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INDIABULLS HOUSING FINANCE LIMITED

application form
(FOR resident Applicants)

Credit Rating : CARE AAA (Triple A) by CARE and BWR AAA by Brickwork

COMMON APPLICATION FORM

FOR ASBA / NON ASBA
Application
Form No.

To, The Board of Directors,

INDIABULLS HOUSING FINANCE LIMITED

ISSUE OPENS ON : September 15, 2016

ISSUE CLOSES ON* : September 23, 2016
*For early closure or extension of the issue, refer overleaf

65000319

PUBLIC ISSUE OF SECURED AND UNSECURED REDEEMABLE NON-CONVERTIBLE DEBENTURES (NCDs) VIDE PROSPECTUS DATED SEPTEMBER 9, 2016

I/we hereby confirm that I/we have read and understood the terms and conditions of this Application Form and the attached Abridged Prospectus and agree to the Applicants Undertaking as given overleaf. I/we hereby confirm
that I/we have read the instructions for filling up the Application Form given overleaf.
BANK BRANCH
REGISTRARS / SCSB
DATE OF
ESCROW BANK / SCSB BRANCH
LEAD MANAGER/ CONSORTIUM MEMBER /
SUB- CONSORTIUM MEMBER /
SUB BROKER/AGENTS
SERIAL NO.
RECEIPT
CODE
TRADING MEMBERS STAMP & CODE
BROKERS STAMP & CODE
SERIAL NO.
STAMP & CODE

Trust Financial Consultancy Services Private Ltd.

3284

Trust Financial Consultancy Services Private Ltd.

3284

1. APPLICANTS DETAILS - PLEASE FILL IN BLOCK LETTERS (Please refer to point no. 27 of the attached Abridged Prospectus)
First Applicant (Mr./ Ms./M/s.)
Date of Birth D D M M Y Y Y Y
Address

Name of Guardian (if applicant is minor)

Pin Code (Compulsory)

Tel No. (with STD Code) / Mobile

Email

Second Applicant (Mr./ Ms./M/s.)

Third Applicant (Mr./ Ms./M/s.)
2. Investor Category (Please refer overleaf) Category I
Category II
Category III
Category IV
Sub Category Code (Please refer overleaf)
3. IN CASE OF APPLICATION IN DEMATERIALISED FORM, PLEASE PROVIDE APPLICANTS DEPOSITORY DETAILS
(Please refer to page no. 12 of the attached Abridged Prospectus) For Nsdl Enter 8 Digit Dp Id followed by 8 digit Client ID / For Cdsl enter 16 digit Client Id
NSDL /
CDSL
4. IN CASE OF APPLICATION TO HOLD THE NCDs IN PHYSICAL FORM, PLEASE PROVIDE FOLLOWING DETAILS
(Please enclose self attested copies of the KYC documents along with the Application Form. For list of KYC documents, please refer overleaf)
Bank Details for payment of Refund / Interest / Maturity Amount (Mandatory)
NOMINATION (Please see point no. 55 of the Abridged Prospectus)
Name of the Nominee : _____________________________________________________ Bank Name : _____________________________________ Branch : ____________________

Please Fill in Block Letters

If Nominee is Minor, Guardians Name : ____________________________________________ Account No.: __________________ IFSC : ______________ MICR Code: ________________
5. INVESTMENT DETAILS (For details, please refer Issue Structure overleaf)
Secured/Unsecured
Secured
Unsecured
Series
I
II
III
IV
V
VI
VII
VIII
IX
X
Issue Price of NCDs (` / NCD)
` 1,000 across all Series of NCDs
Frequency of Interest Payment
Annual
Cumulative
Annual
Cumulative
Monthly Annual
Cumulative
Monthly Annual
Cumulative
Tenor (in years)
3
3
5
5
10
10
10
10
10
10
Minimum Application Size & thereafter in multiple of
` 10,000 (10 NCDs) (individually or collectively across all Series of NCDs) and in multiple of ` 1,000 (1 NCD) thereafter
Coupon (%) for NCD Holders in Category I and Category II 8.55%
NA
8.75%
NA
8.51% 8.85%
NA
8.65% 9.00%
NA
Coupon (%) for NCD holders in Category III
8.65%
NA
8.90%
NA
8.65% 9.00%
NA
8.79% 9.15%
NA
8.70%
NA
8.90%
NA
8.65% 9.00%
NA
8.79% 9.15%
NA
Coupon (%) for NCD holders in Category IV#
For Category I and II For Category I and II ` 1,000 ` 1,000
Redemption Amount (`/NCD)
`
For Category I and II - ` 1,278.47, ` 1,000 For Category I and II - ` 1,000 ` 1,000
` 1,521.41, For Category
` 2,336.07, For Category
` 2,368.48, For Category
1,000 For Category III - ` 1,282.01 For
III and IV - ` 1,531.93
III and IV - ` 2,368.48
III and IV - ` 2,401.30
Category IV - ` 1,283.78
Effective Yield (per annum) for Category I and II
8.55%
8.55%
8.75%
8.75%
8.85% 8.85%
8.85%
9.00% 9.00%
9.00%
Effective Yield (per annum) for Category III
8.65%
8.65%
8.90%
8.90%
9.00% 9.00%
9.00%
9.15% 9.15%
9.15%
Effective Yield (per annum) for Category IV
8.70%
8.70%
8.90%
8.90%
9.00% 9.00%
9.00%
9.15% 9.15%
9.15%
No. of NCDs applied
Amount Payable (`)
Grand Total (`)
#
Additional coupon of 0.10% per annum for senior citizens
6. PAYMENT DETAILS (Please tick () any one of payment option A or B below) Please write a Sole/First Applicants Name, Phone No. and Application No. on the reverse of Cheque/DD.

Amount Paid (` in figures)

(` in words)
(B) ASBA
Bank A/c No.

A. CHEQUE/ DEMAND DRAFT (DD) to be drawn in favour of IHFL NCD Escrow Account
Dated D D M M Y Y

Cheque/DD No.

Asba A/c. Holder Name ___________________________________________________________

(in case Applicant is different from ASBA A/c. Holder)
Bank Name & Branch ______________________________________________________________
____________________________________________________________________________________________________

Drawn on (Bank Name & Branch)

6a. pan & signature OF
SOLE/ first APPLICant

6b. pan & signature OF

SECOND APPLICant

6C. PAN & signature OF

third APPLICant

pan

pan

pan

6D. Signature of ASBA Bank Account Holder(s)

(as per Bank Records)(for ASBA Option only)
I/We authorize the SCSB to do all acts as are necessary to
make the Application in the Issue

1)
2)

Furnishing PAN of the Applicant is mandatory.

Please refer point no. 27 of the Abridged Prospectus

Date : ___________________, 2016

3)

TEAR HERE

Application
Form No.

Acknowledgement Slip for Lead Managers/

Consortium Members / Sub-Consortium Member/
Sub-Brokers / Trading Members / SCSBs

INDIABULLS HOUSING
FINANCE LIMITED
DPID/
CLID

LEAD MANAGERS / CONSORTIUM /

SUB-CONSORTIUM MEMBERS /
SUB-BROKERS / TRADING MEMBERS /
SCSB BRANCHS STAMP
(Acknowledging upload of Application
in Stock Exchange system) (Mandatory)

65000319

PAN

Amount Paid (` in figures)

Date, Stamp & Signature of Escrow

Bank (Mandatory)

Bank & Branch

Cheque / DD/ASBA Bank A/c No.

Dated___________,2016

Received from Mr./Ms. /M/s.

Telephone / Mobile

Email

INDIABULLS HOUSING
FINANCE LIMITED

TEAR HERE

TEAR HERE
PUBLIC ISSUE OF SECURED AND UNSECURED REDEEMABLE NON-CONVERTIBLE DEBENTURES (NCDs) VIDE PROSPECTUS DATED SEPTEMBER 9, 2016
Series

II

Issue Price (` / NCD)

III

IV

VI

VII

VIII

IX

` 1000

Date Stamp & Signature of Lead Manager/ Name of Sole / First Applicant (Mr./ Ms./ M/s.)
Consortium Members / Sub-Consortium
Members / Trading Members / SCSB ___________________________________________

___________________________________________

No. of NCDs applied for

Applications submitted without being uploaded on the terminals of the Stock Exchange
will be rejected.

Amount Payable (`)

Grand Total (`)

Cheque / DD/ASBA Bank A/c No.

Drawn on (Name of Bank & Branch)

Acknowledgement Slip for Applicant

Dated

,2016

All future communication in connection with this application

should be addressed to the Registrar to the Issue. For
details, pleaser refer overleaf. Acknowledgement is subject
to realization of Cheque / Demand Draft.

Application
Form No.

65000319

While submitting the Application Form, the Applicant should ensure that the date stamp being put on the Application Form by the Lead Manager/Consortium Member /Sub-Consortium Member/Sub Broker/Trading Member/SCSB matches with the date stamp on the Acknowledgement Slip

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APPLICANTS UNDERTAKING

I/We hereby agree and confirm that:

1. I/We have read, understood and agreed to the contents and terms and conditions of INDIABULLS HOUSING FINANCE LIMITED, Prospectus dated September 9, 2016 (Prospectus).
2. I/We hereby apply for allotment of the NCDs to me/us and the amount payable on application is remitted herewith.
3. I/We hereby agree to accept the NCDs applied for or such lesser number as may be allotted to me/us in accordance with the contents of the Prospectus subject to applicable statutory and/or regulatory requirements.
4. I/We irrevocably give my/our authority and consent to IDBI TRUSTEESHIP SERVICES LIMITED to act as my/our trustees and for doing such acts as are necessary to carry out their duties in such capacity.
5. I am/We are Indian National(s) resident in India and I am/ we are not applying for the said NCDs as nominee(s) of any person resident outside India and/or Foreign National(s).
6. The application made by me/us do not exceed the investment limit on the maximum number of NCDs which may be held by me/us under applicable statutory and/or regulatory requirements.
7. In making my/our investment decision I/We have relied on my/our own examination of the INDIABULLS HOUSING FINANCE LIMITED and the terms of the issue, including the merits and risks involved and my/our decision to make this
application is solely based on disclosures contained in the Prospectus.
8. I/We have obtained the necessary statutory and/or regulatory permissions/approvals for applying for, subscribing to, and seeking allotment of the NCDs applied for.
9. Additional Undertaking, in case of ASBA Applicants:
1) I/We hereby undertake that I/We am/are an ASBA Applicant(s) as per applicable provisions of the SEBI Regulations; 2) In accordance with ASBA process provided in the SEBI Regulations and disclosed in the Prospectus, I/We authorize
(a) the Lead Manager(s)/Consortium Members/Sub-Consortium Members and Trading Members (in Specified cities only) or the SCSBs, as the case may be, to do all acts as are necessary to make the Application in the Issue, including
uploading my/our application, blocking or unblocking of funds in the bank account maintained with the SCSB as specified in the Application Form, transfer of funds to the Public Issue Account on receipt of instruction from the Lead Manager,
Registrar to the Issue, after finalization of Basis of Allotment; and (b) the Registrar to the Issue to issue instruction to the SCSBs to unblock the funds in the specified bank account upon finalization of the Basis of Allotment. 3) In case
the amount available in the specified Bank Account is insufficient as per the Application, the SCSB shall reject the Application.
10. Additional Undertaking in case the Applicant wishes to hold the NCDs in physical form:
1) In terms of Section (8)(1) of the Depositories Act, 1996, I/we wish to hold the NCDs in physical form. 2) I/We confirm that the information provided in this form is true and correct and I/We enclose herewith self attested copies of the
KYC Documents. 3) I/We confirm that we do not hold any Demat Account.

ISSUE RELATED INFORMATION FOR FILLING THE APPLICATION FORM

KYC Documents: (To be submitted only for holding NCDs in Physical Form): Please provide the following documents along with the Application Form: (a) Self-attested copy of the PAN card; (b) Self-attested copy of your proof of
residence. Any of the following documents shall be considered as a verifiable proof of residence: ration card issued by the Government of India (GOI); or valid driving license issued by any transport authority of the Republic of India; or electricity
bill (not older than three months); or landline telephone bill (not older than three months); or valid passport issued by the GoI; or voters identity card issued by the GoI; or passbook or latest bank statement issued by a bank operating in India; or
registered leave and license agreement or agreement for sale or rent agreement or fl at maintenance bill; or AADHAR letter; or life insurance policy. Self-attested copy of a cancelled cheque of the bank account to which the amounts pertaining
to payment of refunds, interest and redemption, as applicable, should be credited. (c) In absence of the cancelled cheque, the Company reserves the right to reject the Application or to consider the bank details given on the Application Form at its sole
discretion. In such case the Company, Lead Managers and Registrar shall not be liable for any delays/ errors in payment of refund and/ or interest. For information pertaining to KYC Documents, please refer on page 14 of the Abridged Prospectus

Investor Categories:
Category I (Qualified Institutional Buyers)/(QIBs)
Sub Category Code Category II (Corporates)
Sub Category Code
Public Financial Institutions
11
Statutory bodies/corporations
24
12
Public/Private Charitable/Religious Trusts
25
Venture Capital Funds / Alternative Investment Funds, subject to investment
conditions applicable to them under the Securities and Exchange Board of India
Partnership
firms
in
the
name
of
partners
26
(Alternative Investment Funds) Regulations, 2012
Scheduled commercial banks
13
Association of Persons
27
Mutual Funds
14
Co-operative banks incorporated in India
28
State industrial development corporations
15
Regional Rural Banks incorporated in India
29
Insurance companies registered with the IRDA
16
Scientific and/or industrial research organisations, which are authorised to
57
invest in the NCDs and its Sub Category
17
Any other incorporated and/or unincorporated body of persons
58
Provident funds, pension funds with minimum corpus of ` 2500.00 lacs
superannuation funds and gratuity funds, which are authorised to invest in the NCDs
Category III (High Networth Individuals)/(HNIs)
The National Investment Fund set up by resolution F. No. 2/3/2005-DD-II dated
19
The following Investors applying for an amount aggregating to more than
November 23, 2005 of the GoI, published in the Gazette of India
` 10 lakhs across all Series of NCDs in this Issue:
Insurance funds set up and managed by the army, navy, or air force of the Union of India
20
Resident Indian Individuals
31
Insurance funds set up and managed by the Department of Posts, India
55
Hindu Undivided Families through the Karta
32
Indian Multilateral and bilateral development financial institutions
56
Category IV (Retail Individual Investors) /(RIIs)
Category II (Corporates)
The following Investors applying for an amount aggregating upto and including
` 10 lakhs across all Series of NCDs in this Issue:
Companies within the meaning of section 2 (20) of the Companies Act 2013
21
Limited Liability Partnerships registered under the provisions of the LLP Act
22
Resident Indian Individuals
41
Societies registered under the applicable laws in India
23
Hindu Undivided Families through the Karta
42
Secured/Unsecured
Series
Issue Price of NCDs (` / NCD)
Frequency of Interest Payment
Tenor (in years)
Minimum Application Size & thereafter in multiple of
Coupon (%) for NCD Holders in Category I and Category II
Coupon (%) for NCD holders in Category III
Coupon (%) for NCD holders in Category IV#
Redemption Amount (`/NCD)

Effective Yield (per annum) for Category I and II

Effective Yield (per annum) for Category III
Effective Yield (per annum) for Category IV
Put and call option
Security and Asset Cover

Unsecured
V
VI
VII
VIII
IX
X
` 1,000 across all Series of NCDs
Annual
Cumulative
Annual
Cumulative
Monthly Annual
Cumulative
Monthly Annual
Cumulative
3
3
5
5
10
10
10
10
10
10
` 10,000 (10 NCDs) (individually or collectively across all Series of NCDs) and in multiple of ` 1,000 (1 NCD) thereafter
8.55%
NA
8.75%
NA
8.51% 8.85%
NA
8.65% 9.00%
NA
8.65%
NA
8.90%
NA
8.65% 9.00%
NA
8.79% 9.15%
NA
8.70%
NA
8.90%
NA
8.65% 9.00%
NA
8.79% 9.15%
NA
For Category I and II For Category I and II - ` 1,000 ` 1,000 For Category I and II - ` 1,000 ` 1,000 For Category I and II `
`
` 2,336.07, For Category
` 2,368.48, For Category
1,000 ` 1,278.47, For Category 1,000 ` 1,521.41, For Category
III - ` 1,282.01 For
III and IV - ` 1,531.93
III and IV - ` 2,368.48
III and IV - ` 2,401.30
Category IV - ` 1,283.78
8.55%
8.55%
8.75%
8.75%
8.85% 8.85%
8.85%
9.00% 9.00%
9.00%
8.65%
8.65%
8.90%
8.90%
9.00% 9.00%
9.00%
9.15% 9.15%
9.15%
8.70%
8.70%
8.90%
8.90%
9.00% 9.00%
9.00%
9.15% 9.15%
9.15%
NA
The Secured NCDs (Series I to VII) proposed to be issued will be secured by a first ranking pari passu charge on the current assets (including
investments) of the Issuer, both present and future; and on present and future loan assets of the Issuer, including all monies receivable thereunder for
the principal amount and interest thereon. The Secured NCDs will have an asset cover of one time on the principal amount and interest thereon. The
Issuer reserves the right to sell or otherwise deal with the receivables, both present and future, including without limitation to create a charge on pari
passu basis thereon for its present and future financial requirements, without requiring the consent of, or intimation to, the Secured NCD holders or the
Debenture Trustee in this connection, provided that a minimum security cover of one time on the principal amount and interest thereon, is maintained.
No security will be created for Unsecured NCD in the nature of Subordinated Debt (Series VIII to X).
I

II

III

Secured
IV

Additional coupon of 0.10% per annum for senior citizens.

*In case of application for Secured NCDs wherein the Applicants have not indicated their choice of the relevant NCD series, our Company shall allocate series VI NCDs.
*In case of application for Unsecured NCDs wherein the Applicants have not indicated their choice of the relevant NCD series, our Company shall allocate series IX NCDs.
If the Deemed Date of Allotment undergoes a change, the coupon payment dates, redemption dates, redemption amounts and other cash flow workings shall be changed accordingly.
For Grounds for Technical Rejection, Please refer to page no. 17 of the Abridged Prospectus.
For further information please refer to section titled Issue Related Informationon page no. 221 of the Prospectus.

TEAR HERE
In case of queries related to Allotment/ credit of Allotted NCDs/Refund, the Applicants should contact
Registrar to the Issue.
In case of ASBA Application submitted to the SCSBs, the Applicants should contact the relevant SCSB.
In case of queries related to upload of Applications submitted to the Lead Managers/ Consortium
Members/Sub-Consortium Members/Sub Brokers/Trading Member should contact the relevant Lead
Managers/Consortium Members /Sub-Consortium Members/Sub Brokers/ Trading Member.
The grievances arising out of Applications for the NCDs made through Trading Members may be
addressed directly to stock exchanges.

COMPANY contact details

INDIABULLS HOUSING FINANCE LIMITED

Registered Office: M-62 & 63, First Floor, Connaught Place, New
Delhi 110 001, India. Telephone No.: +91 11 3025 2900; Fascimile
No.: +91 11 3025 2501; Website: www.indiabullshomeloans.com;
Email: ihflpublicncd@indiabulls.com Company Secretary and Compliance
Officer: Mr. Amit Jain; Telephone No.: + 91 124 398 9666; Facsimile No.: + 91
124 308 1006; E-mail: ajain@indiabulls.com; CIN: L65922DL2005PLC136029

INDIABULLS HOUSING FINANCE LIMITED

Registrar contact details

Karvy Computershare Private Limited

Karvy Selenium Tower B, Plot 31-32, Financial District,

Nanakramguda, Gachibowli, Hyderabad 500 032, Telangana, India.
Te l : 0 4 0 - 6 7 1 6 2 2 2 2 F a x : 0 4 0 - 2 3 4 3 1 5 5 1
Email: einward.ris@karvy.com Investor Grievance Email:
indiabullshousing.ncdipo@karvy.com Website: www.karisma.karvy.com
Contact Person: Mr. M Murali Krishna SEBI Registration Number:
INR000000221 CIN: U74140TG2003PTC041636