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Application Form hon1eflrst We II uke you home

(Please fill this form in CAPITAL letters 1n blue or bla cl< rnl<)

PERSONAL DETAILS OF APPLICANT

Name (Please leave a blank box between two words)
R A

First Name
B H A D u R y

Last Name
A D A V
-- __,_ -
Gendee,__./
M
Marital Status
✓ Married
Date of Birth
2 0 2 9 9 2 --· -"-

D D M M y y y y

Nationality Religion Caste '-=

✓ Indian ✓ Hindu ✓ Other -=

(*Male applicant- Please mention father's name.Female applicant- Please mention spouse's
name if married and father's name if unmarried)
-- -
*Father's/Spouse Name

p u J A R y A D A V

No. of Year at Current Residence Residential Details

-=-=
0 Year ✓ Owned
Current Residential Address
Street :=-
y A V H 0 u s t N 0 6 3 s u L T
p u J A R A D

p u R K A R M A C H 0 L A p u R
A N
Pio Code Country
City
s 2 2 0 N D A
V A R A N A

State
u T T A R p R A D E s H

Residence Phone Mobile

6 + 9 9 5 6 5 7 5 3 5 6 6
9 5 6 5 1 5 3 5 6

STD CODE
Permanent Address
Street
p u J A R y A D A V H 0 u s E N 0 6 3

A N p u R K A R M A C H 0 L A p u R

Pin Code Country

City
s 2 2 0 N D A
V A R A N A

State
u T T A R p R A D E s H

E-Mail ID

Qualification Vehicle Owned

✓ Matriculate
 I
J,cctJPATION DETAJLS OF APPLICANT
occupation Gross Monthly lrtcome
✓ SelfEmployed 4 0 7 9 6

PAN No. Passport No.

A F H P Y 8 2 7 0 N
AadhaarNo.
X X X X X X X X 8 0

Driving License No. Voter Id No.

Name of the Organization

J A y B A B A R N A s H T A H 0 u s E
..;::::
Experience in the current job Total Work Experience

0 Year g Year
Mobile
+ 9 9 5 6 5 7 5 3 5 6 6

STD CODE

PERSONAL DETAILS OF CO~APPLICANT

Name (Please leave a blank box between two words)
G u D D I D E V

First Name Last Name

Gender Matital Status Nationality Date of Birth
F ✓ Married ✓ Indian 0 0 9 9 0

,
D D M M y y y y
(*Male applicant- Please mention father's name.Female applicant- Please mention spouse's name if
married and father's name if unmarried)
*Father's/Spouse Name ..
R A B A H A D u R y A D A V
~. "

PANNo. Passport No.

H y G p D 2 7 8 C

AadhaarNo.
X X X X X X X X 0 0 7 9

Driving License No. Voter Id No.

Relationship with 1st Applicant

w I F E

Current Residential Address

Street
K A R M A K A R M A s u L T A N p u R C H 0 L A p u
R V A R A N A s
City Pin Code Country
V A R A N A s 2 2 0 N D A

State
u T T A R p R A D E s H
Residence Phone Mobile
7 3 9 8 7 7 5 0 6 0 + 9 7 3 9 8 7 7 5 0 6 0

STD CODE
 A R M A K A R M A s u L T A N p u R C H 0 L A p u

R V A R A N A s
City Pin Code Country
V A R A N A s 2 2 0 N D A

State
u T T A R p R A D E s II

Qualification
✓ Under Matriculate

OCCUPATION DETAILS OF CO-APPLICANT 1

Occupation Gross Monthly Income

✓ Housewife
Name of the Organization

Personal Details Of Co-Applicant 3

Co-Applicant3 Name (Please leave a blank box between two words)
P A R A S Y A D A V
First Name Last Name

Gender M

PAN No. AadhaarNo.

A G D P Y 8 2 7 2 B X X X X X X X X O 5 3 2

PROPERTY AND LOAN DETAILS

Project Code PROP- 100018 Project Name Elegance Residency

Product Type ✓ HomeLoan Loan Amount ✓ 2000000

REFERENCE

I.Name
R A u y A D A V

Relation
F R E N D

Phone No. Mobile

8 4 6 0 5 5 6 4 7 8

STD CODE

2.Name
p u J A R y A D A V
Relation
F R E N D
 Mobile
9 9 9 2 8 7 4 5 7
sTDCODE
 m :CL. \RATION

Each of the undersigned jointly and 'fi

d HFFC' speci ca11Y represents to H p· p·
an to s actual or potential agents b k ome irst mance Company India Limited ("HFFC")
agrees and acknowledges as follows: , ro ers, processors, attorneys, insurers, servicers, successors and assigns and
I/We declare that all the particulars and information . . . . .
and complete and that they shall fio th b . f provided m tlus apphcatto n form ("Application") are true correct
.
or negligen .
t rrusrepre rm •nfie as1s o any Joan BFFC may d ·d t
sentation of thi . . . . _ect. e o grant me/us an d th at any · ' · l
monetary damages to an hs onnation contamed m this :Application may result in civil liability,mtenbona
1
including
on this Applicat io; and/y ~erso_n V: ol may s~ffer any loss due to reliance upon any misrepres
, or 10 cnmma penalties. entation that I have made
I/We confirm and certify that I have attached true copies of the KYC/the income statement
statements/and other documents fi /bank statements/title/legal
.. . or cons1·denng
· th. A · ·
1s pphcatlon. I/We agree that HFFC may take up such references
a1:d make any enqumes lil respect of this Application as deemed necessary and verify
directly or through any third party agent. the information provided
'
~ /We confirm that I/We have had no insolvency proceedings against me, nor have I/We ever
msolvent. been adjudicated
HFFC may make available the information contained in thisAppJication and other informati
on from documents
submitted to HFFC to governmental or other agencies/ banks/financial institutions/credit
bureaus as may be required.
I/We further acknowledge HFFC's right to seek any information from any other
Application. source for considering this

HFFC and its agents, brokers, insurers, servicers, successors and assigns may continuou
sly rely on the information
contained in this Application, and I am obligated to amend and/or supplement the informati
on provided in this
Application (including change in employment, business, phone number, residential address,
etc.) if any of the material
facts that I have represented herein should change prior to approval of the loan applied for
by me.
HFFC shall be entitled to reject theApplication. BFFC, its servicers, successors or assigns
may retain the original
and/or an electronic record of thisApplication along with the information and details provided
hereunder, whether or
not the loan applied by me is approved, for the sole purposes of maintaining records
of its existing and potential
customers.
I opt to receive SMSs/e-mails/telephone calls from HFFC for information related to my
loan account, promotional
schemes, borrowing programmes or facilities introduced by HFFC and such other commun
ication that HFFC may
deem beneficial to me from time to time.
I/We am/are aware that the fees paid by me are non-refundable. I/We further confirm that
I/We have read the brochure
and understand its contents.
APPLICANT AND CO-APPLICANT/S SIGNATURES

Applicants Signature (J_ z I (;rl tt;j ~ (1 "2...~ Co-Applicant/s Signature (22

Date 0 0 2 2 0 2 3 Date 0 0 2 2 0 2 3

Place Gandhinagar Place Gandhinagar