DUAL NAME AFFIDAVIT

I, Mr. /Mrs. / Ms. ___________________________, son / daughter / wife of Mr.__________________________________

Aged ______ Years, Occupation: _________________, R/o__________________________________________________

______________________ do hereby solemnly affirm and state on oath as follows:-

1. I have submitted an application for loan processing in Hero Fincorp Ltd., on _____________________ (DD/MM/YYYY)

2. The name filled in the loan application form is _________________________________(Name as in application form) which is
correct as per _(mention ID proof submitted).

3. My name as per _______(Type of ID proof Submitted) is _________________________ (Name as per ID proof) & as per (Proof
submitted)___________ is (mention name)_______________.

4. The difference in the name is on account of:

a. Mistake occurred/committed by the issuing authority of the ID proof

b. Change of surname after marriage

c. Usage of title

d. Expansion of initials

5. I hereby confirm that the name filled in the Loan Application Form & other loan documents pertains to me.

I do hereby further declare and state as follows:

A. That information given above is correct and nothing has been concealed and I am aware it is illegal and criminal offence to deliberately
furnish false information or suppress information.
B. That I undertake to be entirely responsible for any loss / expenses incurred by the Hero Fincorp Ltd. on account of relying on my
declaration and subsequently make good these losses.

Deponent

VERIFICATION:

The above signature deponent do hereby that the content of my above affidavit are true and correct to my knowledge and belief and nothing
material has been concealed there from:

Verified at _______________ on this __________________ day of ________________ 20___.

Deponent