APPLICATION FORM FORM NUMBER
PLSS2207121257759246
FOR PERSONAL LOANS
Channel Details
Source DSA Sub Source DSA
Campaign Name Campaign Code Additional Information
Other Information Sourcing City New Delhi DSA Name RULOANS DISTRIBUTION
SERVICES PVT LTD
DST RM Name Other Sales User
Bank Branch Name Tele Calling Executive (OCC) DMA Coordinator
Sales Tele Caller Document Executive(Login) Document Executive(Disbursal)
CPA Maker (Login Backend Executive Scheme
Co-ordinator)
Sub Scheme
Application Details
Application Date 07/12/2022 Type of Loan 01 Loan amount required 2500000
Tenure 5 Year Application Form No. Customer Type NTB
ETB Type CRN Purpose of Loan
Applicant Details
CKYC reference CKYC No. CKYC Update Type
ID Proof Type ID Proof No ID Proof Expiry Date
Address Proof Type Address Proof No Address Proof Type
Address Proof Expiry Date First Name SAPTARSHI Middle Name
Last Name SENGUPTA Date of Birth 12/12/1974 Gender Male
Nationality Marital Status Mother's Maiden Name
Father's First Name Father's Last Name Spouse's First Name
Spouse's Last Name No of Dependents Education Qualification
Mobile no 9810009035 PAN Number AJNPG1237B
Personal Mail ID sapto2006@gmail.com
Employment Details
Address Details
Residence Address Details
Residence Address Line 1 C 492, 2ND FLOOR, Residence Address Line 2 PARK, NAER MARKET 1, Residence Address Line 3 KALKAJI, SOUTH DELHI,
CHITTARANJAN
Residence Address Line 4 Pincode 110019 Residence Sub City
City New Delhi State Residence type Rented With Family
Residence Since 07/03/2013 Rental With No Permanent false Prefered Mailing Address
Address
Office Address Details
Office Address Line 1 Office Address Line 2 Office Address Line 3
Office Address Line 4 Pincode City
State
Permanent Address Details
Same as Residence Address false
Permanent Address Line 1 Permanent Address Line 2 Permanent Address Line 3
Permanent Address Line 4 Pincode City
State Permanent Address Contact
Number
Other Address Details
Address Line 1 Address Line 2 Address Line 3
Address Line 4 Pincode City
State
Reference Details
Reference 1_Details
Reference 1_Name Reference 1_Relationship Reference 1 Address
State City Pincode
Reference 2_Details
Reference 2_Name Reference 2_Relationship Reference 2 Address
State City Pincode
Coapplicant / Guarantor Details
Existing Obligation Details
Banking Details
Income Details
Documents Shared
Applicant Type Applicant Name Document Type Document Name Uploaded Date and Time
Declaration
I/We declare that I/we am/are resident Indians and that all the particulars and information given in the application form are true, correct and they shall form the basis of
any loan Kotak Mahindra bank limited (KMBL) may decide to grant me/us. I/We undertake to inform KMBL regarding any change in my/our above mentioned details and
to provide any further information that KMBL may require. I/We further agree that my/our loan should be governed by the terms of the loan agreement executed between
KMBL and myself/ourselves. I/We authorize KMBL and its affiliates to use information from this application for administrative purpose. I/We understand that KMBL
reserves the rights at its sole discretion to reject this application without providing any reasons. I/We authorize KMBL, its group companies and their agents to exchange
or share all the information relating to me and my repayment history with banks, financial institutions, credit bureaus, agencies, statutory bodies etc. as may be required
or as they deem fit. I/We agree that I/we will not utilize the money(ies) receive under the loan agreement(s) for any purpose which are prohibited under any law for the
time in being inforce including but not limited to investment(s) in capital market(s). The Borrower and/or Co-Borrower(s) shall be liable to pay all the charges, fees and/or
interest as prescribed by KMBL. I/We agree that the processing fees collected upfront, shall not be refunded if my/our application for loan is rejected by KMBL on any
ground whatsoever or once the loan has been sanctioned by KMBL, irrespective of whether I/we finally avail the same.
I/We are aware that any new phone number, mobile number, email id provided by an existing Customer while opting for any product of KMBL (eg–Credit Card, Personal
Loan etc) shall be automatically updated in the records of KMBL in lieu of the phone number, mobile number, email id provided at the time of opening the account or
previously registered with KMBL. All further intimations / communications pertaining to the Bank Account shall also be sent by KMBL only to the new phone number,
mobile number, email id and no intimations / communications shall be sent to the phone number, mobile number, email id provided at the time of opening the Bank
Account or previously registered with KMBL.C25
This application form along with the supporting documents shall be the property of KMBL and in case the application is rejected, the documents given to KMBL in
connection with this application including, but not limited to photocopies of original documents, signature verification, address verification and bank details shall remain
with KMBL. The Personal Loan applicant hereby expressly authorizes the Bank to obtain the Personal Loan applicant’s credit reports from the Credit Information Bureau
of India Limited (CIBIL) or any other Credit Information Companies as and when the same is required by the bank for the purposes of Credit verification or the purpose of
the credit review of the Personal Loan applicant.
Applicant(s) understand that the limit/amount of loan, if approved by the Bank, will be mentioned in the Loan Agreement.
I authorize Kotak bank to share my details with any other third party or vendor, appointed by bank for online verification.
I agree to receive notifications on whatsapp from bank regarding my loan information.
Date and Time of E-Acceptance
Place
Signature of Applicant Signature of Co-Applicant (If
applicable)
