INDIVIDUALLOANAPPLICATIONFORM
Wilhyou,rightthrough
FOR APPLYING THROUGI{ DSAS (DIRECT
SELLTNG
AGENTS)
Regd.ofiicu Ramon
Hous€,
HT Parekh
Mars,169,Backbay
Redamalion,
PERSONAL AND EMPLOYMENT DETAILS Cuhrchgale,
Mombai400
020.Phones:
66316000,
22820282.
FaxtDU-2n11205,2
FirslName i,liddle
Name FirstName l\,liddle
Name
FATHER's/HUsBAND's
NA[4E
Cunnelt/Penueuerur*
RESTDENTTAL ADDRESS
'(lfPermanentAddresss dfler€nt
kndlyglvedelas intheboxprovidedal
LandMark: Landlvlark:
lhebollomoflhs page.) PinCode:- State: PinCode: State:
cuinili niiroerCi
ii Selfowned! ! Rented n Leased/Provided
PHoNE
No. wTHSTD CoDE applicant:
E-MALlD
--,^
UATEOFEIRTH/SEX A99 _Y.|!, ! N4!J Age Yrs. trM !
MARITAL
STATUS ! lvarried ! Other n Single ! Marrjed I Other
Others Children Others
OccuPATloN ! Selfemployed
QuALlFrcATroNs
& DEStGNATtoN
MoNTHLylNcoltE
L Ottenlucorr.re
ilPLotEBliiEis
NA[4E
ANDADDRESS
(Please mentiontheaddress
of lheofliceyouarebasedat) PinCode:_
_ - _ State: PinCode: ___ State:
PH0NE
No. wTHSTD CoDE
Ext. Fax:
YRs.tNPRESENT
OccupATtoN Yrs. Retirement
aqe Yrs. Yrs. Retirement
LOANREOUESTED TYPEOF LOAN
Annual !
Amount
Rs.: yrs.- - _--
Term:
! Fixed ! Adjustable
YourmonthlyExpenditure
Rs.: n Combination
youandco-applicant
lnstalment
(ifany)canpayto HDFCpermonthRs.: ! HomeExtension
Loan ! LandPurchase
Loan ! ShortTermBridgingLoan
! NonResidential
Premises
Loans ! HomeEquityLoan
LOAN DETAILS
to meet
1. Landcost Rs. 7. Loanrequested
fromHDFC
FixedRate Rs.
purchase
2. Total price/construction
costRs. Adjustable
Rate Rs.
3. Incidental
costs(ifany) Rs. 8. SavingsfromBank Rs.
e.g.Stampduty,Registration
charges.
etc. 9. Disposalofinvestments
4. Other (please
costs specify) Rs. (fixed
deposits/ shares,
etc.) Rs.
5. l\4arket ofproperty
value '10.Amount already (source
spent , _ ) Rs.
(forHome Equity
Loan) Rs. 11.ProvidentFund(refundable/non+efundable)
Rs.
6. Loanoutstanding
(forrefinance) Rs. 12,Other(specify Rs.
A. Total of funds Rs. B. Estimaieof sourcesof funds Rs.
'A' 'B'whichindicates
Note; whichis thetotalrequirement of funds,should
equalestimate
of sources. thesourcesfromwherethe willbe met.
It is importantthatyou indicatein detailthesourcesfrbmwherethe costwili be metin orderto helDus processvouraol iontaster
F------------_-'1 r--------------1 DSAExecutive:
tl tl
tl Landl\4ark: Phone
No.: Location:
rl
Pincode: _,__ State: ChequeNo.:
PASTERECENT PASTE
RECENT
PHOTOGRAPH To be filled by the Customer only Bank:
OF PHOTOGRAPHOF
APPLICANT CO.APPLICANT DateSubmission of Aool.:____
WITH SUbmitted to(Fxeculive
rare)
SIGNATURE SIGNATURE FROM
HDFC
TOTHEDSA
lr .rl
lr rr I HDFCExecutive: lnitials
lt tt !
lr tt I Customer
Siqrature DateofAcceptance- _ FileNo.
FlIIANCIALINFORMATION
LOANS AVAILED/ PROPOSED
SAVINGS,INVESTMENTS,
ETC. lmportanl:
Nondisclosure
/ falsedeclaraiion ofyourloan
canleadtocancellation
Particulars Applicant Co-applicantapplicalion.
(Rs.) (Rs.) Source OutstandingMonthly Installment Bal.Term
Savings
inBank (Rs.) Payable (Rs.) (Months)
lmmovable
Propedy
with (specify) of Loan Amount
current
value
Applicant:
2. Employer
Current in
balance Bank
Provident (yourshare)
Fundbalance ___-._
.,-,._,_ CreditSociety
(specify).
otherAssets Others
1. Co-applicant:
2. Employer
LifeInsurance
Policy(ies) Bank
Sum Assured CreditSociety
Maturity
Dates Others
BANK ACCOUNT DETAILS (pLEAsE
rEfiT|or{ oFyouRsALARy
DErAtLs Accour{TtNRoy{t}
Name
ofAccount
Holder Name
ofBank Branch tlo.(s)
SinceAccount
A/coperated
1.
z.
DETAILS OF PROPERTY Fo BEPURct{AsED/coNsrRUcrEDi
ExrEl{DEoi As sEcuRtty)(pLEAsE
nrpRovED/oFFERED coMpLETE
AsAppLtcABLE)
Address: Mentiondwelling
unitno.,street,
city, Area ofLand: _,Sq.m.Built-up
._.,__ area: Sq.m.
nearest landmarkandDincode.
mention
lf notselected, intendedlocation: Stage of construction/ extension/ improvement :
lf property
notselected wouldyoulikeHDFCRealty to assistyou? !Y !N
Doyoupropose to rentthedwelling unit? .Y !N
Areyouthesoleownerofthedwelltng unit? .Y !N
PinCode: ls thelegaltitle
to the dwellingunit clear? t]Y |]N
State WillHDFC beabletoobtain firstmortgage ofthedwelling
unit? !Y !N
GEl{ERAL JAppLTGABLE to applrcANr ANDco-AppltcaNr 0F ANy)l
willyoube ableto provide
4. Whatothersecurity
appliedto HDFCfora loan? fY !N
lf yes, File/ LoanA'./cNo. 5.Please select
themodeof repayment to you:
convenient
2. Haveyouoryourspouse
givenguarantee(s) (Notapplicable for employed
applicants,
whoseemployers
havea
for any bonower/sof HDFC? !Y
deduction at sourcearrangementwithHDFC)
L-N
Tick(y') againsttheappropriate
box.
lf yes, a) File/ LoanAJcNo.
a) Deduction of monthly byyouremployer
installment
b) Nameof borrower/s b) Postdatedcheoues
3.Whenwouldyou a) Sanctioned(Dare) c) Standing instructions
to bankers
preferyourloanto be: b) Disbursed {oate)
Areyoua citizen(s)
oflndia?J Yes! No.Status! Resident
IndianJ Non-Resident Doyoubelongto j SC ! ST tr NA.
Indian.
HDFCHomeLoan ProtectionPlan Productsofteredby HDFCSank?
il Yes ! No f] Savinos from HDFCERGOGeneral
from HDFCSLIC? BankAccounl- CardI olherLoans
Credil ! YAs !
REFERENGES (NAMESANDADDRESSES
OF TWOREFEREES
WHOARENOTRELATED
TO YOU)
HDFCmaymakesuch 1 ?,.,
-,.
enquiriesfrom the
refereesif it deems Email: Email:
necessary Tel:(O) (R) Tel:(O) (R)
DECLARATION
Applicant's
Signature Signature
Co-applicant's
