DISBURSEMENT REQUEST FORM

Date : 23/08/2023

Name of Borrower VINOD KUMAR Application ID 10045975

LAN/Agreement No

Flat No/House No Building/House name

Property Address Khata No. - 02, Khesra No.- 1601, Landmark Near Ayodhayaram Mandir,
Mauza Pathara, Ward No. 12,
Thana Mufasil, Thana No.- 372,
Anchal- Nawada, Sub Registry
Nawada, Distt.- Nawada, State
Bihar, Pin code 805123,Near
Ayodhayaram Mandir,,
1601,Nawada,BIHAR-805123
Property Type Residential Pincode 805123

Cheque Favoring Details ARADHYA TRADERS,INDIAN Amount 113380

BANK-7138004612
Payable Location Mode of payment Cheque Printing
Tranche No Tranche 1

I/We understand and agree that Chola shall not be responsible for any dispute that may arise between Builder/Developer/Contractor.

I/We have requested you to debit the Charges/Fees/Pre-EMI payable under the loan transaction in the sanctioned loan amount and such debits
will not affect your right under the loan agreement to charge interest on the loan amount. I/We shall abide by the terms of the loan agreement
and continue to pay the installments in line with the terms of loan agreement.

Customer Signature ____________________

Name of the DST ____________________ DST Signature ____________________