APPLICATION FORM s Su opdoftr 16 13 414 Ar Gull House PoeniWaxke hy, AUXILO {LBs Marg, Kurla West, Mumbai - 400 070 Tel: 022 62463333 www.aupilo.corn The next level beckons Branch Lead ID sweoolLDDLLo—~—~SOSC~S~S Loan Amount DY [TJ ICT) Loan Amount in Worde(@) cross Signed |] Cross Signed Photograph of || Photograph of ‘Applicant Co-Applicont | BLAPPLICANT DETAILS nme COPECO) 2) FatersNeme | CECE 3) MetesName CCE TELE EEE DG De ELE EEL E EE Sanco) 9) spouses Name FEED EEO §) Date of sinh [OID] MA) MIVININ © []Male [_] Femate [_] Transgender 7) Matta status ]Maried(] Unmaried [_lOthers 8)No. of Dependents: -] 9) AadharNo 11 10) pave, CLIC O09 one CC CD EDLC aver COCO 13) passport (les [No ValaPassportNo LLL TT TLL LLL) ve seine CODEC 1s)other B 16) cxve No) 16) Teal Forty neome LLL T1111 11 ra aeoine STEELY LEE LL eres | Labt ded odes ee lest LEE EL 19 Cane aaies FEE EEOC CELL DOOCLLLLL LC OT EE EEL CL EOE EEE EOE LEEE LECCE EE-EEEEEEEEEEELLE} ey CELE LE EE tae CELE LL ose DELL see tandmark (JT TELL Jeincodee| TT 1 [1 Jeounty( ILL 20) Permanent Reidel Address [Somes above EEE EE ELL EEL ELELL LLL LEC) QOS C000 eee ey CEEOL EEC take CEL eis IEE sate EDO C AO _tanemar SOc rincode | LL 11 Jeoumyi TTL 21) LandlineNo [| | | | 11111 I [| 22)Communication Address:[ |Current Res. Address| Permanent Res. Address 23) [Feaaeatoaae] vor Come amon] Sosa cero] 24) Taealammeten [ee [ae [a =| Gaber al Admission status [Not Applied [_|Applied [ |Confiemed campus [| 111111] []ouatcourery| Pathway Country [_]india[_]usa[_] Uk |_]AUS [_] other 2) Universityame [TT TTT TILT TTT rr tt tr tno rrr) 3) Collegenamesaddress [J TT ILE T Tir rrr irri rrr rir) OCOOTTT TT TT Oooo Pt Tt TT ooo ttt) ey COO ste CO Pin code) | [) |) tet — rte —— 3) Coursename [1] TIL TL 111111 14 Course category | ]Diptoma [ [Degree [ Jus [JPG [_jothers 5} Course Ouration | |_| (Years) 6) Course Type |_| FullTime|_] PartTime| | Others 7) Course Steam [ Management [_]Medicine | lEngineering | |Certncate Courses |] Others 8) Course Start Date ID) (alu) SIV) Course End Date (DID) (iu) NII) 9) expected Annual come | [ILL TTT 111 10) Contact Person at Institute (For Admission Verification) vow INCA TAT TTT) a) Contacto [TT TT ICICI TT) &) emainio MLEED EERIE. TT)Dea ia Coe nova Ron aioe neon Tarr Toe are 2 arg Borne orTardoed aise owt pee Se z Toon Required AB=EL LTT TTT 11 E-APPLICANT REFERENCE 1 Neme CTT ee EPe PP 2) Address III) a INDO on 3) Poona! e-mail [TTT PP TIO er) 4) tandphoneNo [TT TT TTT TTT |simobiene [TT TT TTT TTT I 6) Occupation 1) Security offered CY CIN 2) Type of Property Offered Ci Residential CiCommercial CIPlot 3) Cllife Insurance Policy 4) (1 FD (Name of the Institution) ‘Amount 8) Other Details 5) Property Datalls (Address): Flat / Door / House No. Building / House Name Building / House No Wing Floer__ Survey No. Plot No, hy “Taluka District state country Pincode| | 1111) tanaman 7) Local Authority [| Municipal Corporation| Gram Panchayat [ IMunicioal Council 8) Area. 8) Current Market value) [TT [TT TT TT || 1] 2) Propery owned by [| isa. te isa. mts. Personal tals 1). Relofonship with the Applicant] Fother Fiver Oe fs Spouse [ [Relative [Others 2) Relat Pros! talon Cond [ith Cereals |Poxpon [-TMarige Cerne (lohan, 3) Nee CEE Eee Eee 4) Fobervpoow'sNere TEEPE PE ho 8) Mebe Neme COE EEE Eee ELE 6) Date of Binh 575] [Elm [ELZTTI=] 7) [| Mole [_]Femate [Transgender 8) _|Maried | ] Unmarried [_] Others 9% mvme LLL TPIT Liteon Ch LET EEL 1 1 veer 42) AadnarNo ||| 1 1 1111-1 | | 13)Passport | Yes [| No Valid Passport No [T1111 11 4) wreswol EEE LLC LLL LL] omer. CsI LEER 18) Qualcations | ]UG | |Diploma | |Gradvote ||P | [Doctotoie 19)No. of Dependents | | 20) Curent Adress {for inva - residential adres. For non-indidal- registred adres) [DDT PDL) COCO Too ey CETTE TT TTT ICT 1) tetoke COO TT) ote OOO 00 io CLT TTT T 10 torment TIO Tt) PinCode [TT [TT Jeounty CT TT 21). Yeors inthe Currant Address [ [IL] 22) Current Address Type [__]Setf Owned |] Famiy| | Rented ["] Employer Provided 23) Londphone Curor) —|L 11111 24) Permanent ResigentalAderess( _ Sameas above) [I LTT TTT Pir tlt tti irri One e eee e CCP E EEL EECEE REECE EE ECE CEEEEEEEL EC] ey (TET ET ETT TIC 1 totes FT TOOT TT TT) iste STOTT ste CT TTT TTT TT i tondmere CT TUDE oe Prt ti rt Pin Code [TTT -1 IL JCounty LI I I III ]2sptandtine number Permanent) [1 11111111111 25) Communication Address) |Current Res. Address | | Permanent Res. Address 1 AccountHolder Nome [ [TTT [TTT TT I) awene( TT TT PPT iti ir it iit) 3) Nome ofBank (TT TTT) 4ernch (TT TTT ITT TTT ttt tit) 5} Ne Operational since |_| [TI ) 6) se code (FL TT 7 mercedl TTT TI) aavetype TOIT rrr ri) 1) Account Holder Nome {TT TT TTT TTT UL) weno TTT rrr tr irr rit) 3) Nome ofbank [TIT TTT) 4eronch (TTT TTT TTT TTT tt riirrit) 5} Ne Operational since| |_| [| |) 6) wrse code FT 7 mercedl TTT TO) acne TOIT rrr)[JEEMPLOYMENT OR BUSINESS DETAILS: APPLICANT [CO:APPLICANT, 1) Occupation |_| Salaried|_|Set Employed Professional |_|Self Employed Non Professional |_| Retved| Others 2) Total Years in Service/Business [ | | _3)No. eet [1] Years 4) Age of Retirement [| 5) Designation Profession [TT 111111 II 6) Name of the Current Employer or Business/Firm CIR eC) COTTTOIOOCT TT TTT ert Tf Doe Te er) 7) Notwre of Business [TT TT LTT TT TT) aitndustry (TPT TT TT rr 9) Address of he Employer or Business/Fiem [| [| TTT TTT TTP irr irr rr irr ir) oy CTTT PETTITT IOC EEL) some LTT TTT TIT I tr itttt tt) Pin Code [TT [ [1] County (UT TTT TTT lestin 10} Londphone of Employer/ business [IT | TT [TT ) rwebsie (TTT TE Pr 12) Emp ID ee a Offciol Email © [TT TT TIN ele fore tel Pele imieieist! TTT) 13} Gross Mon Solay/rcome® LT [1 | ||| |) 16) Net Monthy Solay/ncome « Er) 16) Ofper Morshiyncomoe (TT TT TTT 1 | |) 17) torotincomenisrriye (PT TTT rr rrr) Personal E-mail 0 [LILI 2 tardies EETEE TTT TT 11 5 notin Eee ‘Occupation eT en pacha ieee re een eee ‘Applicant Co-Applicant ‘Additional Co-Applicant Guarantor 3 2 Colour Photos 1D 2 Colour Photos [D2 Colour Photos 3 2 Colour Photos 1 Photo 1D Ph 5 Restdonce Poot 1D Date of Birth Proof 5 Rosdence oot Sree Voricton 1D Income Proof 5 Colaterel Documents Proof 5 Cafstarel Documents 11 Relationship Proof 1 Relationship Proof 1 Fees Structure Noise Comparysnarms coe nt permit secptne of xtnar any tthe loa anacion he carpany prefer alae loa ree payments tebe made orn ppt ree opens banc account vough ary banking meus uh te nequerDOINEFTATESINDS, Caste hal be sly response or aah sanacian i any care Ou th the Companysteperrtstveroramoeater Whe appear rs nor orrerse oe sntheo pleat eben cn fe ae othe oappeatt Secon eee Sdareesonrecorstorthepurposeotdererminngpaceo upper 5, Signoture of Applicant Signotre of Co-Applicon Date: 915) I) PTT) Pra Date: 19) ) PPT) Nareertne appar ul Fnsere Fate Lntes Company} ha receed yur aplistn for Eaton Loan ate The suresh be erdenvured tobe processes win Swern djs ‘Ser sucesstaly meng alte rete eter a dow by te company rts yur appeaton vero, cecs of dormer ana eormatan prone equre an pecs! Irvestgntons Th Company requctsyute il copast whe company ender ke agetsincaryaganveratono hed, eae: OTS) (TM) ETT rece; —____ Stamp Signature