=U65991UP201SPLC058928 . 4 Regd. Office:- 5, Mohan Bhag, Opp. D Bhuteshwar Road Mathura 281001 PHOTO SIGNATURE NT Nationality... Resident individual Non Resident [_] Foreign National Inique identification Number (UID)! Aadhaar, If any... Proof Of Identity Submitted PAN exempt cases Please tick 2 |UID (Adhar) Passport Voter ID Driving License, Others]. Stated. Proof Of address to be provided by Applicant. Please submit ANY ONE of the following Valid Doc Passport [_] Ration Card [_] Voter Id Card [[] Driving License Latest Telephone Bill(only Land Line ) Latest Electricity Bill Latest Gas Bill Not more than 3 months old, Validity/Expiry date of proof address submitted Gross Annual Income Details Below 1 Lac 1-5 Lacs $-10 Lacs Net-worth in. 2s of (date), : A. Occupation Details: Private sectorService [_]Public Sector |Government Service Business Agriculturist Retired Housewife JStudent, Others cscs 2. Certificate / Account No. . Amount Deposit:...... -osmsnn5, Balance in a/o(in case of RD). _ Type of security(in case of other than deposits) & its valu i ). Loan Amount required : Rs. 11. Purpose of Loan: FOR OFFICE USE ONLYNSTRUCTIONS elfattested copy of PAN card is mandatory forall of all the documents submitted by the int should be self-attested and accompanied by js for verification. In case the original of any ment is not produced for verification, it hen the i should be properly attested by entities wrized for attesting the documents, as per the list tioned under. 3 if any proof of identity or address is in a foreign inguage, then translation Into English is required. Name & address Of the applicant mentioned on the Loan Form, should match with the documentary proof ibmitted. "5. If correspondence & permanent address are different, then proofs forboth have to besubmitied. 2,Unique identification Number (UID) Adhar)/Passport/ Voter ID card/ Driving License. Tdentity card! document with applicant's Photo jissued by any of the following: Central/State vernment and its Departments, atuiory/Regulatory Authorities, Public Sector Undertakings, Scheduled Commercial Banks, Public Financial Institutions, Collages affiliated to ersities, Professional Bodies such as ICAI, ICSI, ar Council etc., to their Members; and Credit cards / C. Proof of Address (POA); List of d admissible as proof of Address :( *Document an expiry date should be valid on the d submission.) 1. Passport/ Voter identity Card/ Ration Card R Lease or Sale Agreement of Residence/ Driving Lic Flat Maintenancebill/ Insurance Copy. 2. Utility bills like Telephone Bill (only line), Electricity bill or gas bill-Not more then 3 m old. 3.Bank Account Statement / Passbook Not more th months old. 4. Proof of address issued by any of the following Managers of Scheduled Commercial Bank Sched Co- Operative Bank/ Multinational Foreign Ba Gazetted Officer / Notary Public/Elected representati to the Legislative Assembly or Parliament D issued by any Govt. or Statutory Authority. 5. Identity card / document with address issued by any the following Departments , Statutory /Regulatory Authorities, P Central/ State Government and Sector Undertakings, Scheduled Commercial Banks, Public Financial Institutions , Colleges affiliated t Universitics and Professional Bodies such as IK ICAL.ICSI, Bar Council ete. to their Members. 6. The proof of address in the name of the spouse may accepted. D. List ofpeople authorized to attest the documents: 1. Notary Public, Gazetted Officer , Manager of Scheduled Commercial/ Co-oper: Multinational Foreign Bank( Name , Designation& Se should beaffixed on the copy). ¢ to inform you of any change therein immediately. In case any of the above information is sho e or misleading or misrepresenting; lam / we are aware that I/we may be hell liable for it. ID, Signature of Introducer