ................................. .................................

Stage of Construction ................................. .................................

To be considered only in case loan is for purchase of land/site and .................................

construction of house thereon .

(B) FOR PURCHASE OF FLAT /READY BUILT HOUSE (Including where building is (D) FOR TAKE OVER/ FORE-CLOSURE FROM OTHER BANK/ INSTITUTION /
under Construction) EMPLOYER

Purchase price (Agreement Value) Rs............. Date of availing the loan .............

Add: Stamp Duty +Registration Charges Rs............. Amount of loan/s availed Rs.............

Cost of the project Rs............. Balance outstanding as on date Rs.............

Advance payment made if any Rs............. Original repayment period (Including repayment ............. Years/Months
holiday period)

Stage of construction (Enclose Engineer’s ............. Monthly instalments payable Whether the Rs............. Yes[ ] No [ ]
Certificate) account is regular

Whether dwelling unit is booked? Yes [ ] No [ ] If No, the amount of over due Rs.............

Date of Booking ............. Amount to be paid to the other Bank/ Financial Rs.............
Institution (if taken over by our Bank)

Built up area of the Unit ............. ............. ............. .............

Likely date of completion ............. ............. ............. .............

If the building is completed,Particulars of completion ............. Whether certificate from the Bank/Financial Institution Yes [ ] No [ ]
certificate/ Occupancy certificate issued if any from whom the loan is being taken over is enclosed.
In case building is under construction Stage of
construction (Enclose Engineer’s Certificate)

I/We declare that all the particulars and information furnished above are true, correct and complete and they shall form the basis of any credit decision to be taken by the
Bank. I/We have not ever been adjudicated insolvent nor any insolvency proceedings are pending against me/us. I/ We further understand that the loan is at the sole
discretion of the Bank. I/We confirm that the funds shall be used for the stated purpose only and shall not be used for speculative/anti-social purposes. I/We authorize
Corporation Bank to conduct such checks as it considers necessary in its sole discretion and also to authorize the Bank to release such informati on or any other information
in its records to any agency for the purpose of credit appraisal/sharing or for any other purposes.

Place:

Date:

Signature of the Applicant Signature of the Co-applicant/s

 PARTICULARS OF GUARANTOR

NAME IN FULL ...............

FATHER’S / HUSBANDS NAME .
DATE OF BIRTH & GENDER ...............
MARITAL STATUS ............... RELIGION : ...............
EDU. QUALIFICATION ...............
IF PROFESSIONAL ...............
PAN No

PASSPORT NUMBER ...............

VOTER CARD NUMBER ...................
DRIVING LICENCE NO ...............
RESIDENTIAL ADDRESS PRESENT PERMANENT

,,, ,,,
OFFICE ADDRESS. ...............
OCCUPATION ...............
NET WORTH & INCOME Net Worth: Rs. Net Annual Income: Rs. (Furnish proof of income such as salary slip/F-16/ IT return
etc)

Statement of Assets & Liabilities should be submitted as per Bank’s format.

PRESENT BANKERS

NAME OF THE PRESENT BANK/S &BRANCH ............

DEALING WITH SINCE ............
CREDIT FACILITIES ENJOYED, IF ANY. A/C NO. LIMIT (in lacs) Bal.O/S(in lacs) EMI(Rs)

I declare that all the particulars and information furnished above are true, correct and complete to the best of my knowledge & belief. Further I

declare that I am not a close relative of the borrower/s.

I hereby agree to stand as guarantor to .........................................................................loan (nature of facility) for Rs...........................

(Rupees....................................................................................only)sought by Mr/Ms...........................................................

Affix recent passport

size
Photograph
Place: of Guarantor
Date:Signature of the Guarantor with signature