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Wilhyou,rightthrough
FOR APPLYING THROUGI{ DSAS (DIRECT
SELLTNG
AGENTS)
Regd.ofiicu Ramon
Hous€,
HT Parekh
Mars,169,Backbay
Redamalion,
PERSONAL AND EMPLOYMENT DETAILS Cuhrchgale,
Mombai400
020.Phones:
66316000,
22820282.
FaxtDU-2n11205,2
FirslName i,liddle
Name FirstName l\,liddle
Name
FATHER's/HUsBAND's
NA[4E
Cunnelt/Penueuerur*
RESTDENTTAL ADDRESS
'(lfPermanentAddresss dfler€nt
kndlyglvedelas intheboxprovidedal
LandMark: Landlvlark:
lhebollomoflhs page.) PinCode:- State: PinCode: State:
cuinili niiroerCi
ii Selfowned! ! Rented n Leased/Provided
PHoNE
No. wTHSTD CoDE applicant:
E-MALlD
--,^
UATEOFEIRTH/SEX A99 _Y.|!, ! N4!J Age Yrs. trM !
MARITAL
STATUS ! lvarried ! Other n Single ! Marrjed I Other
Others Children Others
OccuPATloN ! Selfemployed
QuALlFrcATroNs
& DEStGNATtoN
MoNTHLylNcoltE
L Ottenlucorr.re
ilPLotEBliiEis
NA[4E
ANDADDRESS
(Please mentiontheaddress
of lheofliceyouarebasedat) PinCode:_
_ - _ State: PinCode: ___ State:
PH0NE
No. wTHSTD CoDE
Ext. Fax:
YRs.tNPRESENT
OccupATtoN Yrs. Retirement
aqe Yrs. Yrs. Retirement
to meet
1. Landcost Rs. 7. Loanrequested
fromHDFC
FixedRate Rs.
purchase
2. Total price/construction
costRs. Adjustable
Rate Rs.
3. Incidental
costs(ifany) Rs. 8. SavingsfromBank Rs.
e.g.Stampduty,Registration
charges.
etc. 9. Disposalofinvestments
4. Other (please
costs specify) Rs. (fixed
deposits/ shares,
etc.) Rs.
5. l\4arket ofproperty
value '10.Amount already (source
spent , _ ) Rs.
(forHome Equity
Loan) Rs. 11.ProvidentFund(refundable/non+efundable)
Rs.
6. Loanoutstanding
(forrefinance) Rs. 12,Other(specify Rs.
A. Total of funds Rs. B. Estimaieof sourcesof funds Rs.
'A' 'B'whichindicates
Note; whichis thetotalrequirement of funds,should
equalestimate
of sources. thesourcesfromwherethe willbe met.
It is importantthatyou indicatein detailthesourcesfrbmwherethe costwili be metin orderto helDus processvouraol iontaster
REFERENGES (NAMESANDADDRESSES
OF TWOREFEREES
WHOARENOTRELATED
TO YOU)
HDFCmaymakesuch 1 ?,.,
-,.
enquiriesfrom the
refereesif it deems Email: Email:
necessary Tel:(O) (R) Tel:(O) (R)
DECLARATION
Applicant's
Signature Signature
Co-applicant's