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Application Form Two Wheeler Loan
Application Form Two Wheeler Loan
Bank
Application Date: D D M M Y Y Y Y Branch: Branch Code:
2.5 cm 2.5 cm
3.5 cm
Personal Details:
Mr./Ms./Mrs.
Date of Birth D D M M Y Y Y Y
4. PAN: (In absence of PAN, Provide the form No. 60/61) 5. Voter ID Card No.
Landmark:
City:
State:
PIN Code:
15. Residence Ownership: Owned Co. provided Parental Rented 16. Rent per Month: ` _________________________________________________ ____________________
18. Education: Matriculate HS/Dip. Graduate PG & Above Others (Specify) ___________________________
Employer/Business’s Address:
(i) Salaried: Pvt. Sector Govt. Central Govt. State PSU Defence MNC Others (Specify)___________
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(ii) Self-employed: Proprietorship Partnership Other (Specify) __________________________________________________
Relationship with the Applicant: Friend Relative Relationship with the Applicant: Friend Relative
Name:
Address:
Occupation:
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28. Credit Facility Availed with Other Bank/Financial Institution, if any:
Applicant Guarantor
Details of Loans from Other Banks Loan 1 Loan 2 Loan 1 Loan 2
EMI: (In `)
Loan Tenure:
29. If Credit Card Holders, Details of the Credit Card Applicant Guarantor
Cash in Hand:
Immovable Assets/Properties:
Movable Assets:
Other Liabilities:
Income Tax :
Other Deductions:
Net Salary/Income:
Total Income:
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34. Vehicle(s) used
Car Two-wheeler NA No. of Vehicles: One Two More Vehicle: Owned Co. provided Financed
Currently:
Cost of the Vehicle: (Ex-showroom Price) (In `) Maker and Model of the Vehicle:
Declaration
DECLARATION FOR THUMB IMPRESSION/SIGNING IN VERNACULAR LANGUAGE
(This declaration must be signed by a person other than the employee of Bandhan Bank Limited. The Witness should be related to the Applicant)
This is to certify that I have read out the contents of this application form to Mr. /Mrs. _____________________________________________________________________________________
and he/she has understood the same.
Further, I would also like to certify that Mr. /Mrs. ________________________________________________________________________________________________ has affixed his/her thumb
impression or has signed in vernacular language in my presence after I have explained the above contents to him/her. I declare that whatever I have stated herein above is true and
correct to the best of my knowledge & belief.
Date: D D M M Y Y Y Y
Address:_______________________________________________________________________________________________City ________________________________________________________
Declaration
Relationship Declaration: Details of Relationship with the Director/Senior Officer of Bandhan Bank
Name of the Director/Senior Officer _____________________________________________ Relationship with the Director/Senior Officer __________________________________
I/we hereby declare that all the particulars and information furnished in the application form are true, correct, complete and up-to-date in all respects. I/we have not withheld any information. I/we
confirm that I/we had no insolvency proceedings initiated against me/us, nor have I/we ever been adjudicated insolvent and further confirm that I / we have read and understood the contents. I/we
are aware that the fees paid by me/ us are non-refundable. I/we are aware about the rate of interest charged by Bandhan Bank. I/we understand that the document submitted shall not be returned
to me/us. The sourcing channel has not collected any cash or cheque other than PF to be deducted by Bandhan Bank. I/ we also confirm that the Loan proceedings will be utilised for the purpose as
mentioned in the application form and not for any other speculative purpose. I/we also authorise Bandhan Bank or its agents to make references and inquiries related to the information in this
application which Bandhan Bank considers necessary. I/we also authorise Bandhan Bank to exchange/ share all the information relating to my/ our Loan details and repayment history to other
Banks/Financial institutions/ Credit Bureaus/Agencies as may be required, I/ we shall not hold Bandhan Bank liable for use of this information. I/we undertake to inform Bandhan Bank regarding any
change in my residence/employment/occupation/transfer and to provide any other information that Bandhan Bank may require. I/we further agree that my Loan shall be governed by the rules of
Bandhan Bank which may be in force from time to time. Bandhan Bank reserves the right to reject any application without providing any reason. I/we undertake to bear processing, service, documen-
tation charges etc. as stipulated by the Bank from time to time. I/we agree, note and understand that Bandhan Bank shall be entitled at its sole discretion to call back, the entire Loan/advance
whether due and payable or not at any time, without assigning any reason and enforce its rights, remedies and securities.
Date: D D M M Y Y Y Y
Place : ________________________________
Signature of the Applicant Signature of the Guarantor
We have received Two - Wheeler Loan application from Mr./Ms./Mrs. ______________________________________________ ________________________________________________
Place : ________________________________