SALES FINANCE APPLICATION FORM

Application Date 1 6 1 2 1 8 LOS No. 6 1 1 6 8 0 9

FILL ALL FIELDS CAPITAL LETTERS ONLY.
CD DP OTHERS
SF 39467000051
PERSONAL DETAILS APPLICANT CO-APPLICANT
Occupation Salaried Business Self employed professional Retired Housewife Student Other
If self employed professional Doctor CA/CS Consultant Architect Lawyer Other
If Business: Type of company Proprietor: Partnership Pvt.Ltd Public Ltd Ltd Liability co. Other
Nature of
Manufactuer Agriculturist Service Provider Trade/Distributor Retailers Other
business
If Salaried: Type of company Pvt Ltd. Partnership Proprietorship Public Ltd PSU Govt. MNC Other
Designation

GSTIN available: Yes No GSTIN No. Effective Date D D MM Y Y Y Y

Please tell us about yourself : New Customer Existing Customer Loan No. Relationship with Applicant

Applicant Name M R S Z E E N A T H B A N U
Father's Name A M E E R B A S H A PAN D S C P B 1 0 3 6 G
Mother's Name A S M A T H B Date Of Birth 0 9 0 2 1 9 8 3
Gender : Male Female Are you : Married Single No of Dependents Mobile 9 9 7 2 0 2 9 3 5 9
Email ID j i n a t h b a n u 8 6 @ g m a i l . c o m
Religion SC ST OBC OTHER Voter ID No.

Driving License No. Exp.Date D D M M Y Y Y Y

Passport Number Exp.Date D D M M Y Y Y Y
VID No. CKYC No.

Education : Graduate Under Graduate Post Graduate and above Other

ADDRESS DETAILS
Present Residence (Tick one) Owned Parents Co Provided Rented Monthly Rent (Rs) 6 0 0 0 . 0 0
Present Address (Resident) N O 2 4 6 , 1 S T A C R O S S , N E A R H K G N C
O M P L E X , R A M A S A N D R A R O A D , C H I K K A B A S T I , B A
N G A L O R E
Landmark N E A R H K G N C O M P L E X City B A N G A L O R E
State K A R N A T A K A Pincode 5 6 0 0 5 6
STD 0 8 0 Tel. Years at Current : Residence 1 City 1 5

Business/Employer's Name R O M A N E N G L I S H S C H O O L I N C O O R D
Address N E A R D I A M O N D A P P A R T M E N T , U L L A L A U P A N
A G A R A , B A N G A L O R E

City B A N G A L O R E
State K A R N A T A K A Pincode 5 6 0 0 5 6
STD 0 8 0 Tel. Ext. Mobile 8 0 5 0 5 6 6 1 7 9
Total years in Service/Business No. of years in current job / Business 1 3 Preferred mailing address : Residence Office

Official Email ID j i n a t h b a n u 8 6 @ g m a i l . c o m

Please tick in case the permanent address is same as residence address

Permanent/Residence (Tick one) Owned Parents Monthly Rent (Rs.)

Permanent Address(Residence) N O 2 4 6 , 1 S T A C R O S S , N E A R H K G N
C O M P L E X , R A M A S A N D R A R O A D , C H I K K A B A S T I , B
A N G A L O R E
Landmark N E A R H K G N C O M P L E X City B A N G A L O R E
State K A R N A T A K A Pincode 5 6 0 0 5 6
Permanent Tel. No. : STD 0 8 0 Tel.

Loan Application Form

 SF 39467000051
INCOME DETAILS
Please tell us about your income. Annual Salary / Business Income Rs. 1 8 0 0 0 0 . 0 0
Other Annual Income Rs. Rental Agricultural Other

Bank details - Name of Bank S T A T E B A N K O F I N D I A Year Opened 1

Branch V I J A Y A N A G A R B R A N C H B A Customer ID

Account Number 2 0 4 5 9 7 5 8 3 1 6 Types of Account : Saving Current CC/OD

Credit Card Details - CARD No. Expiry Date M M Y Y IFSC Code S B I N 0 0 0 7 9 8 5

Card
Bank Name
Type
ASSETS OWNED
Asset Owned: CAR Bike Refrigerator AC Washing Machine TV/LED/LCD Computer
REQUESTED LOAN DETAILS
Loan Amount Rs. 9 9 9 0 . 0 0 Tenure : 1 0 months Advance EMI's 3
Dealer Name S A N G E E T H A M O B I L E S U L L A L A
Product Type & Nos. MOBILE
Manufacturer SAMSUNG
Model SM-J415FZKFINS
REFERENCE DETAILS
(Name and address of references living in the same city. One references mandatorily, to be a relative not residing with the applicant. )
(1) Name N A D E E M K M
Relationship with applicant F R I E N D
Residential address

City State

Pin STD 0 8 0 Phone Mobile 9 8 8 6 2 7 6 2 3 9

(2) Name A L E E M P A S H A
Relationship with applicant R E L A T I V E
Residential address

City State

Pin STD 0 8 0 Phone Mobile 9 8 8 0 0 0 6 3 5 9

DECLARATION
1. I/We declare that I/we am/are citizen of India and all the particulars and information given in this application form are true,correct and complete and no material information has been
withheld or suppressed.
2. I/We shall advise HDB Financial Services Limited (hereinafter referred to as "HDBFS") in writing of any change in my/our residential or employment/business address.
3. I/We confirm that the funds shall be used for the stated purpose and will not be used for speculative or anti-social purpose.
4. I/We authorize HDBFS to conduct such credit checks as it considers necessary in its sole discretion, to make any enquiries with other finance companies/registered credit bureau/other
institutions regarding my application and to release such or any other information in its records for the purpose for credit appraisal/sharing for any other purpose. HDBFS reserves the
right to retain the photographs and documents submitted with this application and will not return the same to the applicant.
5. I/We understand that the sanction of this loan is at the sole discretion of HDBFS and upon my/our executing necessary security (ies) and other formalities as required by HDBFS.
I/We further agree that my/our loan shall be governed by the rules of the HDBFS which may be in force from time to time.
6. Payment: No cash/bearer cheque has been collected from me/us upfront towards processing of the loan application. All payments made to HDBFS shall be in the name of "HDB
Financial Services Limited" only.
7. I/We will not be entitled to avail of any benefits/discounts/free gifts or any other benefit, which is not documented in the loan agreement.
8. I/We confirm that I/We have no insolvency proceedings against me/us nor have I/We ever been adjudicated insolvent.
9. I/We confirm that I/We am/are not related to any of the Directors/Senior Officers of HDBFS.
10. I hereby consent to receiving information from Central CKYC registry through SMS/EMAIL on the above registered number/email address
11. I/We understand the Risk Gradation and Interest Rate on a Loan that I have applied for will be based on Loan amount, tenure, down payment, Security/Collateral offered for the Loan,
risk parameters, market conditions, cost of funds, loan history with HDB, credit score provided by credit information company, my/our age, income and any other information as may
be required for the purpose of credit evaluation.
12. I/We am/are aware the normally applicable Indicative interest rate on loans and other charges are available on the website www.hdbfs.com.
I, hereby give my consent to HDB, to obtain my Aadhaar number, Name and Fingerprint / Iris for authentication with UIDAI. HDB has informed me that my identity information would
only be used for demographic authentication / validation / e-KYC purpose for transaction contemplated herein. HDB has also informed that my biometrics will not be stored / shared and
will be submitted to CIDR only for the purpose of authentication as required under the UIDAI regulation from time to time.
I/We consent /do not consent to receive information / service etc for Marketing purpose through Telephone / Mobile / SMS / Email by HDBFS/its agents.
I/We confirm that I/we have read and understood the above Declaration, and that the details provided on the form are correct.

DOCUMENTS COMPANY USE ONLY:

The list is not exhaustive Self SO Code H F 0 0 2 8 0 4
Salaried
only indicative Employed
Address Proof SM Code H M T 0 0 4 7 7
Identity Proof TM/ASM Code H D B 8 8 5 7 9
Last 3 months bank
statement
CM/RM Code H D B 7 8 8 8 5
Last 3 months Salary Slip Dealer Code 3 9 4 6 7
Business Proof
Scheme Code 1 0 1 0 1 0
Aadhaar Card
Branch: BANGALORE-SF
PAN Card

Signature of
Applicant :
Date :

ACKNOWLEDGMENT SLIP
Name of the Applicant Z E E N A T H B A N U
Date of Application 1 6 1 2 2 0 1 8 Location Date & Time of receipt

HDB Contact Person Name Stamp & Signature

Application will be processed within 7 working days of receiving the application with all necessary documents, subject to the applicant
providing all additional information that HDB Financial Services Ltd. may require solely for the purpose of evaluating the credit Contact No.
worthiness of the applicant.