eRibir APPLICATION FORM TOQOAQODOC AR Sone *Vo2COAFSS05SS1510 ‘Contract No. 3905531599 _ pos code: 011260280 SA Code 0312 Dato _ 15/07/2019 ‘APPLICANT DETAIL Name YASH VISHWAKARMA Gender Male Fathers Name RAJESH VISHWAKARMA Dato of Binh 19/1172000 Mothers Nemo ANU VISHWAKARMA Profession White collar ob Economical Status _ Salaried - Other NotIncome Re. 18,000.00, APPLICANTCCONTACTS Mobile 602234037 ‘emma aaaress| CCorespondence Address H NO 821, foor 0, C SECTOR SHAHPURA NEAR BANSAL HOSPITAL HUZUR [BHOPAL TRILANGA MADHYA PRADESH, NEAR BY BANSAL HOSPITAL, Bhopal, Bhopal Residential Adkess __HINO..821, oor, © SECTOR SHAHPURA NEAR BANSAL HOSPITAL HUZUR ‘BHOPAL TRILANGA MADHYA PRADESH, NEAR BY BANSAL HOSPITAL, Bhopal, Bhopal, Madhya Pradesh, 452039 ‘Yer. would Bk to obain the fit for applying and obtaining Loan from Horne Cre nda France Private Limited (HCN) ove the phone, era ms, ‘ei customer port (a. Contact Options) espe the appcable terme and condone of HCI. REFERENCES —ContactRelaion ‘Name ‘Contac phone numbers Close family porson [MANISH VISHWAKARMA, 8962812663 Fiend/ColeaguelRelaive _-SHIVAMX 6260522660 ‘here conte tht thave the parmiesion trom the aforesaid persons for providing ir contact data o HCN fo cain ham in eepact of vericaton of my eto spain rm tora Heo samy eal pt ne ptt em awh ren pose ne ie or ‘iettion and updating purpose. ‘DOCUMENTS TO PROVIDE WITH LOAN APPLICATION dom & Ares Prot PAN Ferm 60 (es apes), Aathaar (ashe), Ean Satara, Bark Passbook, Passport. Ding zones, Vee 1, Uy BL, RREGA sob Cav, Ler soed ty Neral Popaton Reger cananing name & edt, Goverment Howse Aloeent Lote, Property tunica Tox Recait Income rot (whee appa: Income tax au Sere, Bank taeman shoving Salary cust ‘Document Type ry PAN Car (OVD) BPZPYTESGA CCancoled cheque UD Ada Prot 7226 understand confi thatthe Appin Farm icogreoh anda de dooumens suited by eo HCIN sal not be eum ome ad HOIN sol are he ah {Stat iy sre Fue, undertaieoifem HCN win 7 dys ef any change any ofthe delat manned hr ‘TORN DISBURSAL DETAIL {Thereby submit the detail of my bank account forthe purpose of disbursing Loan Amount in case the loan application is approved by HCIN, Bank Account No. 2178010110072 Bank's Branch KOLAR ROAD ‘Account Type SA Bank Name UCO BANK ‘Account Holders Nome YASH VISHWAKARMA LOAN DETAIL | declare that | have applied forthe loan as per following detall whichis ax per my requirements, Loan Amount (Rs) +,s0a0000 Flt etorost Rat 282% pa. Termefthe Loan St ments MIR.) sert.00 Safe Pay Fee Per Month (Re:) 32500 Monthy instalment (Rs) 506.00 Processing Fee (Rs) -eon.00 Number of vance instalment 0 ‘Advan Instaiment (Rs) ° [Number of Monthy instalment 61 Payment frequency Monty Loan Purpose Trvecment-Now Business ue Date ‘sino evry nonin | conf at hae ape ova ae sree (SAFE PAY) ar careful) undestacing fhe ems &conons fr SAFE PAY as avalon webs of HIN i. Sccitomesrdtcotnearparte-goemance end ages to uncondionay abi yt sera. futher understand and agree tha Lot ensue under Grup Lie [Rane chore of HN, be SAE PAY ow tal a nade the smo of nsrance prt ae encnednnsrsnoe appar Cricat of rence DECLARATION 1 Ther nen at a eee fn nd emote heh rn sige xed he Repleon Fem nd a tr omer pape crn ‘Sela af custard pesosg prea pees tec oe Se eva sso oisacs ees cbemennwhrge ow ha Coins Opn by me, avon. conc nd ano a emai a me ‘eehetteoreees [TTREEPETTSS snag tt ten fm a tng tc an ay orion! Py ay 8 ot Ray ares fon ra a ef HCN ew era Sigel el om sn ee une sn bs Gea Tm ard Codua ie tatareg Perodua PON ey MEM ase he Bono ei ee cas Sets she Refers Ns S60 det "822018 (STCY 1 ony et HEN Sa ee eat ry on wi 2 ann mune ae eve be hte cher | cae at ot of otandg dom rman toa ad cl omen Soe ers et me Werle see ne ntfs be er, om HC a pnp cae eb ney ean Pe CR Hae esl bce pope geting kr tr pute py fon pa uso, a ay. ce og EIR ‘ets enh ony chge nh a ot nar and on sharpest ic ey pomp. TNomercoten fl HOM vce cgee der Hh Lo nur ny aa kt don be rented at a Bean ron, ACKNOWLEDGMENT TO THE LOAN APPLICATION. ‘Wo, Home Crest nda France Pate Lined CIN} acknowlage the recap of au eppoaton fo ioan rom us. The re pai of prcesing te apoan 615 We .to8. ae separ ning a equred worst liga rqured mealies ard execuon off ecumets regired by HIN. In dro escrn e ‘les ou poten, pose cortact ar el ore at 0126652868 ora examen, ate 150772018 Applicant's Signature Place BHOPAL Yd