Two Wheeler Loan Application Form

Application Date 2 7 0 8 2 2 LOS No.

TW 1916641422000045
Personal Details
Please tell us about yourself : New Customer Existing Customer Loan No - _____________________________
Applicant Name R A M A S A R E
Name as per
Aadhar
R A M A S A R E
Father's Name J A G A N N A T H
Mother's Name S A V I T R I D E V I
Date Of Birth 0 4 0 6 1 9 8 3 PAN A R F P A 1 9 8 7 L Mobile 9 6 9 5 7 2 6 7 6 4
Email ID
Account Number 0 9 1 4 0 0 0 1 0 0 1 3 5 1 2 7 Year Opened 5
IFSC Code P U N B 0 0 9 1 4 0 0 Type of Account Saving Current CC/OD Occupation SELF-EMPLOYED
Bank Name PUNJAB NATIONAL BANK Annual Salary / Business Income Rs 2 2 8 0 0 0 . 0 0
Current Address SEJKHURD SEJ KHURD,SITAPUR SEJKHURD,UTTAR PRADESH
Present Residence (Tick one) Owned Parents Co Provided Rented Bachelor accommodation
Landmark NEAR MANDIR Pincode 2 6 1 1 5 1 Gender : Male Female
City P I S A W A N - S I T A P U R State U T T A R P R A D E S H

Product And Sourcing Details

Dealer Name HANUMAT AUTO SALES G T ROAD Dealer Code 191664
Dealer Address G.T.ROAD GURUDWARA MAIGALGANJ LAKHIMPUR-KHERI UTTARPARDESH
Sub Dealer/DSA
Sub Dealer/DSA Code
Name
SO Code HF106133 SM Code HF084904 Branch SITAPUR
Non- Payment Rate
Loan Advance
Product Type Manufacturer Model Tenure No.Of EMIs Refundable EMI (in RS) Mode of Of
Amount EMI's
PF EMI Interest
TWO WHEELER HONDA MOTORS CD110 DREAM DLX BSVI 60500 24 1 24 0.00 3086 ACH 11.2%

Add-On
S.No Cross Sell Product Service Provider Service Type Card Number Loan Amount
1 LOYALTY CARD HDBFS HDBFS 202203122311 1199

EMI & Cashback

EMI
Total EMI Amount Total Loan Amount
. Product EMI (in RS) Add-On EMI (in RS) Promo Code Login Date ACH Waived off Due
(in RS) (in RS)
Date
Monthly Revised
3086 64 3150 61699 REGULAR 27-Aug-2022
EMI
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 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/We hereby consent to receiving information from Central CKYC registry through SMS/EMAIL/Whats app. on the above registered number/email address. Sign
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 HDBFS, 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. 27-Aug-2022
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.
13. I/We, hereby give my consent to HDBFS, to obtain my Aadhaar number, Name and Fingerprint / Iris for authentication with UIDAI. HDBFS has informed me that my identity
information would only be used for demographic authentication / validation / e-KYC purpose for transaction contemplated herein. HDBFS 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.
14. I/We sign, deliver and confirm that I/We am /are submitting this form after having read and fully understood (and/or being explained to me/us in the language understood by me)
the Terms and Condition for availing finance and add on services/products from HDBFS.
15. I/We consent to receive information / service etc. for Marketing purpose through Telephone / Mobile / SMS / Email//Whats app. by HDBFS/its agents.
16. I/We confirm that I//we have read and understood the above Declaration, and that the details provided on the form are correct.
17. For existing customer - I declare that there is no change in my identity and address details on PAN, Aadhaar, Address Proof, other officially valid document submitted earlier to
HDB Financial Services Limited (HDBFS). I request HDBFS to accept the KYC documents submitted earlier for present loan.

HDB Financial Service Limited New No: 128/4F, Old No.53A, 4thFloor, Greams Road, M.N Office Complex, Chennai -600006 Page 1 of 3
 TERMS & CONDITIONS FOR ADD-ON PRODUCTS AND SERVICES
Add On Product 1 - Aabhar Card - HDBFS
The Sealed packet carrying the Aabhar Card would be opened in Customers presence. This card would be linked to Customer's
Personal Name and hence cannot be used or transferred to anyone else. In case of any misuse, transfer to third party and default in
payment of existing or future loan payment to HDB Financial Services Limited (HDBFS), the Aabhar card shall be disabled by
HDBFS without any intimation to Customer. Aabhar Card is the sole property of HDBFS and hence to be returned to HDBFS if
found to be misused. Aabhar Card is just a facility for the Future Loan Approval Process with HDBFS but it does not guarantee
any specific Pre-approved Loan Amount. The Loan Amount Approval and Sanction will be at the sole discretion of HDBFS only
and Customer shall not raise any objection to the final decision of HDBFS.HDBFS Aabhar Cards entitles the holder, host of
benefits including Road side assistance on Two Wheeler financed, Accidental death benefits, Protection benefit to vector borne
diseases, hospital cash, as well as Loan protection through various partner tie-ups. The host of benefits are applicable for the latest
loan availed from HDBFS under Loyalty card program , in case there are more than one active loans .All claims are subject to
terms and conditions as per the benefit provider.

Declaration
I/We sign, deliver and confirm that I/We have read and fully understood (and/or being explained in language understood by me) the contents of the
Terms and Conditions for availing add on services/ products from HDBFS as set out hereinabove. I/We confirm that HDBFS can reject application
without assigning any reason.

Mr. / MS./ M/S Signature

RAM ASARE
Borrower Borrower

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 TWO WHEELER LOAN APPLICATION FORM

Application Form Acknowledgement

Applicant Name R A M A S A R E
Date Of Application 2 7 0 8 2 0 2 2 Location S I T A P U R
HDB Contact Person
R O H I T V E R M A
Name
Stamp &
Date & Time Of
03/09/2022 02:47 PM Signature Contact No. 7 9 8 5 3 0 3 9 9 4
Form Generation (HF106133)
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 worthiness of the applicant

ACKNOWLEDGEMENT
Cross Sell Product Name : HDBFS
Applicant Name R A M A S A R E
Date Of Receipt 2 7 0 8 2 0 2 2 Card Number 2 0 2 2 0 3 1 2 2 3 1 1
Card Type A A B H A R C A R D Card Amount 1 1 9 9
Nominee Name R E K H A D E V I
Relationship with
W I F E
Nominee
Date Of Birth 0 1 0 1 1 9 9 0
Nominee details as per KYC

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