Father/Husband’s
Name
Sex M F M F
Resident Resident
Do you belong to
SC ST OBC SC ST OBC
No.of dependents
Children Others Children Others
Educational/Professional
Qualifications
.............................. ........................
Occupation Details ................................................. .................................................
.................................................. ..................................................
No.of years in .................................................. .................................................
present occupation
.................................................. ..................................................
Designation &
Employee Number. .................................................
.................................................
Date of Retirement
................................................ ..................................................
DETAILS OF BANK ACCOUNTS
NAME OF A/C. TYPE OF A/C. NAME OF BANK & ACCOUNT NUMBER
HOLDER BRANCH
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FINANCIAL INFORMATION
Please indicate below details of investments and all loans taken/proposed from employer,
Provident Fund, etc., and instalment(s) payable per month on the same including interest
against each loan.
i) Mention House No./Plot No., Area, City, PIN Code, Proposed Built up Area and address of housing
society/builders/seller.
...................................................................................................................................................................................
.............................................................................................. .....................................................................................
ii) Plot/Flat/House allotted by a
LOAN REQUEST
Purpose of Loan 1. Purchase of 2. Purchase of 3. Construction 4. Extension of 5. Improvement/
a new flat/ flat/house being of new house house/flat Renovation
house Resold of house/flat
As per the scheme of the Bank, I/we apply for a loan on a fixed rate basis / floating rate
basis. (Delete whichever is inapplicable)
PROPOSED REPAYMENT
Post-dated cheques
(A) LOAN FOR CONSTRUCTION (B) LOAN FOR PURCHASE OF (C) LOAN FOR EXTENSION/
HOUSE/FLAT (READY REPAIRS
BUILT)
3. Purchase price of Plot. 3. Purchase price Rs....................... 3. Market value of existing structure
Rs.............. Rs.........................
4. Cost of additional items
4. Architect’s fees Rs.......... Rs............................ 4.
5. Cost of construction. Rs.......... 5. Total Cost Rs............................ (A) Is the property mortgaged to any
institution :-
II. In case of Flat 6. Area of Plot/Undivided Yes No
share of land.........................
1. Area of undivided shares (b) If yes, name of Institution :-
of land ........................... 7. Built up area Sq. Ft....................... ________________________
2. Cost of undivided share 8. Market Value (c) Value of outstanding loan
of land Rs....................... against the mortgage :-
Land Value Rs.................. Rs............
3. Cost of semi-finished flat
Rs........................ Structure Value Rs............ 5. Details of proposed repair/
extension :-
4. Cost of completion or/and ------------------------------------------
additional items Rs.................. ------------------------------------------
III. Registration Charges -------------------------------------------
Rs................................. -------------------------------------------
DOCUMENTS REQUIRED
(Please tick wherever necessary)
I/We have attached the following copies of supporting documents (duly attested wherever necessary)
NOC under the Provisions of ULC Act, 1976. Original of the same.
IT Returns for the last 2 years’ (if IT assessee) duly accepted by the ITO.