CLAIM FOR RELEASING INCENTIVE TO DSA

NAME OF DSA
ID NO
MOBILE NO
ACCOUNT NO
IFSC CODE
GSTIN

Details of Housing Loan to be sourced:

Name of Customer
Housing Loan No.
HL Sanctioned Amount
Branch Name Loan Sourced
Incentive Eligible

Place: Mangalore

Date: 12.05.2020 Signature of DSA

1) Certificate by Branch Head

This is to certify that above proposal is referred by Mr. has
been sanctioned Rs. And disbursed Rs. .

2) He is eligible for incentive Rs. Being 0.25%/0.30%/0.35% loan

sanctioned amount.

Signature of Branch Head Counter Signed by RAH Head