APPLICATION FORM FOR PERSONAL LOAN

___________________________________________________________________________________________________________________________

APPLICATION NUMBER: Application Date:

Branch Branch Code

Affix Photo
Of applicant
Staff (Yes/No) CIF ID and sign across

Personal Details
Name: Date of Birth*

Father’s/Spouse Name Gender

ADDRESS: (As per address proof)

Land Mark City/Dist

State PIN Contact No.*
Mobile No* Email ID*
*Mandatory
Other Details
No of Dependents Present Residence Owned/ Rented/ Co Provided/ Parental/Rented
Education Religion Category

Employment Details
Name of Employer/ Emp Code
Business Designation

Address

City/Dist State Bihar Pin

Category: Manufacturing Trading Service Others ______________________________

Constitution: Proprietor Others ___________________ Trade license no. (If available)______________

Income, Banking & Other Details ________________________

Annual Salary/ Business Income Rs Other Income Rs Specify

Bank Details:
Name of the Bank Branch Type Of account

Credit Card Details: Issuer CC Limit Outstanding

Other Loan Obligations:

Income Declaration

a) I________________________, owner of /working with M/S_______________________________ has an average monthly sale of

Rs ______________________ (Not Applicable in case of salaried individual) since_________ (year in service/business). My monthly
income is Rs __________________per month.
b) I would be comfortable to pay an EMI up to Rs ____________per month.

___________________________ _____________________________________
Signature/ Thumb impression of Applicant Signature of Witness
The contents of the form has been explained by me to the
Applicant and the same has been understood by him / her
Loan amount applied for Duration (M)

Purpose of Loan:______________________________________________________________________________
Relationship Declaration: Details of relationship with and Director/ senior officer of Bandhan Bank

Name of the Director/ Senior Officer_______________________________ Relationship with Director/ Senior Officer___________

Declaration
I/We hereby declare that all the particulars and information furnished in the application form are true, correct, complete and up-to-date in all respects.
I/We have not withheld any information. I/We confirm that I have had no insolvency proceedings initiated against me/us, nor have I ever been
adjudicated insolvent and further confirm that I / We have read and understood the contents. I/We are aware that the fees paid by me/ us is no
refundable. I/ We are aware about the rate of Interest charged by Bandhan Bank. I/we understand that the document submitted shall not be returned to
me/us. The sourcing channel have not collected any cash or cheque other than PF to be deducted by Bandhan Bank. I/ We also confirm that the loan
proceeds will not be utilised for any speculative purpose. I/We also authorise Bandhan Bank or its agent to make references and inquiries relative to
information in this application which Bandhan Bank considers necessary. I/We also authorize Bandhan Bank to exchange, share, and part with all
information relating to my Loan details and repayment history information to other Banks/Financial institutions/ Credit Bureaus/Agencies as may be
required and shall not hold Bandhan Bank liable for use of this information. I/We undertake to inform Bandhan Bank regarding any change in my
residence/employment/Occupation/Transfer and to provide any other information that Bandhan Bank may require. I/we further agree that my loan shall
be governed by the rules of Bandhan Bank which may be in force from time to time. Bandhan Bank reserves the right to reject any application without
providing any reason. I/We undertake to bear processing, service, documentation charges etc. stipulated by the Bank from time to time. I/We agree,
note and understand that Bandhan Bank shall be entitled at its sole discretion to call back, the entire loan/advance whether due and payable or not at
any time, without assigning any reason and enforce its rights, remedies and securities.

Date:
Place:

___________________________ _____________________________________
Signature/ Thumb impression of Applicant Signature of Witness

KYC DOCUMENTS The contents of the form has been explained by

me to the Applicant and the same has been
PHOTO ID: Passport VID Card Aadhar card Driving License Pan Card* Others (Specify) understood by him / her
RESIDENCE PROOF: Passport VID Card Aadhar card Driving License Bank Statement/ Others (Specify)
*Please furnish Form 60/61, in absence of PAN card.
_____________________________________________________________________________________________________________________________

DEBIT AUTHORISATION:

I do hereby authorize the Bank to debit payments of Processing Fees, Loan Instalments dues or/and any overdue/Late Charges/cheque bounce charges from
the Savings/Current Account No ……………………

I, hereby agree and confirm that these instructions shall be irrevocable and will be operative till the closure of the Loan.
Further, the Bank is authorized to debit any residual amount as balloon payment being the last installment for closure of the loan account as and when
required.

__________________________ ______________________ __________________________

Signature/ Thumb impression of Applicant Signature of Witness Signature of Bandhan Bank Limited
The contents of the form has been explained by
me to the Applicant and the same has been
understood by him / her

FOR OFFICE USE ONLY

The information furnished above are verified

Appraisal note:
Particulars Details
Approved Loan Amount

Loan Tenure

EMI Rs

Processing Fees

Sanctioned by (Branch Head/ Sanctioning Authority)

Name Emp Code- Designation .
To the best of my knowledge, Applicant is not my relative as per RBI master Circular on Loans & Advances.
Date Signature