“ANNEXURE B”

TO BE APPROPRIATELY STAMPED AND NOTARISED

AFFIDAVIT – CUM – UNDERTAKING

I ………………………………………………………………………………………………………
RESIDING AT …………………………………………………………………………………………
…………………………………………………………………………………………………………..
Do hereby solemnly affirm on oath and state as under:
1) That I have applied for housing loan from LIC Housing Finance Ltd., (Loan Application
No…………………………….)For construction / purchase of my house / flat at (Property
address)…………………………………………………………………………………………………
………………………………………………………………………………………….
2) That I or any member of my family does not own any pucca house in any part of India.
3) That the ownership of the property is in the name of ……………………………………………
4) That our total family income does not exceed Rs………………………….. p.a.
5) That my Family members are:
Sl No. Name of Family member Age Unique ID No. (AADHAR
NO.)

6) That I have read and understood all the conditions, rules & regulations, applicable for the
Prime Minister Awas Yojana (PMAY) and that I am eligible for Credit Linked Subsidy Scheme
(CLSS) under PMAY.
7) Further, I/We also undertake that I/We have not availed of Central assistance under any
housing scheme from Government of India.
8) Further I undertake that this subsidy can be recalled if :
a. My account becomes NPA
b. Any condition/requirement with respect to above CLSS under PMAY is not complied
with by me
c. House for which this subsidy is being claimed is not completed within 36 months of
disbursement of first installment of housing loan
d. Any information given by me is found incorrect.
e. In the event of default in repayment of the loan by the borrower/beneficiary and the
loan becoming Non-performing assets (NPA), LICHFL will proceed for recovery of the
dues through such measures as considered appropriate, including foreclosure action.

Name and Signature of Applicant Name and Signature of Co-Applicant

APPLICANT CO-APPLICANT

PLACE :
DATE :