Regd. Office : 9th Floor, Antriksh Bhawan, 22, Kasturba Gandhi Marg, New Delhi - 110 001.

Website : [Link]. Toll Free: 1800 120 8800

CIN: L65922DL1988PLC033856

Loan Application Form

Instructions :
1. Please write all the information in BLOCK LETTERS. 2. Please do not overwrite nor use correction fluid. If required, please cancel and rewrite with due authentication. 3. Tick the box wherever applicable. 4. All details
must be filled in, please write NA if not applicable. 5. Please add another application form if there is more than one co-applicant for the loan. 6. Please ensure that all the documents are self-attested by you. 7. Please take
photocopies of all the documents that are submitted to PNB Housing Finance Ltd. for your personal record

LOAN DOCUMENTS CHECKLIST

**Officially Valid Document (OVD) For
Customer Type Income Document Common Document
Identity and Address Proof
Where Applicant
Passport Latest Salary Slip for last 3 months/Form Educational Qualification Proof (Latest Degree)
Co-Applicant is an Individual Driving license 16 for last 2 years Pan Card of Applicant/Co-Applicant
Salaried Employees Proof of possession of Aadhaar Number Last 6 months' bank statements (Salary
((Redact first eight no of Aadhaar) Account)
Voter's Identity Card issued by the Election Certificate and Proof of business along
Commission of India with Business profile
Job card issued by NREGA duly signed by an Last 3 years' income tax returns with
officer of the StateGovernment Profit/loss Account (Duly certified by
Letter issued by the National Population chartered Accountant)
Register containing details of the name and Last 12 months' bank statements (Self and
address Business)

Whether Applicant/
For KYC of Proprietor, please refer OVD Last 3 years' income Tax returns with Proof of registered office of company (GST
CoApplicant is a Sole Section above Certificate, Electricity Bill,telephone bill)
Proprietor all Annexure (Duly authenticated
Certificate and Proof of business existence along
oftax authority)
with business Profile
Certificate and Proof of business
along with Business profile

Last 12 months' bank statements

Whether Applicant/
Certificate of Incorporation Last 3 years' income Tax returns with all
CoApplicant is a Company Memorandum of Association and Articles and Annexure (Duly authenticated of tax
Association authority)
Pan card of Company A resolution from the board of directors Last 3 years' income tax returns with Profit/loss
List of Shareholders along with share holding and power of attorney granted to its Account (Duly certified by chartered Accountant
pattern on company letter head managers, officers or employees to
For KYC of Director/Authorised Personnel, transact on its behalf
please refer OVD Section above
Last 12 months' bank statements

Whether Applicant/
Certificate of Incorporation A resolution from the partners of LLP and
CoApplicant is a Limited LLP Agreement power of attorney granted to its managers,
Liability Partnership ~ LLP Pan card of Company
For KYC of limited Partner/ Authorised officers or employees to transact on its
Personnel, please refer OVD Section above behalf

Whether Applicant/ Proof of business existence along with business

Registration certificate A resolution from the partners and power Profile
CoApplicant is a Partnership Partnership Deed with all Amendment of attorney granted to its partner to
Firm For KYC of Partner/ Authorised Personnel, transact on its behalf
please refer OVD Section above

Whether Applicant/
Registration Certificate, Bye laws~ Society Last 12 months bank statements Pan card of society/Trust/HUF
CoApplicant is a Society/Trust Trust Deed in Case of Trust A resolution passed by all members/board
Proof of registered office of society/ Trust of Trustee and power of attorney granted
(Latest electricity bill or any other certificate to its member/ Trustees, officers to
from statutory authority) transact on its behalf Last 3 years income tax returns with Profit/loss
For KYC of Trustee/ Authorised Personnel, Account (Duly certified by chartered Accountant)
please refer OVD Section above

Whether Applicant/ Co-

HUF Deed Last 12 months' bank statements
Applicant is a HUF Proof of registered office of HUF A resolution passed by HUF or power of
Latest electricity bill or any other certificate attorney granted to its Karta to transact on
from statutory authority ) its behalf
Certificate and Proof of business existence
along with business Profile
Photos of Karta, Co –Parcener
For KYC of karta/ Co Parcener, please refer
OVD Section above

• All documents have to be Self- attested • Photocopy of Title Documents of the Property, • Approved Plan Dual Filled Application from with across signature on photograph
• Process Fee Cheque in favour of “PNB Housing Finance Ltd” (We do not accept any cash) • **For Director/Authorised Personnel/Beneficiary Owner/Proprietor/Partner/Trustee/Karta KYC,
please refer OVD Document

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FAQ’s

1. What is the process of applying for a Home Loan?

Step 1: Submit your loan application along with required set of documents. Step 2:Your application would be assessed on the basis of various eligibility and funding norms.
valuation and title check may be carried out by the company/representative to determine the property value and legal clearance of the property to arrive at the loan amount. S
and regulatory guidelines, PNB Housing may approve or reject the loan application. Step 5: Submission of the original property documents takes place along with signing o
of registered property papers and submission of Post Dated Cheques/ECS. Step 6:Upon finding all the documents in order, PNB Housing will disburse the loan amount basi
construction to the developer/contractor. The EMI/Pre-EMI will commence after the disbursement.
2. Am I eligible for a Home Loan?
YouareeligibleforaloanifyouareaSalaried,[Link],a
dependents,co-applicant'sincome,assets,liabilities,stabilityandcontinuityofoccupation,[Link],theloaneligibilitywillalsobedependentonthevalueo
3. What percentage of property value can be funded?
We can fund upto 90% of the property value in case of Home Loan and upto 60% in case of Loan Against Property. However, PNB Housing funding norms may change fro
4. What is EMI and pre-EMI?
Your loan is repaid through Equated Monthly Instalments, which include principal and interest component. EMI repayment starts from the subsequent month of full loan dis
is the simple interest, payable every month till the time loan is fully disbursed.
5. In case of change of Floating Rate of Interest, will my EMI or Tenure change?
Keeping the borrower's interest in consideration, EMI is kept unchanged till a point. In exceptional situations, the EMI is changed to support the principal repayment within
6. What security do I need to provide?
The prime security for the loan is by way of deposit of title deeds and/or such other collateral security as may be necessary. The title of the property should be clear, marketa
encumbrances.
7. Can I prepay my Home Loan? Are there any charges applicable?
Yes, an individual borrower can prepay their loan without any prepayment charges any time during the loan tenure if the same is under Floating Rate scheme. For loan unde
prepayment charges may be applicable, please refer to the schedule of charges under “Fair Practice Code” section on our website, [Link].
8. What will be the fee and other charges to a loan account?
A processing fee is applicable for both housing and non-housing loan. Prepayment Charges: No Prepayment charges shall be payable for partial or full prepayment in the flo
For all other loans, prepayment charges will be applicable on partial or full prepayment if the loan was taken for business purpose. For complete fee details, please refer to S
available on our website [Link] or please contact our nearest office.
9. What will be Rate of Interest to a loan account?
Interest will be applicable on the basis of customer profiling and on the basis of type of loan. Gradation of interest will be on the basis of factors such as Credit Bureau score
details, please refer to our website [Link] or please contact our nearest office.
10. How do I get my Income Tax Certificate?
You can download the Income Tax Certificate anytime by loggin on to ‘Customer Portal’ through our website – [Link]. However, we also send Income Tax Statement to all o
each financial year.
11. Can I view my loan account details online?
Yes, you can view your loan account details online by loggin on to [Link] and register yourself in order to enjoy hassle free, onl
services.
12. Does the property need to be insured?
Customer should ensure that the property is insured against uncertainties like earthquake, fire or any damage anddestructionduetonaturalandman-madecalamities,duringthete
13. Who is eligible for PMAY 2.0 (Interest Subsidy Scheme)?
Any loan which fulfils the below criteria will be eligible to apply for PMAY2.0 (ISS)

Eligibility Checklist

Disbursed on or after September 01, 2024 Carpet Area <= 120 square meters (1291.67 square feet)

Female Ownership – Women should be owner/coowner in the

Loan Amount <= 25 Lakhs
proposed property.
Property Value (including land for P+Q) <= 35 Lakhs Loan Type (Only Housing Loans)
Loan Tenor >= 60 months (5 years) Not Booked as Balance Transfer
Household Income (all family members) < 9 lakhs Family member should not own a pucca house anywhere in India

Fair Practice Code is available for reference in all our branches and also on our website: [Link]

ACKNOWLEDGEMENT

We acknowledge the receipt of loan application form. We will get back to you either in writing, email, letter or via telephone with the status of your Loan applied with us
within 15 working days.
This is subject to furnishing of all the necessary documents as mentioned in this Application Form or as communicated to you by PNBHFL during the loan appraisal
process.
Further we confirm having received the upfront processing fee üas cheque of _________________________________ , favouring ‘PNB Housing Finance Ltd.’
via Cheque/Draft no. ______________________________________________ drawn on ________________________________________________________

Please note we do not accept processing fee in cash

Sales Representative Name ____________________________________________ Phone _____________________________________________________________

Service Branch _______________________ Email ____________________________________________________

Sales Representative's Signature _______________________________ Sales Representative Employee ID ______________________________________

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 Loan Application Form

Sourcing Branch - SOLAPUR

Servicing Branch - SOLAPUR

1. Personal Details Applicant Co-Applicant

(Prefix) (FirstName) (MiddleName) (LastName) (Prefix) (FirstName) (MiddleName) (LastName)
1.1 Name (Full) Mr. MOHAN PANDURANG KALBURGI Ms. LAXMI MOHAN KALBURGI
1.2 C-KYC Number
1.3 Father's/Husband's Name Pandurang Baburao
1.4 Mother's Maiden Name Hirabai Subhadra
1.5 Date of Birth 11-12-1975 01-02-1980
1.6 Communication Address M A L A D R O A D , V E M A L A D R O A D , V E
R D A N T C O M P L E X , R D A N T C O M P L E X ,
T A L S A N G A M N E R T A L S A N G A M N E R
, . , A H M E D N A G A , . , A H M E D N A G A
R , M A H A R A S H T R A R , M A H A R A S H T R A
, 4 2 2 6 0 5 , I N D I A , 4 2 2 6 0 5 , I N D I A

City Ahmed Nagar State MAHARASHTRA City Ahmed Nagar State MAHARASHTRA
Pin 4 2 2 6 0 5 Block/Taluka
Pin 4 2 2 6 0 5 Block / Taluka
Self owned Family Rented Company Lease
Relation with Applicant Wife
Other
Address Type Rural Semi-Urban Urban Metro Rural Semi-Urban Urban Metro
1.7 Permanent Residence S N O 1 0 A 2 3 2 , S H M A L A D R O A D , V E
I V G A N G A N A G A R , R D A N T C O M P L E X ,
S H I V G A N G A M A N T A L S A N G A M N E R
D I R J A V A L , . , S O , . , A H M E D N A G A
L A P U R , M A H A R A S R , M A H A R A S H T R A
H T R A , 4 1 3 0 0 6 , I , 4 2 2 6 0 5 , I N D I A
N D I A
City Ahmed Nagar State MAHARASHTRA
City Solapur State MAHARASHTRA Pin 4 2 2 6 0 5 Block/Taluka
Pin 4 1 3 0 0 6
1.8 Phone with STD Code 8 6 0 5 4 7 2 3 2 2 8 2 7 5 2 8 1 0 2 9
1.9 Mobile No. 8 6 0 5 4 7 2 3 2 2 8 2 7 5 2 8 1 0 2 9
1.10 Email ID (Personal) swarsakshi9@[Link] swarsakshi9@[Link]
1.11 Gender
Male Female Transgender Male Female Transgender
1.12 Marital Status
Single Married Other Single Married Other
1.13 No. of Dependants 0 Children 0 Other 0 Children 0 Other
1.14 Category
General SC ST Other General SC ST Other
1.15 Any Disabilities
Yes No Yes No
1.16 Type of Impairment

1.17 Percentage of Impairment

1.18 UDID Number

*OBC-NCL - Other Backward Classes - Non-Creamy Layer | *OBC - Other Backward Classes | *SC - Scheduled Castes | *ST - Scheduled Tribes

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1. Personal Details Applicant Co-Applicant
Whether Manual
1.19 Yes No Yes No
Scavenger

Hindu Muslim Sikh Hindu Muslim Sikh

1.20 Religion Christian Buddhist Jain Christian Buddhist Jain
Zoroastrian Other Zoroastrian Other
1.21 PAN/Form 60 A X C P K 3 2 5 0 B J M P P K 3 0 3 0 L
Form 60 Form 60
1.22 Aadhaar Card No. X X X X X X X X 0 5 3 0 X X X X X X X X 1 0 4 4
1.23 LEI No. (for
non-individual borrower
only)
1.24 Qualification Other Professional Other Professional
1.25 Residential Status Resident Non-Resident Resident Non-Resident

2. Employment Details Applicant Co-Applicant

Salaried Self Employed Business Salaried Self Employed Business
2.1 Occupation Professional Homemaker Non-Salaried Professional Homemaker Non-Salaried
Others Others
If Salaried:
If Salaried:
Government Employee Private Sector Employee
Government Employee Private Sector Employee
Public Sector Employee
Public Sector Employee
If Self-Employed:
If Self-Employed:
Freelancer Contractor
Freelancer Contractor
If Business:
If Business:
Small Business Medium Business
Small Business Medium Business
Large Business
Large Business
If Professional:
2.2 Distinct Occupation If Professional:
Doctor Lawyer Engineer Architect
Doctor Lawyer Engineer Architect
Teacher/Professor Artist
Teacher/Professor Artist
Finance Professional Management Consultant
Finance Professional Management Consultant
Other Professionals
Other Professionals
If Homemaker:
If Homemaker:
Homemaker
Homemaker
If Non-Salaried:
If Non-Salaried:
Farmer Fisherman Transport Driver
Farmer Fisherman Transport Driver
Daily Wage Worker Street Vendor
Daily Wage Worker Street Vendor Artisan Artisan
2.3 Whether Ex-Servicemen Yes No Yes No
2.2 Designation
2.3 Employment No.
Swar sakshi international
yoga and naturopathy
Malad road, Verdant
Name complex, Tal sangamner, ., _______________
2.4 Address of Employer/ Ahmed Nagar,
Business Concern Pin
MAHARASHTRA, 422605,
India
Pin 4 2 2 6 0 5

Office Phone with STD

2.5 Code
Extn. No.

Version - 2.8.0
2.6 Official Email Id swarsakshi9@[Link] swarsakshi9@[Link]
TotalYears inPresent
2.7 1 Years 3 Months 0 Years
Occupation
2.8 Total Work Experience 15 Years 0 Years
2.9 Retirement Age 75 Years ______________ Years
2.10 Total Monthly Income 60000
Other Income 10,000.00
Total
2.11 Monthly Expenses 0

2. Employment Details Applicant Co-Applicant

2.14 Household Annual Income
I can pay Monthly EMI
2.15
upto

3. Loan Details
Amount Requested 2000000.00 Loan Period 15 Years

Type of Home Loan: Floating Fixed (Years) 2 3 Other Please specify ______________________________________

Purpose of Loan : Housing Business Purpose Working Capital Medical Expenses Marriage Expenses Repay existing
loans
Children Education Buy Car/other White goods Personal use Construct a Commercial Property
Construct a Housing Property

Loan Status: Primary Origination Balance Transfer Pool Buyout Co-Lending Others

If Yes, Outstanding Loan Amount ________________________ Name of Financial Institution ________________________ Running Since
__________________________
In case of Lease Rental Discounting, please provide
Address of property given on
Lease _________________________________________________________________________________________________________________
Name of
Lessee(s) ________________________________________________________________________________________________________________________________
Details of Lease : Area ________________________Rent per sq. ft. ___________________Gross/Net Rent (`) ______________________________________

Preferred Date 1) Loan Sanction 2) Loan Disbursement

Requirement of Funds (Not applicable for LAP) Sources of Funds (Not applicable for LAP)

Total Purchase Price 0.00 Loan required from PNBHFL 2000000.00

Construction Cost _______________________________________ Amount already spent _______________________________________
Other Cost _______________________________________ Saving from Bank/Investment _______________________________________
Total _______________________________________ Total _______________________________________

If NRI, please provide Power of Attorney details

POA Name __________________________________________ Landline No ___________________________________________________
Address _________________________ Mobile No. _________________________
_________________________ Email _________________________
_________________________ Relation with POA _________________________

If, (please select) Company Partnership Firm LLP Society Trust is Applicant/Co-Applicant, please provide below details of the selected
option:

Registration No./CIN _______________________________________ Date of Registration/Incorporation ________________________ PAN _________________

Details of Partners (in case of Partnership Firm)

_____________________________________________________________________________________________________

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4. Financial Information
Saving/Investment Loan Taken
Particulars Applicant Co-Applicant Source of Purpose of Loan O/S Amount EMI Balance Term
Loan (Months)

Saving in Bank Applicant ______________ ______________ ______________ ______________

BankI ______________ ______________ ______________ ______________
BankII ______________ ______________ ______________ ______________
Immovable Employer
Property ______________ ______________ ______________ ______________
Other
Other Assets Co-Applicant ______________ ______________ ______________ ______________
BankI ______________ ______________ ______________ ______________
(specify)
___________________ ___________________ Bank II ______________ ______________ ______________ ______________
1. ___________________ ___________________ Employer ______________ ______________ ______________ ______________
Other
2. ___________________ ___________________
3.

5. GST Details Applicant Co-Applicant

GST Identification Number
To be considered for Invoice Generation
Applicant Co-Applicant (Tick any 1 box)

6. Bank Account Details

Name of Account Holder A/c Type Bank Name Branch Name A/c No
AT & POST GHULEWADI,
TALUKA
MOHAN PANDURANG
Saving UNION BANK OF INDIA SANGAMNER,DIST. 322502010042503
KALBURGI
AHMEDNAGAR,PIN - 422
605.

7. Details of Property (Offered as Security)

Address Status of Property Type of Property Type of Transaction

Flat
S no 11/2/a/1, Plot no 42, Shivganga nagar, Solapur, Ready
Shelgi, ., MAHARASHTRA, India, 413006 Independent unit Direct Allotment
________________________________ Proposed
House Resale
________________________________ Under Construction
Other/Land

Freehold Leasehold
City Pin Code

Estimated Market Value

7.1
_____________________________________________________________________________________________________________

Rural Urban

7.2 Details of Property (Offered as Security) will be in the name of

i. ______________________________________________________ ii. _______________________________________________________

7.3 Has/Have the applicant(s) or spouse of applicant(s) earlier applied to PNB Housing for loan? Yes No

If yes, please provide details __________________________________________________________________________________

7.4 Have you taken the loan before? Yes No

If yes, please specify ________________________________________________________________

7.5 No. of dwelling units owned by the borrower (excluding current property)

__________________________________________________________________________________

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Version - 2.8.0
8. Reference: (Name and Address of two references not related to you)
1. Name Shyam Rahane 2. Name Rajesh Battul

Relation FRIEND Relation FRIEND

Address Address

Landline 09511812703 Mobile 9511812703 Landline 07020245004 Mobile 7020245004

Email Email

9. Preferred Address for Communication

Present ResidentialAddress Permanent Address

Office Address Property Address (to be Financed)

How did you come to know about PNB Housing?

Existing Customer of PNB Housing Friend/Relative Builder

Service Associate Advertisement Other

If other, please specify ……...............................................................................................................................................................................................................................................

10. PMAY*

Do you want to apply for PMAY (ISS) 2.0? Yes No

DECLARATION:
1.I/We understand understand that we have to apply online on PMAY-HF(Urban) within 7 days of loan sanction,to be considered for PMAY2.0 Interest Subsidy Scheme.
2.I/We understand that failure to apply on time may result in me/we not getting [Link] will not be held responsible for this delay.
3.I/We understand that in case I/We have expressed our desire to avail subsidy,the processing is contigent on me/we applying for PMAY subsidy on time.
4.I/We understand that the grant of subsidy is subject to eligibilty and verification of details and documents(as submitted).

DECLARATION:
I/We apply for sanction of loan duly secured by the mortgage of the immovable property or such other securities as may be required by PNB Housing Finance Limited (“PNBHFL”).
I/We declare and confirm: 1. That all the particulars and information given in the application form are true, correct and complete and updated in all respects, I/We have read and understood the said contents which have also been explained
to us/me in vernacular; 2. That no material and relevant information to this application has been withheld/concealed; 3. That no insolvency or bankruptcy proceedings have been initiated against me/us nor have I/we ever been adjudicated
insolvent; 4. That there has never been an award or an adverse judgement or decree in a court case involving breach of contract, tax malfeasance or other serious misconduct which shall adversely affect my/our ability to repay the loan; 5.
I/We have never been a defaulter with PNB Housing or any other financial institution; 6. That if any discrepancy is found or observed from the information given above and the documents produced in support thereof, PNB Housing shall
have the sole discretion to cancel the sanction at any stage and recall the loan if already disbursed, in such an event, the processing fee shall be liable to be forfeited; 7. PNB Housing shall be under no obligation to refund the
registration/upfront/processing/any other fee in any event; 8. I/We undertake to inform PNB Housing regarding any change in respect of the above information submitted including change in address, income and telephone numbers etc.; 9.
To pay processing charges as applicable and charged by PNB Housing; 10. Having read and understood the terms and conditions relating to Housing Finance Scheme and hereby agree to be bound by the said terms and conditions or by the
revised additional terms and conditions which may at any time hereinafter be made while the loan availed by me/us is still outstanding; 11.I/we agree that PNBHFL reserves the right to charge different PNBRRR based on the category of
customers their risk profile and product type on such reset date and reset frequency as decided by PNBHFL; 12. I/We authorize PNB Housing or its agent/service provider to carry out CIBIL/other bureau enquiries/reports, share customer
data, make references and carry out any other third party vendor checks/verifications relating to information in this application form which PNB Housing considers necessary; 13. I/Weshall indemnify PNB Housing against any loss or
damage ( which PNB Housing may suffer) as a result of any action / claim raised by such institutions or any third party for making reference, conducting investigations and/or making disclosures in terms of the preceding clause ; 14. PNB
Housing reserves the right to reject the loan application at its sole discretion; 15. I/We permit PNB Housing to contact me/us with respect to the products and services being offered by PNB Housing or by any other person (s) and further
allow PNB Housing to cross sell the other products and services offered by such other person (s); 16. I/We further agree to receive SMS alerts/whatsapp/emails/letters etc related to my/our application status and account activities as well as
product use messages that PNBHFL and/or its group companies will send, from time to time on my/our mobile no./emails/letters etc as mentioned in this Application Form; 17. I/We confirm that laws in relation to the unsolicited
communications referred in 'National Do Not Call Registry' as laid down by 'Telecom Regulatory Authority of India' will not be applicable for such information/communication to me/us; 18. I/We further agree to comply with KYC norms of
RBI and submit all relevant KYC data and information as may be requisitioned by PNBHFL from time to time; 19. I/We have not appointed/shall not appoint on our board of directors/board of trustees/governing body any person whose
name appears on the defaulters list of the RBI and/or is also a director on the board of any other company/trust/society/governing body which has been in default to PNBHFL or identified as a wilful defaulter by any bank or financial
institution as per the parameters determined by RBI from time to time and agrees to remove any person from its board of directors/board of trustees/governing body whose name has been identified as a defaulter (as per CIBIL) and/or
'wilful defaulter' by RBI; 20. I/We shall utilize the loan only for the purpose for which it is disbursed and no other purpose; 21. I/We shall create security and/or furnish guarantee in favour of PNBHFL as may be required; 22. I hereby
submit voluntarily at my own discretion, the physical copy of Aadhaar card/physical e-Aadhaar / masked Aadhaar / offline electronic Aadhaar xml as issued by UIDAI (Aadhaar), to PNBHFL for the purpose of establishing my identity /
address proof; 23. The consent and purpose of collecting Aadhaar has been explained to me in local language. PNBHFL has informed me that my Aadhaar submitted to PNBHFL herewith shall not be used for any purpose other than
mentioned above, or as per requirements of law; 24. I confirm that I am not a US person or a resident for Tax purpose in any country other than India, though one or more parameters suggest my relation with the country outside India.
Therefore, I am providing the following document as proof of my citizenship; 25. Borrower understand that the Lender has adopted risk based pricing, which is arrived by taking into account broad parameters like Credit profile, CIBIL
scores, Occupation, Loan Product and Loan amount. Any change in interest rate will take into account these factors and conduct of an account as well; 26. I hereby consent to receiving information from Central KYC Registry through
SMS/email on my registered number/email address. Applicant Co-Applicant
Except to the extend disclosed to PNBHFL, no director or a relative/near relation (as specified by RBI) of a director of a banking/NBFC (including PNBHFL) or a relative/near relation (as specified by RBI) of a senior official of PNBHFL (as
specified by RBI) is: the Applicants(s), or a partner of our concern, or a trustee, member, director, employee or our concern, or of a subsidiary, or our holding company, or a guarantor on my/our behalf, or holds substantial interest in our
concern or my/our subsidiary or holding company. Details of any such as referred to above: ______________________________________.

Applicant’s Signature CoApplicant’s Signature

Date :25-05-2026 Date :25-05-2026

Place : SOLAPUR Place : SOLAPUR

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For Office Use Only
Sourced by (Tick as applicable) DSA DST Direct HLA

Channel Name _____________________ Channel Code ______________ Connector Name SOL|CON|2207|73806-AMOL YUVRAJ KOKATE
Connector Code _____________________

DMA/Connector GST State ______________________________________________________

TL Name SOL|TEA|PH19292|1302|84039-PRAMOD BASAVRAJ KABADE-PH19292 TL Code PH19292 SM Name __________________ SM

Code ___________________________

Login Fee _________________ Bank Name ____________________________ Cheque No __________________________ Date

___________________
Lead source Partner Contact Centre Other File No. _____________________________
A Housing Finance Company promoted by Punjab National Bank

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