You are on page 1of 10

LOAN APPLICATION FORM

Borrower’s Name kolla vamsi krishna

Applied credit limit 0.00

Max Tenure 36 months

Application Form
Date of Application 16-02-2022
Lead ID lead1fs05nrhj5143

Loan Amount 0.00


NAME: kolla vamsi krishna
IMEI : 384b103bbbe3eb65
Timestamp : 2022-02-16
07:58:34
Sanction Amount 0.00
Tenure (Days) 14 days

Purpose of Loan Business Loan

Epaylater ID 1374762
Borrower Details
Name of the Borrower kolla vamsi krishna
Father's Name
Mother's Name
Nationality Indian
Date of Birth 10-08-1998
Gender male

Mobile Number 8886428693

Email Address 8886428693@example.com


PAN IZQPK5239A
S/O BRAHMAIAH 3-69 RAVULAKOLLU
PONNALURU MANDALAM

Residential Address
MALEPADU Pincode 523109
City
ANDHRA PRADESH Country India
State

Permanent Address
City Pincode

Country India
State
Occupation Type Retailer

Proof of Identity Aadhaar Card

Proof of Address Aadhaar Card

Name of Business tata consultancy services

Industry Category Loan

Industry Subcategory Business Loan

Monthly Income 100000.00

NAME: kolla vamsi krishna


IMEI : 384b103bbbe3eb65
Timestamp : 2022-02-16
07:58:34
Bank Details
Name of the Bank
Account Number
Account Holder Name
IFSC Code
MICR Code

Customer's Undertaking
1. I/We hereby apply for a finance facility for the short term business loan ("Loan/Credit
Facility") mentioned in this application. I/We declare that all the particulars and information
and details given/filled in this Application Form are true, correct, complete and up to date in
all respects and no information has been withheld and I/we understand that the information
given in this application shall form the basis of any loan that AEFPL may decide to grant to
me/us and if at any stage of processing this application, it comes to the knowledge that, I/we
have provided any incorrect or incomplete information, fabricated documents, or fake
documents, they will be treated by AEFPL as having been manipulated by me/us and
AEFPL shall have the right to forthwith reject this loan application, cancel / revoke any
sanction or further draw downs or recall any loan granted at any stage of processing the
application, without assigning any reason whatsoever and AEFPL and its employees/
representatives/ agents / service providers shall not be responsible/liable in any manner
whatsoever to me/us for such rejection or any delay in notifying me/us of such rejection
(including for any payments which may have been made by me to any vendor/ service
provider prior to cancellation). I/We understand that AEFPL will also be procuring personal
information from other sources/agents and I/ We have no objection for the same. I/We
further confirm that I/we am/are aware of all terms and conditions of availing finance from
AEFPL. I/We authorize AEFPL to make reference and inquire relating to information in this
application which AEFPL considers necessary, including from the banks where I hold bank
accounts. I/We authorize AEFPL to procure my /our PAN No/copy of my/our PAN Card,
other identity proof and Bank Account details from time to time, exchange, part with/share all
information relating to my/our loan details and repayment history with other banks/financial
institutions /CIBIL/CRIF etc. and periodically obtain / generate CIBIL, CRIF, Experian,
Hunter and such other reports as may be required and shall not hold AEFPL liable for use of
this information. I/We confirm that there are no criminal or insolvency proceedings against
me/us.

2. I/ We declare that I/ We have not made any payment in cash, bearer cheques or by any
other mode along with or in connection with this Application Form to the person collecting
my/our Application Form. I/ We shall not hold AEFPL or its
employees/representatives/agents/service providers liable for any such payment made by us
to the person collecting this Application Form.

I/We, would like to know through telephonic calls, or SMS on my mobile number mentioned
in the Application Form as well as in this undertaking, or through any other communication
mode, transactional information, various loan offer schemes or loan promotional schemes or
any other promotional schemes which may be provided by AEFPL and hereby authorize
AEFPL and their employees, agents, or associates to do so.

3. I/we understand that we have the I/we have an option of not providing the information as

NAME: kolla vamsi krishna


IMEI : 384b103bbbe3eb65
Timestamp : 2022-02-16
07:58:34
required in this application form or as may be required by AEFPL from time to time,
however, I/We do hereby expressly and irrevocably authorize AEFPL to collect, store, share,
obtain and authenticate any aspect of my personal information / KYC either directly or
through any of the authorized agencies and disclose such information to its
agents/contractors/service providers and to also use such information in the manner that
may be required by AEFPL including for the purposes of this loan and for purposes of its
business and for such time period as they may deem fit. In this regard, I/we expressly and
irrevocably authorize AEFPL to collect, use, verify and authenticate my / our personal
identity information / KYC in any manner without any notice to me / us.

4. I/We confirm that we know English, we have read and understood and accepted the general
terms and conditions for the grant of Loan Facility. I/we also understand that the General
Terms and Conditions shall be deemed to be applicable to any Drawdown granted by
AEFPL pursuant to this application form.

5. I / WE are not taxable as a US person / persons under the laws of the United States of
America (US) or any state or political subdivision thereof or therein, including the
District of Columbia or any other states of the US. Further, I / we are not taxable as a
tax resident / residents under the laws of the country outside India. I/We agree to
submit a new form within 30 days if any information or certification on this form
becomes incorrect.

Credit Facility Agreement


AEFPL shall be entitled to take such legal action as it may deem fit, upon occurrence of any
of the Events of Default as set out and agreed by me/us in the above mentioned General
Terms and Conditions of loan.

This CREDIT FACILITY AGREEMENT ("Agreement") is made at the place and the day
mentioned in Most Important Terms and Conditions ("MITC”) specified below

By and Between
The Borrower(s), details whereof is/are more particularly described in the MITC specified
below and, wherever the context so requires, includes a Co-Borrower(s) named therein and
hereinafter collectively (if there is more than one Borrower(s) referred to as the "
Borrower(s)) of the ONE PART,
AND
Arthashastra EpayLater Financial Private Limited, a company registered under the
Companies Act, 2013 having its registered office at Unit No. 510, Fifth Floor, Vipul
Business Park, Sohna Road Gurgaon Haryana 122001 , and inter alia a Branch Office at
the address stated in the MITC appended hereto (and hereinafter referred to as " AEFPL"
which expression, unless repugnant to the context, shall be deemed to include its
successors and assigns) of the OTHER PART.

WHEREAS the Borrower(s) has requested to AEFPL for a loan for profession/personal
/business requirements and upon the request of the Borrower(s) AEFPL has agreed to grant
the Loan (as defined hereinafter) upon the mutually agreed terms and conditions herein
appearing.

NOW IT IS HEREBY AGREED BETWEEN THE PARTIES HERETO AS UNDER: -

All capitalized terms mentioned in this Agreement shall have the meaning as

NAME: kolla vamsi krishna


IMEI : 384b103bbbe3eb65
Timestamp : 2022-02-16
07:58:34
specified in the GTC mentioned below
1. Subject to the terms and condition contained in the General Terms and Conditions
applicable to the borrower(s) for availing credit facility ("Hereinafter referred to as "GTC"
which term shall include amendments to the same and any additional terms mentioned by
AEFPL from time to time ), the Borrower(s) herein agrees to borrow from AEFPL and AEFPL
agrees to lend to the Borrower(s) the sum specified in the MITC (which sum is hereinafter
referred to as the "Loan") hereto. The most important terms applicable for the Loan are
mentioned in the MITC. All other term of the Loan sanctioned will subject to the terms
mentioned in the GTC. The specific and most important terms applicable to the Loan is
mentioned in the MITC.
2. The Borrower(s) certify that the information and documents provided to AEFPL for availing
the Loan are true & accurate and no material information has been withheld /suppressed.
The Borrower(s) hereby authorize & give consent to AEFPL to disclose without notice to
them, information furnished by them or related documents executed or to be executed in
relation to the facilities availed from AEFPL, to AEFPL's other branches, subsidiaries,
affiliates, Credit Bureaus, Rating agencies, Service Providers, Banks/Financial Institutions,
Government/Regulatory authorities or third parties for KYC information verification, credit
risk analysis, or for other related purposes that AEFPL may deem fit.
3. Borrower(s) further agree that this Loan transaction shall be governed by the GTC as
specified above. The Borrower(s) confirm having received a copy of the GTC. The
Borrower(s) further confirm that he/she/they have read and understood the terms and
conditions mentioned in the GTC applicable to this loan and accept the terms and conditions
unconditionally and agree that these terms and conditions may be changed by AEFPL at
any time and accordingly he/she/they will be bound by the amended terms and conditions.
4. The Borrower(s) confirm that:
Taxes may be applicable will be charged in connection with the loan
AEFPL will not be liable for loss or delay in receipt of documents /photographs and such
aforesaid documents will not be returned, under any circumstances, once submitted to
AEFPL. Bullet repayment will be due on at the end of the Tenor.
The borrower shall be liable to pay a penal interest as per the rates mentioned in MITC; the
event of delay in repaying the loan amount/tranche of a loan amount within the tenure.
* Other charges or fees applicable f or the Loan mentioned in the MITC are acceptable to
the Borrower(s). Borrower(s) confirm that GST registration information and registration
number
provided is true and correct. Borrower(s) further understands that if his/her/their GST
registration number is not provided or is incorrect, then GST Authority may not grant
him/her/them GST Input Credit for GST on charges.
IN WITNESS WHEREOF, THE PARTIES HERETO HAVE SIGNED THIS AGREEMENT
IN ACCEPTANCE OF ALL TERMS AND CONDITIONS STATED ABOVE AND THE
SCHEDULE HERETO ON THE DAY, MONTH AND YEAR MENTIONED IN THE
SCHEDULE.
MOST IMPORTANT TERMS & CONDITIONS (MITC)
Please read carefully before confirming
ACKNOWLEDGEMENT FORM
Date: February 16, 2022
I/We refer to Application Reference No. 1374762 and the Loan Agreement executed by me
/ us in favor of Arthashastra EpayLater Financial Private Limited ("AEFPL"). I/We have been
provided the following information and agree with the same and have accordingly filled up
the aforesaid Agreement:

NAME: kolla vamsi krishna


IMEI : 384b103bbbe3eb65
Timestamp : 2022-02-16
07:58:34
Date February 16, 2022

Name of the Borrower kolla vamsi krishna

Loan/Facility Amount Rs. 0.00/- (Rupees Zero Only)

Validity period for facility 36 months

Rate of Interest (per annum) 0 % p.a.


In the event there is default in Repayment at the end of
the Tenor, Interest at the rate 36% p.a. to be paid by the
Customer/ Borrower under the Loan/Credit Facility from
the date of disbursement till repayment of all the
outstanding amounts by the Customer/ Borrower
Additional Interest (“Additional Interest”)

Processing Fees 0
Loan can be availed for each tenor, subject to full
repayment of all the outstanding amounts under the
Loan/Credit Facility (including tranches thereunder),
Term/Tenor of the Loan or a within the due date specified for respective tranches
tranche of Loan (“Tenor”)
Repayment shall mean repayment of all the outstanding
amounts including costs, charges, duties, taxes, etc.
(“Bullet repayment”) on or before the end of the Tenor
specified herein above, for Loan/ Credit Facility availed
by the Customer/ Borrower from AEFPL from time to
Repayment time

“Supplier” shall mean the entity from whom the


Borrower/Customer is purchasing the goods and for
which loan/credit facility is being availed by the
Interest Repayment Borrower/Customer from AEFPL

NAME: kolla vamsi krishna


IMEI : 384b103bbbe3eb65
Timestamp : 2022-02-16
07:58:34
All the charges indicated above or elsewhere in the Loan
Agreement shall be inclusive of all taxes and statutory
levies as may be applicable on same including without
Taxes & Levies limitation tax on goods and services with cess.

Following terms and conditions shall be applicable in


addition to the terms mentioned in the General Terms
and Conditions applicable to the borrower(s) for availing
Credit Limit Facility The same is available at
https://epaylater.in/term.html Additional Terms shall
Additional Terms and prevail in case of inconsistency with the terms
conditions mentioned in the GTC

Place of Arbitration and


Jurisdiction Mumbai

APPLICATION FORM FOR LOAN DISBURSEMENT BY IMMEDIATE PAYMENT


SERVICE (IMPS)
Date: February 16, 2022
To
Arthashastra EpayLater Financial Private Limited
________________________________
________________________________
________________________________
Sub: Loan disbursement by Electronic Fund Transfer through IMMEDIATE PAYMENT
SERVICE (IMPS)
Ref: Loan Application ref No. : 1374762
Loan Account Number : 1209173
Dear Sir,
With reference to my / our loan application, I / We hereby unconditionally instruct
Arthashastra EpayLater Financial Private Limited (“AEFPL”) to directly remit the sanctioned
loan amount of Rs. 0.00 /- ( Rupees Zero only) ( after deduction of pre EMI interest,
documentation charges & processing charges) as per following details:-
Details of the Beneficiary

Beneficiary's Bank name ICICI Bank

Beneficiary’s Bank a/c name Arthashastra Fintech Pvt. Ltd.

Beneficiary’s Bank a/c # 120405000433

NAME: kolla vamsi krishna


IMEI : 384b103bbbe3eb65
Timestamp : 2022-02-16
07:58:34
Beneficiary's Bank Account Type Current

Beneficiary's Bank payable Mumbai


Location
Beneficiary’s Bank Branch IFSC ICIC0001204
code
MICR Code 400229141

Amount to be remitted 0.00

I / We hereby declare that:


- The particulars given above are true, correct and complete to the best of my/our
knowledge. I / we shall be responsible for the accuracy of the particulars given in the
payment instruction.
- I / We shall be bound by any payment instruction executed by AEFPL, if AEFPL had
executed the payment instruction in good faith and in compliance of instructions for
electronic fund transfer.
- The disbursement of the Loan in favour of the above said Beneficiary shall be deemed to
be the Loan granted to and availed by me/us. The disbursement of the Loan amount in
favour of the above Beneficiary payee shall not affect my/ our obligation in relation to the
Loan facility.
- AEFPL shall not be liable for any loss or damage arising out of or resulting from
incomplete information, delay in transmission, delivery or non delivery of electronic
message or any mistake, omission or error in transmission or delivery thereof or any act or
event beyond its control. Notwithstanding above, in the event of any delay in the
completion of the funds transfer or any loss on account of error in the execution of the
funds transfer pursuant to a payment instruction due to any negligence on the part of
AEFPL, 's liability shall be limited to the extent of payment of interest at the bank rate for
the period of delay in the case of delayed payment.
- AEFPLshall not be liable for non credit or crediting remittance amount to wrong
beneficiary on account of incorrect information furnished by me/ us in this application form.
- Beneficiary bank may levy charges on inward remittance and deduct the same from the
remitted amount.
I understand that all IMMEDIATE PAYMENT SERVICE (IMPS) instructions are irrevocable
and there is no facility for giving stop payment instruction in respect of remittances through
IMMEDIATE PAYMENT SERVICE (IMPS).

Charge Sheet
Processing Fee Not Applicable

Foreclosure/Prepayment Charges Not Applicable

NAME: kolla vamsi krishna


IMEI : 384b103bbbe3eb65
Timestamp : 2022-02-16
07:58:34
Bounce/Late Payment Charges INR 500

Additional Interest Charges Not exceeding 3% per month accrued on daily


basis from the date of disbursement
* PLEASE DO NOT SIGN THE ABOVE DOCUMENT, IF BLANK.
* PLEASE DO NOT PAY CASH TO ANYONE FOR THE PROCESSING OF YOUR
LOAN. IN CASE YOU ARE ASKED, PLEASE REFUSE AND CONTACT YOUR
NEAREST AEFPL BRANCH.
* FOR ALL PAYMENTS MADE TO ANY REPRESENTATIVE OF ARTHASHASTRA
EPAYLATER FINANCIAL PRIVATE LIMITED TOWARDS ANY FEE / CHARGES,
PLEASE ASK FOR VALID RECEIPT.
* IF ANY VERBAL COMMUNICATION MADE TO YOU IS IN CONTRADICTION TO THE
ABOVE TERMS & CONDITIONS, PLEASE CONTACT US AT 8100 05 05 05 (MON-SAT
9:00 A.M. TO 8:00 P.M.) OR WRITE TO US AT
Terms & Conditions:
I/We acknowledge that:
* The above are the most important terms of the aforesaid Loan, and all other terms and
conditions of the Loan shall be as specified acknowledgement form, Loan Agreement and
the GTC
* AEFPL is entitled to add, to delete, recall the facility in event of default without any
notice or modify any of the aforesaid terms and conditions and the same shall be
binding on me/ us.
* In the event of any change of address for communication, any change in my/our
job, profession, the same shall be intimated by me/us to AEFPL, one month in
advance.
* I/We are aware that the Loan agreements, GTC and other incidental documents
executed by me/us integrate all the conditions mentioned herein or incidental thereto,
and supersede all negotiations or prior

writings, except for those provisions specified herein. In the event of any conflict
between the terms, conditions and provisions of the Loan
agreement/GTC/documents executed incidental thereto with the terms mentioned
herein, then in such an event the terms, conditions and provisions mentioned herein
shall prevail

NAME: kolla vamsi krishna


IMEI : 384b103bbbe3eb65
Timestamp : 2022-02-16
07:58:34
NAME: kolla vamsi krishna
IMEI : 384b103bbbe3eb65
Timestamp : 2022-02-16
07:58:34

You might also like