Application Form

Applicant Details:
Agent Branch Name ATE_TW_N Product Type Two Wheeler
Lead Number L11102409164 Application Number A11102404378
Loan Applied On 11/10/2024 17:44:06
Customer First Name Nallabati Customer Last Name Lakshmana Rao
WhatsApp number is same
Customer Phone Number 9959233484 Yes
as contact number
Register for WhatsApp
WhatsApp Number 9959233484
banking

KYC details:

D.O.B. as per KYC 10-06-1969 Aadhar No **** **** 2158

Passport No Not Applicable PAN **** **** **
VoterId No Not Applicable Driving Licence No Not Applicable

Address Details:
Permanent / Current Residential address

Address Proof Aadhaar

2-4-6 near chinni vari rama hajeshareef veedhi
Address Line 1 Address Line 2
temple Vijayanagaram
State ANDHRA PRADESH District VIZIANAGARAM
City VIZIANAGARAM KYC Pin Code 535002

Demographic Details

Preferred address for #of family members are

Permanent Address 4
communication residing with you
Country of Residence India Marital status MARRIED
Spouse Name Kusama Father's Name Suryarao
Communication Language
Mother's Name Ammalamma Telugu
Customer Qualification GRADUATE Email Id Not Furnished
Repayment By Borrower

Asset Details:
Vehicle type New Product Two Wheeler
Purpose of purchase Personal Make HONDA
HONDA SHINE 125
Model HONDA SHINE 125 BS 6 Variant
DISC OBD2 BS VI
Dealer/Sub-dealer name DADI MOTORS
Loan Details:
Requested Loan Amount INR 65,500.00 Requested Tenure 12 Months
Customer IRR 21.07 %
Motor Insurance from
IndusInd
Funded Non-Funded
1st year Insurance
INR 6,193.00 Motor Insurance Premium INR 0.00
Premium
Service Charges INR 600.00 Documentation Charges INR 1,200.00
Basic Price INR 68,634.00 GST Amount INR 19,217.00
Discount on Basic INR 0.00 Ex-showroom INR 87,851.00
Other Charges On Road price INR 109,500.00
Income Details:
Income Source 1
Annual Income INR 850,000.00 Name of Recipients Bank KARUR VYSYA BANK
Bank Account Number 1436155000067499 Salaried
Self Employed Employer/Business Name General stores

Current Years in >3 Year Total Years in >3 Year

employment/business employment/business
Profile GENERAL BSR occupation 95012
STORESKIRANA SHOP
Do You File ITR?
Do You File GST?
Captured Income Method Not applicable
Assesment Year Not applicable Document Type Not applicable
From Month Not applicable To Month Not applicable
GST Number Not applicable

Declaration Content:
With reference to RBI Circular (Ref: DBOD No. Dir BC.4/13.03.00/2012-13, Clause 2.2.1) on granting loans
and advances to relatives of directors and clause 2.2.2 on restrictions on grant of loans and advances to
officers and relatives of senior officers of the banks.

i.Is the Borrower a Director or a relative of any of the Directors of a Bank or Financial Institution or NBFC?
(including IndusInd Bank and its subsidiaries) as defined in said circular? No
ii.Is the Borrower a relative of any of the Senior Officers of the Bank, as defined in said circular? No
iii.Is the Relationship with the Director of our Bank or some other Bank?

MOST IMPORTANT DOCUMENT:

Document Type KYC Document Belongs To
Aadhaar Borrower
Customer Image Borrower
PAN Borrower
Customer Bank Statement Borrower

IMPORTANT NOTE :
 Kindly ensure to properly check and self-attest all documents submitted with date.
Kindly do not make any payment in cash, bearer cheque or kind to the Executive in connection with this loan application.

Note that :

The receipt of your application form for the loan does not imply automatic approval of your loan by IBL. Incomplete / defective application will not be processed and IBL shall not be
responsible in any manner for the resulting delay or otherwise. IBL may request for additional documents other than those collected in connection with the application. IBL shall not be liable
for loss or delay in the receipt of documents. IBL reserves the right to reject any application without assigning any reasons

IBL reserves the right to retain the photograph and documents submitted along with the application form and shall not return the same to applicant even if the loan application is rejected (or) is
withdrawn. However, IBL would ensure appropriate discarding of the documents and/or oath submitted as per OTS records and Data Maintenance Policy. IndusInd Bank (IBL) will decide
quantum of the loan at its sole discretion. The Monthly Installments (EMI) in connection with the loan will be due as per the schedule intimated. I/We note that, the instalment pattern and
interest/ amortization break-up is tentative and is subject to change basis finally disbursed loan amount and actual dates of disbursement. I/We also note that, moratorium of any would be
equated to a full month i.e., 30 days and where the gap between actual date of my/our loan disbursement to chosen first/second instalment due date(s) is more than block of 30 days, then the
bank would be charging the necessary interest at agreed ROI and may recover the same upfront, or load of along with instalment due rear ended basis, as may be mutually agreed. All
repayment instruments / mandates are to be issued favoring "Indusind Bank Limited" and duly filled in as required The loan is sanctioned on fixed rate of interest basis and the said ROI is
arrived at by adding/adjusting tenor premium, Credit Risk Premium and Business Strategy spread on currently declared Marginal cost of funds based Lending Rate (MCLR) as the case may be.
The applicable ROI would stand revised subject to the terms as specified in the final loan sanction Letter/Loan agreement. The loan being fixed in nature, ROI would not be reset periodically.

I / WE CONFIRM THAT THE EXECUTIVE COLLECTING THE APPLICATION / DOCUMENTS HAS / HAVE INFORMED ME / US:

The applicable rate of effective ROI (Customer IRR) and the equivalent rate of interest on IRR (simple rate of interest) terms. The interest on this loan would be calculated on monthly
diminishing basis. Equated Monthly Instalments (EMI) will be due as per the schedule intimated. Processing Fees, Admin Fees, Documentation Charges, Stamping Charges, Trade Certificate
Charges (at actuals), NeSL Regn. Charges, etc. (non refundable) that will be charged towards loan application.$ The other applicable charges such are : Repayment Dishonour / Rejection
Charges; Collection Charges; Repayment Mode Change Charges; Repayment Swapping Charges (within the mode); Consecutive (two or more) Repayment Dishonour / Rejection and Related
Pullout Charges; Closure of Bank account (without intimation) from which Repayment instruments/ECS has been issued; Loan Cancellation/Re-booking Charges,CIBIL/other CIB Credit
Information Report (CIR), SMS/Telecalling chages, Collection charges, Cash Handling charges, Travel & Collection follow-up charges etc. and these may be applied as per laid down
conditions duly covered ion the loan agreement. (Refer to latest Schedule of Charges for further details).$ The Inclusive/Exclusive of GST+Cess+Other levies that if any, may be applicable
from time to time that will be charged in connection with various categories of fees / charges collected.

THAT:

Incomplete / defective application will not be processed and IBL shall not be responsible in any manner for the resulting delay or otherwise. IBL will not be liable for any loss or delay in
receipt of documents. Documents / Photographs will not be returned under any circumstances, once submitted to IBL. Approval of the application is at the sole discretion of IBL and the
quantum of the loan will be finally decided by IBL. In case of used / refinance / top-up loans, the finance amount / decision to finance would depend on valuation of asset and Bank’s internal
valuation grid/guidelines and norms. Equated Monthly Installments (EMI) will be due as per the schedule intimated. Details of all charges, fees levied are as may be applicable for your
loan/loan product are hosted under the heading schedule of charges in our website. Please Click here to view the current applicable Schedule of Charges. Please Note: Schedule of Charges can
be subject to revisions. You may visit www.indusind.com to view the current rates. The Foreclosure charges are levied / calculated on the balance principal outstanding of the loan. (Subject to
clauses governing part prepayments) The loan terms as sanctioned are applicable for the specified product as indicated in the loan application and are valid for a period of 7 days only. Where
for some reasons, there is a delay in concluding the loan, IBL reserves the right to revise the loan terms as may be applicable at the time of actual loan availment.

I / We also confirm that,

a) The executive has not made any commitments to me / us regarding the loan quantum / sanction process (or) promised any deviation / waivers or favourable terms b) The executive has
collected self attested copies of the documents mentioned on the front side and verified the same with originals produced by me / us c) We have not given / made any payment in cash, bearer
cheque or kind along with or in connection with this loan application to the said executive (or) to any other employee of the bank (or) to any other third party d) No cash/blank instruments has
been given by me/us alongwith the application, nor have I/We been promised any free gifts/inducements to apply for this loan facility. e)
The details of loan terms / conditions inclusive of all charges have been read by me / us in full / read out to me / us (in vernacular) and understood by me / us.

f) The copy of latest applicable Schedule of Charges and BCSBI code of Bank 's commitment to customers has been collected by me / us; I / We further note that the latest SOC and copy of
code is also hosted in Bank 's website www.indusind.com I/We voluntarily give my/our consent to IndusInd Bank to use my Aadhaar Details to authenticate me from UIDAI and link the
Aadhaar Number to all my/our existing / new / future loan accounts and customer profile (CIF) with your bank and use my/our Mobile numbers for sending all SMS Alerts to me/us. **
Original Verified: Executive representing IBL should verify and certify all copies of documents submitted by applicant (with originals) in his presence and sign with date. $ During the
currency of the loan, the Bank reserves the right to modify any / all the charges / fees applicable, from time to time, with a formal communication addressed to me/us (sent to my/our registered
address).
DECLARATION BY THE APPLICANT

I/WE THE PROPOSED BORROWER/CO-BORROWER/GUARANTORS IS/AREASSESSED

FORM 60 INFORMATION (If Applicable)

I/We do hereby declare that what is stated is true to best of my/our knowledge and belief. I/We further declare that I/We do not have Permanent Account Number and my/our estimated total
income (including income of spouse, minor child etc. as per section of 64 of income tax Act 1961) computed in accordance with the provision of Income Tax Act, 1961 for financial year in
which the above transaction is held will be less than the maximum amount not chargeable to tax. I/We confirm that, all information furnished in Form 60 is true, complete in all respects. I/We
note that, for any false declaration. I/We shall be liable to prosecution under section 277 of the Income Tax Act 1961. I/ We note that the Bank has accepted Form60 basis my/our information
and declaration given.

I/We also certify that the vehicle will be operated under my/our direct supervision and control and that I/We shall utilise the asset/funds only for the purpose(s) mentioned/declared in the loan
application/agreement.

I/We also agree and confirm that the said vehicle will be insured comprehensively covering all risks including riot/civil commotion and unlimited third party risks until all dues on the contract
are paid and the vehicle loan NOC is released by the bank to me/us.

I/We agree specifically agree not to transfer, pledge or otherwise delineate the Vehicle/Asset and further declare that the Bank shall have the direct charge on the vehicle, till such time, the loan
is active in the bank’s books.

I/We warrant that the properties mentioned herein are our exclusive properties and will not in any way be transferred or alienated until the obligations arising out of the agreement are fulfilled
and

I/We further state that I/We are aware and agree that the Bank shall be entitled to repossess the Assets/Vehicle in case of default without notice and I/We agree to surrender the Asset/Vehicle
in case of default.

In submitting the above application, I/We the undersigned, solemnly affirm that the information above set forth are in all respects true, correct and accurate and upto date in all respects and the
same may be relied upon by the Bank and that being “assisted digital journey”, were submitted by me/us (or) were declared by me/us (or) were gathered basis my/our credentials submitted to
the bank.

I/We hold ourselves liable for any mis-statement wrongful assertion.

I/We have not knowingly withheld any information that might affect the acceptance of my/our proposal.

I/We expressly agree to notify immediately the Bank in writing of any material change that may occur in my/our financial and other condition.

I/We confirm that I/We had no insolvency proceedings initiated against me/us nor have I/We ever been adjudicated Insolvent. I/We have read the application form and brochures and am/are
aware of all the terms and conditions of availing finance from Indusind Bank Ltd.

I/We undertake to inform the Bank regarding any change in my/our residence/employment and to provide any further information that the Bank may require.

I/We agree that this proposal shall be the basis of the contract between us.

I/We authorise Bank or its agent to make references and deduping/verification/validation/checking enquiries relating to information in this application which Bank considers necessary.

I/We further agree that my/our finance shall be governed by the rules of IBL which may be in force from time to time and note that the Bank reserves the right to reject an application basis
valid reason.

I/We also authorise Bank to exchange, share, part with all and necessary information relating to my/our finance details and repayment history information to other Fis/Credit
bureaus/agencies/Banks/CERSAI(CKYCR) to Insurance companies (where insurance products are chosen by me/us) (or) use/ rely upon a any other downloaded data from entities like NSDL,
UIDAI, CKYCR CERSAI, NeSL, GST portall/ banks, wherein I/We hold, operate and maintain bank accounts (or) have tagged my/our UPI/VPA credentials etc., with other
branches/subsidiaries/associates/affiliates or to any third parties as may be required for KYC Information verification, credit risk analysis or other related purposes that, the Bank may deem fit,
1/We hereby give consent to share my/our information to CKYCR, CERSAI, NeSL etc., to create necessary identifier tags for me/us and also give specific consent to receive information from
Bank any Registry through sms/email on the above registered contact number/ email address relating to registration of my/our data in any registry. I/ We shall not hold the Bank liable for use
any of this information.

I/We also walve the privilege of privacy and privity of contract.

I/We voluntarily give my/our consent to IndusInd Bank to use my/our Aadhar Details to authenticate me/us from UIDAI and link it to all my/our existing/new/future loan accounts and
customer profile(CIF) with the bank and to use my Mobile Number for sending all SMS Alerts to me/us. I/We have consented to do eKYC checking vide Biometric/OTP route. I/ We request
and specifically authorize the bank to update my / our Current Residential address as mentioned under Current Residential Address, as the address for Communication; as my / our address as
recorded in UIDAI is old and not up-to-date/ current/latest. All correspondence pertaining to my / our account should be sent to the updated communication address and I/ We specifically
consent to the same.

I / we hereby declare that all the above information furnished by me / us is true, correct and complete. In the event of any change in this address, I / we confirm to inform the Bank of the
Address change, within maximum two weeks and submit necessary documents to enable the bank to update its records.

I/We agree and acknowledge that only direct telephone numbers (not board/general telephone numbers of offices/corporates/employers) will be accepted for registration of “Do not call”
request as per TRAI requirement and I/We note that, I/We may receive call(s) from the Bank to verify the correctness of the request for registration and also note that, the Bank may use my/our
contact details to contact me/us and offer carefully selected products and services from time to time either directly or through any of its agents or authorized representatives.

I/We agree to receive information on product/services etc. for Marketing prupose through Telephone/Mobile/SMS/Email by the Bank/its agents

Consent sent on/at: 11/10/2024 18:01:05

Consent given on/at: 11/10/2024 18:01:44