HOME FINANCE APPLICATION FORM

Application ID: PF157440 Lead No: LD-00117761

No. of 1 Home Finance AMIT.SRIVASTAVA Tenor of Finance(in months): 240
Applicants: Advisor:
Applicant Primary Relationship with 0 Family protection plan Yes
Type: primary: required:
Product : Standard Ijara Product Subtype Standard

A. IDENTIFICATION DETAILS
Full Name in English (as per passport ): (First Name / Middle Name / Last Name )
Antonina Kolyada
Date Of Birth: 15/05/1986 UAE Resident: Resident
Nationality: Ukraine Gender : F
Passport No: PU012215 Length of stay in UAE ( Months): 132
Resident/Emirates ID: 784-1986-8053591-5
B. PERSONAL DETAILS
Mobile No: 971547349555 Email Address: Tonyakt@ukr.net
Preferred Method of Marital Status : Single
Contact
Education: Post Graduate No of dependent/children : 0
C. RESIDENTIACAL ADDRESS DETAILS
Address: Global Lake View,504, JLT Dubai
Town/City Dubai PO Box: 2623
Country: United Arab Emirates Resident Tel No. 971547349555
Email Address (P): Tonyakt@ukr.net Email Address(O):
Reference Name 1: Ruslan Abaev Reference Phone 1: 971564798999
Reference Name 2: Mrs Kaini Zou Reference Phone 2: 971581441991
D. HOME COUNTRY DETAILS
Permanent Address in your Home Country
Address: Odessa, Koroleva street, 122, flat 46 Ukraine
Town/City: Ukrain PO Box: 264
Country: Ukraine Home County Tel No:
Reference Name 1: Svetlana Kolyada
Mobile No: 80979063240 Landline no:
Reference Name 2: Svetlana Kolyada
Mobile No: 80979063240 Landline no:
E. PROPERTY DETAILS
Project Name: PRE APPROVAL Developer Name
Property Address:
Expected use of Property Purchase Type
Property Type
Property Value(AED): 1,031,250 Finance Value(AED): 825,000
Down Payment Amount: 206,250

Page 1 of 5 Customer’s handwritten/physical signature [ ]

This is a system generated document and does not require a bank signature/stamp ‫ختم البنك‬/‫هذا المستند معتمد الكتروني اً وال يحتاج توقيع‬
Dubai Islamic Bank Public Joint Stock Company, licensed and regulated by the ‫ شركة مساهمة عامة مرخصة وخاضعة لرقابة مصرف اإلمارات العربية المتحدة المركزي‬،‫بنك دبي اإلسالمي‬
Central Bank of the UAE
Confidential
F. Current Employment DETAILS
Employment Type: Salaried
Company Name Atelier Luxury Gulf L.L.C
Nature Of Business Limited Liability Company license for Employed Since 20/11/2021
Sole Proprietorship
Position OTHERS
Office Address
Address Atelier Luxury Golf LLC D3, bld 3, floor4
PO Box 2623
Town/City Dubai Country United Arab Emirates
Office Tel No 97143253981 Office Fax No
G. Previous Employment DETAILS
Company Name
Address
PO Box Position
Town/City Country
Office Tel No Office Fax No
Nature Of Business Employed since
H. Monthly Income Details for Salaried Applicants in AED
Basic Salary Housing Allowance Annual Bonus Rental Income Other Income Total Income
13,333 0 0 0 0 13,333
I. Monthly Income Details for Self-Employed Applicants in AED
Type Of Company: Date Of Establishment:
Trade License No No Of People Employed:
Estimated Monthly
Income(AED):
J. ASSETS ( Estimated Market Value in AED – Including Outside the UAE)
Deposits/Investments House/Real Estate Ow ned Other Assets Total Assets
0 0 0 0
Details of Bank Account Held
Bank Name Account No
DUBAI ISLAMIC BANK 049520082743001

K. LIABILITIES (What You Owe - including outside the UAE)

Existing Facility Institution Nam e Finance Am ount (AED) Monthly Installment (AED)
CREDIT CARD DUBAI ISLAMIC BANK 180.00
CREDIT CARD DUBAI ISLAMIC BANK 180.00

L. ADDITIONAL DETAILS FOR EQUITY RELEASE

Equity Release: Property purchased from

Page 2 of 5 Customer’s handwritten/physical signature [ ]

This is a system generated document and does not require a bank signature/stamp ‫ختم البنك‬/‫هذا المستند معتمد الكتروني اً وال يحتاج توقيع‬
Dubai Islamic Bank Public Joint Stock Company, licensed and regulated by the ‫ شركة مساهمة عامة مرخصة وخاضعة لرقابة مصرف اإلمارات العربية المتحدة المركزي‬،‫بنك دبي اإلسالمي‬
Central Bank of the UAE
Confidential
 Antonina Kolyada

Applicant Name: Signature Date

Note: Va lue Added Tax (VAT) ca me i nto effect in the United Ara b Emirates from 1 Ja nuary 2018. Therefore, from Ja nuary 1, 2018, a l l DIB rates & fees where
VAT a pplies have been revised to be VAT i nclusive.

Page 3 of 5 Customer’s handwritten/physical signature [ ]

This is a system generated document and does not require a bank signature/stamp ‫ختم البنك‬/‫هذا المستند معتمد الكتروني اً وال يحتاج توقيع‬
Dubai Islamic Bank Public Joint Stock Company, licensed and regulated by the ‫ شركة مساهمة عامة مرخصة وخاضعة لرقابة مصرف اإلمارات العربية المتحدة المركزي‬،‫بنك دبي اإلسالمي‬
Central Bank of the UAE
Confidential