INDIVIDUAL LOAN APPLICATION FORM

Tick (4) against the appropriate bo! P"ease #rite or t$pe in %LOC& L'TT'R(
P'R(ONAL AND 'MPLO)M'NT D'TAIL(
Particulars App"icant Co*app"icant
Full Name &A+I MO,D! A%U (UFIAN TA%INDA ,A(AN &,AN
Fathers Name COMMAND'R (R'TD!) &A+I A%U &A(,'M-
(()- %N
M! O%AIDULLA, &,AN
Mothers Name (AL',A A&,T'R C,O.D,UR) ,A(INA &,AN
Husbands Name
If applicable
N/A &A+I MO,D! A%U (UFIAN
Current Residential 'A(T'RN PARADI('- APARTM'NT NO! 012-
34 (,'5UN%A5IC,A- D,A&A
'A(T'RN PARADI('- APARTM'NT NO! 012- 34
(,'5UN%A5IC,A- D,A&A
address
Is the residence
R'NT'D Own
Employers
Post Code 2111 2111
!el No
6340164
"ate of #irth 12/17/2677 A5'8 30 )R(!7 MONT,( 10/ 19/ 2690 A5'8 :7 )R(! ; MONT,(
$e%
MAL' Female MAL' Female
Marital $tatus
$in&le MARRI'D Other $in&le MARRI'D Other
No of "ependants C,ILDR'N8 12 Others' C,ILDR'N8 12 Others'
Occupation
'MPLO)'D $elf employed 'MPLO)'D $elf employed
(ualification MA(T'R( OF %U(IN'((
ADMINI(TRATION (M%A)- MA<OR IN
MAR&'TIN5 IN :11; FROM CIT)
UNIV'R(IT) = C5PA 3!41 OUT OF 0!11
(CAL'!
MA(T'R( OF ART( IN
OR5ANI+ATIONAL MANA5'M'NT IN
:114 FROM UNIV'R(IT) OF C'NTRAL
CALIFORNIA (%AN5LAD'(, CAMPU()-
C5PA8 3!:4 ON 0!11 (CAL'!
PO(T 5RADUAT' DIPLOMA IN ,UMAN
R'(OURC' MANA5'M'NT IN :110-
UND'R IN(TITUT' OF P'R(ONAL
MANA5'M'NT- %AN5LAD'(, AND
O%TAIN'D 2
(T
CLA((!
AIRCRAFT MAINT'NANC'
'N5IN''RIN5 (ICAO T)P' II
(TANDARD T,R'' )'AR( COUR(') IN
2666 FROM AIR T'C,NICAL TRAININ5
IN(TITUT' OF &OL&ATA- INDIA!
'L'CTRICAL AND 'L'CTRONIC
'N5IN''RIN5 (''') IN :117 FROM
A,(ANULLA, UNIV'R(IT) OF (CI'NC'
AND T'C,NOLO5) (AU(T)- D,A&A AND
'ARN'D C5PA 3!34 OUT OF 0!11 (CAL'!
"esi&nation C,I'F '>'CUTIV' OFFIC'R FR''LANC' 'L'CTRICAL CON(ULTANT-
PR'VIOU(L) .OR&'D FOR ACI LO5I(TIC( ?
(MA 'N5IN''RIN5 COMPAN)
Office Name
) *ddress
(UP'R (TAR PROP'RTI'( LIMIT'D- UC'P
C,')N' TO.'R (3
RD
FLOOR)- 34
(,'5UN%A5IC,A- RAMNA- D,A&A
N/A

Post Code' 2111 Post Code' N/A
!el No 93627:2*::
N/A
Mobile No ) E+
mail
127444::171 12926:93909
No of ,ears in
Present
Occupation
10 MONT,( Retirement *&e' N/A ,rs
Retirement "ate N/A -
,rs Retirement *&e' ,rs
Retirement "ate - -
"epartment ((PL Employee No 220: N/A Employee No N/A
!a% Identification
Number
170*217*0722/(ALAR) CIRCL' * ;- TA>'(
+ON' * 3- D,A&A
293*219*732;/ CIRCL' ;1- TA> +ON' ;- D,A&A
Monthly Income
.prime source/
T&! :-6:-111/ Pay "ate' FIR(T .''& OF
'V'R) MONT,
!0 N/A Pay "ate' N/A
Rental Income !1 NIL !1 NIL
Other Income !1 NIL $ource' NIL !1 NIL $ource' NIL
!otal Income T&! :-6:-111/
!1 NIL
E%pense
Rent' T&! :1-111/ Others' !0 0:-111/ Rent' !1 NIL Others' !1 NIL
LOAN APPLI'D FOR
*mount' Tk! 34-11-111/
Purpose' Construction F"at E%tension Impro2ement Plot
Others
!erm' 24 ,rs Month"$ insta"@ent $oA can pa$ to D%,8 !1 41-111/
PROP'RT) CO(T AND FINANC' D'TAIL(
'sti@ateB FAnBs ReCAireB (oArces oD FAnBs ReCAireB
!otal Purchase Price or *mount *lready $pent !1345465444-
Estimated Construction Cost
!109-19-111/
$ource' O.N
Re&istration Cost 7oan Re8uested from "#H !1 39-11-111/
Other Cost5 if any !10-11-111/ $ources of #alance *mount
.please specify/ (AL' P'RMI((ION $a2in&s from #an1
!10-11-111/
CO(T- R'5I(TRATION CO(T "isposal of In2estment !1 21-19-111/
Personal #orrowin&s
!19999999999999999
7oan from Pro2ident Fund-Employer
!19999999999999999
Others .please specify/ 999999999 !19999999999999999
!1
!otal Funds Re8uired !1 4:-19-111/ !otal Planned Funds !1 4:-19-111/
Note'3 !otal Planned Funds should at least e8ual !otal Funds Re8uired
: "etailed sources of funds re8uired are important to help us process your loan application

FOR OFFIC' U(' ONL)
*FFI; PHO!O *FFI; PHO!O "*!E OF RECEIP!
99999999999999999
OF *PP7IC*N! OF CO+*PP7IC*N! FI7E N<M#ER
99999999999999999
=I!H $I>N*!<RE =I!H $I>N*!<RE *PP7IC*!ION FEE$ !1
99999999999999999
INI!I*7
99999999999999999
FINANCIAL D'TAIL(
D'TAIL( OF (AVIN5( AND A(('T(
Particulars App"icant Co*app"icant
$a2in&s in #an1 T& :-11-111/ T& 31-111/
Immo2able Property
.please specify/
N/A
Other *ssets such as
Insurance Policy .with
maturity date/5 $a2in&
Certificate5 F"R5 =a&e
Earners #ond5 $hare etc
2! <I%AN %IMA CORPORATION-
:! (UNLIF' IN(URANC' COMPAN) LTD!
'>IM %AN& DP( A/C! NO! 1172:211297279
D'TAIL( OF %ORRO.IN5( AND LIA%ILITI'( .Please &i2e details on all your present outstandin& and proposed loans/
App"icant Co*app"icant
$ources of
7oan
Outstandin&
*mount .!1/
Monthly
Instalment .!1/
#alance !erm
.Months/
Outstandin&
*mount .!1/
Monthly
Instalment .!1/
#alance !erm
.Months/
Employer
#an1 0-73-2:7/ :7-931!74/ 27 Ni" Ni" Ni"
Pro2ident Fund
Car 7oan
Others
%AN& ACCOUNT D'TAIL(
Name of the *ccount Holder Name of #an1 #ranch !ype of *ccount *ccount No
3 0a?i Mohd *bu $ufian Prime #an1 7imited "il1usha $a2in&s 346:3@44:@:@A
: 0a?i Mohd *bu $ufian H$#C 7td >ulshan $a2in&s 44B3C:46A443
PROP'RT) D'TAIL( (TO %' PURC,A('D/CON(TRUCT'D/'>T'ND'D OR IMPROV'D)
For F"at/P"ot PArchase For O#n ConstrAction/'tension
"e2elopers Name ,A(AN AND A((OCIAT'( LIMIT'D (,AL) 7and $i?e 999999 $ftD Ealue of 7and !1 99999999999
ProFect Name' UDA)AN RO&TO&ORO%I #uilt+up *rea 999999 $ft No of <nits999999999
#uilt+up *rea' 224: (!Dt ? 2 Car Parking UnitD Purchase Price
!1 09-19-111/
*ddress' Please mention complete postal address of the property
UNIT ID E AT PLOT E </0/6- %LOC& E <- ('CTION E 3-
MIRPUR- D,A&A PO(T COD'8 2:2;
Cost of Construction !1 999999999999999999999999999
*ddress' Please mention complete postal address of the property
999999999999999999999999999999999999999999999999999
999999999999999999999999999999999999999999999999999
Post Code'
E%pected Possession #y 21/21/ :12: Present $ta&e of Construction' FINI(,IN5 .OR& I(
5OIN5 ON
"o you propose to rent the dwellin& unitG )'( No If ,es then monthly rent e%pected !1 :1-111/
Is the le&al title to the property clearG )'(
No
=ill "#H be able to obtain first mort&a&e on the propertyG )'(
No
5'N'RAL INFORMATION (APPLICA%L' TO ALL T,' APPLICANT()
Ha2e you or your spouse applied earlier to
"#H for a loanG ,es NO
How did you &et to 1now
"#HG
Please select the mode of repayment con2enient to
you'
Post dated che8ues.post dated che8ues from/
If yes5 File-7oan *-c No 99999999999999
Radio !E
#an1 ,(%C
*mount and term 999999999999999999
Newspaper
Ma&a?ine
#ranch 5UL(,AN
Ha2e you or your spouse &i2en &uarantee.s/
for any borrower.s/ G ,es NO
%Ai"Ber
Relati2es
Friends
Mail
*ccount No 113*26:194*112
"eduction from salary by employer
If yes5 File-7oan *-c No99999999999
Others .please specify/' *ny other .please specify/99999999999999999
Name of borrowers
=hat other security will you be able to
pro2ideG .please specify name and 2alue/
R'F'R'NC'( (NAM'( AND ADDR'(('( OF T.O R'F'R''( .,O AR' NOT R'LAT'D TO )OU)
."#H M*, M*0E $<CH IN(<IRIE$ FROM REFEREE$ *$ I! "EEM$ NECE$$*R,/
Name 3/ :/
Occupation )
"esi&nation
*ddress
!el'Off' Res' !el'Off' Res'
D'CLARATION8 I-=e declare that all the particulars and information &i2en in the application form are true5 correct and complete and that
they shall form the basis of any loan "#H may decide to &rant me-us I-=e confirm that I-we ha2e read the brochure and understood the
contents I-=e further confirm that I-we ha2e had no insol2ency proceedin&s a&ainst me-us nor I-we been adFudicated insol2ent I-=e am-are
aware that the E8uated Monthly Instalment .EMI/ comprisin& principal and interest is calculated on the basis of annual rests I-=e a&ree that
"#H may ta1e up such references and ma1e such in8uiries in respect of this application5 as it may deem necessary I-=e underta1e to inform
"#H re&ardin& any chan&e in my-our occupation-employment and to pro2ide any further information that you may re8uire I-=e further a&ree
that my-our loan shall be &o2erned by rules of "#H which may be in force from time to time
FFFFFFFFFFFFFFFFF 9999999999999999999
App"icantGs (ignatAre Co*app"icantGs (ignatAre