Annexure-‘A’ (REVISED)

PRADHAN MANTRI AWAS YOJANA (URBAN)- PMAY(U) -CLSS

SELF DECLARATION
(Name of Applicant/Co-Applicants should be the same as in Aadhar Card)

The Assistant General Manager/

Chief/ Branch Manager,
State Bank of India,
RACPC, Egmore, Chennai
_____________________

Date: 17th June 2021

Dear Sir/ Madam,

Sankar P
“I/We___________________________________________________________________
______________
_________________________________ (name of the borrower/ co-borrowers)* hereby
declare that :-
_______ _____
(i) I/We have applied for Housing Loan under EWS/LIG/MIG-I/MIG-II Scheme of Pradhan
Mantri Awas Yojana (U)- Credit Linked Subsidy Scheme.

(ii) I/We and my spouse and unmarried children do not own a pucca house in any part of
India.

(iii) I/We have not availed any loan under this Scheme nor have applied for Home Loan
under this Scheme to any other Banks/Financial Institutions.

(iv) The details of our family members (above 18 years age) are as given under :-

Name as per Aadhar Aadhar No PAN NO. Annual

Card Gross
(Relationship with borrower in Income
brackets)
Borrower Sankar P 890480067555 GFBPS4039K Rs.8,10,252/-
Co-borrower
Family member 1 Radha M 385966714712 -- --
Family member 2
Family member 3
Family member 4
TOTAL Rs.8,10,252/-

(v) My/our total household GROSS INCOME from all sources is Rs.
Rs.8,10,252/-
_____________________per annum, as given above.

(vi) I/ We have not been availing/ have availed subsidy under other verticals of PMAY or
any other Central Government housing schemes.

(Signature of applicant) (Signature of co-applicant)

Continued…P/2
 (vii) I/We have been made to understand that the subsidy amount will be recovered by the
Bank for refund to Government of India under the following circumstances:

a) we fail to complete construction of house/ take possession of the house

within 36 months from the date of the disbursement of 1st installment of the loan
amount.
b) In the event of default in payment of EMIs of the loan by me/us and the
account becoming NPA.

(viii) The payment of subsidy by the Government of India in no manner, whatsoever,

reduces my/our liability towards the dues payable to SBI, together with interest during the
entire loan period.

(ix) I/ We understand and accept that if at any stage, it is found that the information given
by me/ us is false/ not true, all benefits given to me under the schemes would be withdrawn
and legal action as demand fit, would be taken against me.

(x) I/ We gives our consents for sharing Aadhar Details of all our family members with
Central Nodal Agency and MoHUA for the purpose of processing our application under the
above referred scheme.

(xi) I/We GIVE/DO NOT GIVE our consent to the Bank for processing my/our application
under Normal Home Loan scheme, in case I/we are not eligible under the PMAY (U)-
CLSS scheme.

Yours faithfully,

(Signature of applicant) (Signature of co-applicant)

40014769198
HTL ACCOUNT NUMBER : _____________________

-The beneficiary family comprises of husband, wife and unmarried children. Only the
spouse and unmarried children will be permitted to join the loan as co-borrower/
guarantors.

-However, in case of adult earning member (irrespective of marital status) may be treated
as a separate household provided he/ she do not own a pucca house in his/ her name in
any part of India.