APPLICATION FORM FOR HOME LOAN
For office use only
Personal Details
Information
Applicant
Co-Applicant
Relation with Applicant: Parent Spouse Other
First Name
Middle Name
Last Name
Father’s/Husband's Name
Income Tax PAN No.*
Identification no.(tick any one)*
Passport no. Voter ID
Driving License UID
Date of Birth* and Gender
d d m m y y y y
Male Female
d d m m y y y y
Male Female
Category
Physical Ex-Serviceman Minority
Handicapped None of these
Physical Ex-Serviceman Minority
Handicapped None of these
Educational Qualification*
Undergraduate Graduate PG
Professional course Other
Undergraduate Graduate PG
Professional course Other
Marital Status and No. of dependents in the household
Single Married
No. of Dependants
Single Married
No. of Dependants
Email address
Phone details (STD code – Tel res.)
__
__
Mobile No.
Relative of Staff/ Director of bank?
Yes No
Yes No
Residential Address
Applicant
Co-Applicant
Residence Address* (Present)
City: State:
Pin: Country:
City: State:
Pin: Country:
Residence Address* (Permanent)
Same as above
City: State:
Pin: Country:
City: State:
Pin: Country:
Status of current residence
Owned (Self/spouse/ dependent children)
Owned (Parents) Rented by Self/Spouse
Leased by company/govt. Other
Owned (Self/spouse/ dependent children)
Owned (Parents) Rented by Self/Spouse
Leased by company/govt. Other
Years at current residence*
Years Months
Years Months
Address for correspondence
Current Residence Permanent Residence Office
Current Residence Permanent Residence Office
*Supporting documents duly signed by the applicant should be attached
Recent Photograph of Applicant
Recent Photograph of Co-Applicant
Branch: ___________________
Reference no.: _____________
Received on: ___/___/___
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Work and Financial Details
Information
Applicant
Co-Applicant
Employment Nature
Salaried Self employed Professional Other
Salaried Self employed Professional Other
If professional
CA Doctor Engineer/Architect Lawyer
Small/Marginal farmer Other agriculturist Other
CA Doctor Engineer/Architect Lawyer
Small/Marginal farmer Other agriculturist Other
Nature of Organization
Govt./PSU Public Ltd. Co. Pvt. Ltd.
Proprietorship Partnership Other
Govt./PSU Public Ltd. Co. Pvt. Ltd.
Proprietorship Partnership Other
Period in Current Employment/ Business
Years Months
Years Months
Total Employment/ Business Period
Years Months
Years Months
Date of Retirement (If salaried)
Years Months
Years Months
Name of Organization/Business
Designation
Office Address
City: State:
Pin: Country:
City: State:
Pin: Country:
Phone details (STD code – Tel off.)
__
__
If Self Employed/Professional
Income in last 3 Financial years*(Rs.)
(As per Income Tax Return)
FY1 (20__ - 20__)
FY 1 (20__ - 20__)
FY 2 (20__ - 20__)
FY 2 (20__ - 20__)
FY 3 (20__ - 20__)
FY 3 (20__ - 20__)
If Salaried/Other
Annual Income* (Rs.)
Gross
Gross
Net
Net
Spouse's financial information*
IT assessee & paid tax last yr Earns but not formally
IT assessee but no tax paid Does not earn
IT assessee & paid tax last yr Earns but not formally
IT assessee but no tax paid Does not earn
Bank Account Details
(Details of PNB a/c if applicable)
Account I
Account II
Account I
Account II
Name of Bank
Branch
A/c No. (details of salary a/c. for salaried)
Statement of Assets and Liabilities*
Information
Applicant
Co-Applicant
Assets
Immovable Properties
Amount (Rs.)
Amount (Rs.)
Building/House
Land
Movable Properties
Cash
Deposits with banks
Investment in government securities
Others
Total
*Supporting documents duly signed by the applicant should be attached
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Proposed Loan Details
Information
Applicant
Purpose for which loan is required
(Details as per enclosure 'A' or 'B')
Purchase of Plot/land
Construction of house
Purchase of Built house/Residential flat/under construction
Carrying out Repairs/Renovation/Addition/Alteration to existing house/flat
Take over loan from other bank/FI
Total Cost of house/flat/construction and
Applicant's contribution/Margin
Total Cost (Rs.)
Applicant's contribution/
Margin (Rs.)
Loan Amount applied (Rs.) and Rate of Interest option
Floating Fixed
Repayment Period proposed
Years Months
Moratorium/Holiday Period: Months
Monthly Installment
Mode Advance Cheques Standing Instructions Electronic Clearing System
I/We hereby request for a loan as above and declare that: The information given in the loan application is true and nothing has been concealed. The undersigned undertakes to inform the Bank any change in my residence/office address and to provide any further information that the Bank may require. The undersigned has been informed of the charges/fee to be levied by the Bank and agrees to pay upfront fee, documentation charges, etc. as applicable ad charged by the bank. The undersigned hereby agree to be bound by these terms and conditions or by the revised additional terms and conditions which may at any time hereafter be made while the loan obtained by me/us is still outstanding.
Yours faithfully,
Signature of Applicant: ____________________________________ Signature of Co-Applicant:_________________________________
Name of Applicant: _______________________________________ Name of Co-Applicant: ____________________________________
Date: Date:
Place: Place:
Note: In case there is more than one co-applicant, he/she should fill up another form.
Statement of Assets and Liabilities (Contd.)*
Information
Applicant
Co-Applicant
Liabilities
Outstanding Loans/Advances
Amount (Rs.)
Amount (Rs.)
Bank(s)
Employer
Provident Fund
Relatives and Friends
Others
Total
Net Worth (Actual in Rs.)
(Assets-Liabilities)
Information about other Loans taken (including previous loans from PNB)
Total Loan Limit (Rs.)
Total Monthly Repayment (Rs.)
Whether Regular
Yes No
Yes No
Other Information
Information
Applicant/Co-Applicant
Collateral security proposed
Yes No
If yes
Type of collateral Property NSC/LIC Policy/Govt. Security Shares Others
Value of collateral (Rs.)
Guarantor Available
Yes No
If yes, then furnish details in Part II
Pending court cases of Banks/Financial Institutions against Applicants/ As Partners/As Director:
Yes No
(Enclose details on an annexure, if needed)
Reference Details
Reference I
Reference II
Name
Address
City: State:
Pin: Country:
City: State:
Pin: Country:
Mobile No./Telephone
*Supporting documents duly signed by the applicant should be attached
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ENCLOSURE - 'A'
ADDITIONAL INFORMATION REQUIRED TO BE GIVEN IF THE LOAN IS REQUIRED FOR CONSTRUCTION OF A HOUSE OR FOR CARRYING OUT REPAIRS/RENOVATION/ADDITION /ALTERATION TO THE HOUSE/FLAT
(* applicable only in case of carrying out repairs/renovation/addition /alteration to the house/flat)
1.
Purchase price/acquisition cost of land:
(Please attach attested copy of sale deed /lease deed)
2.
Address, location & surroundings of the house/flat (a rough plan indicating the location and surroundings of the house should be attached)
3.
Name & Address of the seller(s) /dealer/Housing Society to whom the payment is to be made
4.
Area of land (sq.metres)
5.
Proposed built up area
6.
Estimated cost of construction OR repairs/renovation/addition/alteration (Estimate from qualified Engineer/ Architect be attached)
7.
Particulars of construction OR particulars of repairs /renovation/ addition/alteration be given
(Plan approved by the competent authority be attached)
8.
Purchase price/original cost of house/flat as per the sale/title deed in case the house was constructed by the present owner, the purchase price of the plot and cost of construction of the house should be separately stated. (Please attach a certified copy of the sale/title deed) *
9.
Present market value of the house/flat *
10.
Whether the plot is free hold or lease hold (In case the plot is lease hold, please state whether the lessee is authorised to mortgage the house - copy of the letter of authority from the lessor be attached)
11.
Has sanction for construction from the Competent authority been obtained? (If yes, give details and attach copy of plan duly approved by Municipal Body / Corporation concerned)
12.
Whether the plot on which construction or House on which repairs/renovation/addition/alteration is proposed is free from all encumbrances whatsoever (Attach non encumbrance certificate)
13.
Whether the place where the property is/will be situated is served by some Municipal Body/other agency?
14.
Any other information
ENCLOSURE - 'B'
ADDITIONAL INFORMATION REQUIRED TO BE GIVEN IF THE LOAN IS REQUIRED FOR PURCHASE OF A BUILT HOUSE / RESIDENTIAL FLAT/UNDER CONSTRUCTION OR IF THE LOAN IS BEING TAKEN OVER FROM ANOTHER BANK/FI
1.
Address, location and surroundings of the house proposed to be purchased (Please attach a map/plan of the house)
2.
Name & Address of the seller(s) /dealer/Housing Society to whom the payment is to be made
3.
Covered area of house/flat
4.
Year in which the house/flat was Constructed /allotted
5.
Whether completion certificate from the competent authority obtained (If yes, attach copy)
6.
Name & address of the present owner of the house / flat
(Attach proof)
7.
The price at which the house/flat is proposed to be purchased (Attach copy of agreement to sell / letter of allotment)
8.
Whether the house is built on a lease hold plot. If so, whether authority to mortgage the house is available to the lessee (copy of letter of authority from the lessor be attached)
9.
In case lease hold property is intended to be purchased on power of attorney/agreement to sell basis (attach proof):
(a) Whether the vendor is original allottee of the house/flat:
(b) Whether the development authority/housing board, etc. which allotted the property to vendor has a scheme in force for conversion of lease hold property into free hold property
(c) Whether vendor is in possession of property
10.
Whether the place where the property is/will be situated is served by some Municipal Body/other agency?
11.
Whether the house proposed to be purchased is free from all encumbrances whatsoever (attach non encumbrance certificate)
12.
Please provide the following details in case of a take-over loan only
Name of Bank/FI from which loan is being taken over:
Limit (Rs.):
Present Outstanding (Rs.):
Place:
Date: Signature of the applicant(s)
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Part II GUARANTOR INFORMATION
*Supporting documents duly signed by the guarantor should be attached
Personal and Employment Details
Personal Details
Employment Details
First Name
Employment Nature
Salaried Self employed Professional Other
Middle Name
Last Name
If professional
CA Doctor Engineer/Architect Lawyer
Small/Marginal farmer Other agriculturist Other
Father’s/Husband's Name
Nature of Organization
Govt./PSU Public Ltd. Co. Pvt. Ltd.
Proprietorship Partnership Other
Income Tax PAN No.*
Identification no.(tick any one)*
Passport no. Voter ID
Driving License UID
Period in Current Employment/Business
Years Months
Date of Birth* and Gender
d d m m y y y y
Male Female
Name of Organization, Designation and Address
City: State:
Pin: Country:
Educational Qualification and Relationship with applicant
Spouse Parents
Son/Daughter Other
Email Id
Address
Current Residence Address*
Permanent Address
Address
City: State:
Pin: Country:
City: State:
Pin: Country:
Phone details (STD code – Number)
__
Mobile No:
Financial Details
Information
Guarantor
Is he/she an Income tax payee
Yes No
Total Income in last 2 Financial years (Rs.)
FY 1 (20__ - 20__)
FY 2 (20__ - 20__)
Bank Account Details (Existing customer should give details of PNB account)
Name of Bank
Branch
A/c No. (details of salary a/c. for salaried)
Statement of Assets and Liabilities*
Liabilities
Assets
Outstanding Loans/Advances
Amount (Rs.)
Immovable Properties
Amount (Rs.)
Bank(s)
Building/House
Employer
Land
Relatives /Friends
Movable Properties
Provident Fund
Cash
Deposits
Investment in govt. securities
Others
Others
Total
Total
Net Worth (Actual in Rs.)
Recent Photograph of Guarantor
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Having fully apprised myself of the particulars submitted in loan application dated…………….. for ……………………... (mention purpose) loan of Rs. ………………………………to be considered by the bank to Shri/Smt/Miss Son/Wife/ Daughter of Shri ………………………………………………
I have agreed to furnish my guarantee for repayment of the loan. I hereby declare that I know the above mentioned applicant(s) very well for the last………no. of years. The information furnished by me is true and correct to the best of my knowledge and belief.
Yours faithfully,
Signature of Guarantor: ________________________________
Name of Guarantor: ___________________________________
Date:
Place:
Note: In case there is more than one guarantor, he/she should fill up another form (Part-II Guarantor Information).
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PNB 1054/2012
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