= =22 AMBIT Finvest Pleose fill in all the required details in BLOCK LETTERS Tick GZ boxes as applicable Fragati-ke/partner eecklaen Tisecured — CJunsecured L]vehicle Finance Loon Application Ne. Look Airitint i OO Required Tenor in Months ibavceiagsty (new Ctop-vp Dlused cy Cused cor] Used Tractor 1287998 Clothers others, please specify Purpose of Loan Dote of Incorporation Constitution Or PAN No. TAN No. GST No. Office Type Registered Address Ciy Stote Tel. No.1 Mobile Operating Address City Landmork State Tel. No.1 Mobile Email Clossification LiMicro| Lismeit Medium ‘Monufacturing Investment in Plan’ ond Investment in Pont and Investment in Plont and Enterprises and ‘Machinery or Equioment Machinery oF Equipment: Machinery oF Equipment: Enterprises rendering Not more thon Rs. 1 crore and | Not more than Re.10 crore Not more than Rs. 50 erore Services ‘Annual Turnover : not more and Annual Turnover : not «and Annual Tumever : not than Rs. 5 crores more than Re. 50 everes more than Rs. 250 crore 1 ApplAmbi¥ct 21ver 1.0= AMBIT Finvest Pragati ke partner Noture of Business ] Menufacturer Service Provider Retailer Wholesaler INDUSTRY TYPE (TICK THE RELEVANT BOX): Agriculture & Allied Activity Food 8 Restouront Professional Services Automobiles Healthcare Reo! Estote Chemical Industrie! Intermediote Goods Rentol/Accomodation Computer Jewellery Rubber Construction Material Leather Textiles Consumer Goods [Metals Transportation Contractor Other Services ‘Wood & Weoden Products Education Insitute Paper [) Biecice & electronics Petroleum Products [] Finonee Plastics [INDIVIDUAL DETAILS ‘APPLICANT _CO-APPLICANT / GUARANTOR™** Name Relation with Applicant « FathersSpouse Name Boniness Details (Gabe filed cases of CV Loany | TR8POrter No of Vehicles —_______| Transporter: No of Vehicles "actor loan) Experience in Years —________| experience in Years pie cate voters id caro: voters id card No. Passport No: | Passport io Vali Ti: abd Ti [driving ueenceNo:__ | ving ticence No Valid Tit Valid Til ewe no, | Darr io, PAN Card No: Date of ith (DOM ‘Mothers Maiden Name itzenship| Nationality Sue Orson Ona Tire Cresent Ona Oro Retigion== otis] usin ith Dhinds I nusim sith Cletwistan 2 Jain Cleusdrst | Dhenriian 2 sain Cousdnst Dotter (ts specify) others (ts speci Gategonr isonet Ose Ost Cw Cone Licerert Cise Ost Cnr Chose Gender Coma iterate Ci tansgender | Cimole _Lifemale _ L] tanigender Marital Statue No.of Dependants Eaueation Institute’ University ApprAmbitOct 21/er 1.0== AMBIT Finvest Pragati ke partner ‘CO-APPLICANT / GUARANTOR'** tandmark City: ‘State cy Emaild Ema Contact Detals| STD code: Te Res) ‘STD code Teles) ‘Maile No: Mobile No ype of Residence Lisettowned []Rental Monthy Rents, Liset-owned C]Rental Monthy Rent Rs Parental Clemployer Provided Paying Guest CoParentsi_ Clemployer Provided [Paving Guest ‘Address: 2 Tandmare ‘andar cry Pincode: chy Pincode Emad Type of Residence [iselt-owned Cental Monthly Rent As Dsettovmed lRental Monthly Rent Rs Bearental Clemployer Provided C)Paying Guest CiParentai Clmployer Provided []Paying Guest Year of Residence at Address -2 ys. months Leena mnths ‘Office / Business Address Tanda ‘andrmark cy: State Picode: iy ‘Sate Pincode Email Emailed Occupation Seloved Cicot. Corinate ClPublic Seltempioyed [)Sel-employed Professional yi_[ others Pease Speciy Settemgloyed L)Seitemployed Profesional [Saved CiGovt Clervate Copublic ci [J Others, Please Specify Peed in Curent émpiyment/ Busnes yts__months yrs__months Total Employment Business Peed _——"s____months months ‘Monthy income other income Communication Address Dl aderess:1 Caddress: 2 Cy offceBusiness Address (Di Address: 1 ClAdidress: 2 T offceBusiness Address AADHAR DECLARATION : (name ot plcant/o-Applcant) (Namect Applicant /Co-Apelcant) Tere sib volun at my on aacetion, Re pips copy of selvatested Aachsor cardphyscal @-Aadhaar / ‘asked Abdhaor/ fine electronic Aaghaar aml asisued by Uibaladhaay, to Ambit FinvestPrvate Limited (Company) ‘forthe purpose ct enabiahing mysenttyadstess p00! ‘if Company/s KYC requerment. nove redactewbacked futimy Aadhaor sumer on the Aedhaar copy wh beng haredath tha Company. Signatur: Name Tarebysubmit voluntariyat my own duction the phyical copy of selratested ahaot cea/physal e-Aadhaar / ‘asied Asghaa’/ fie secyorlcAaahaar amas issued by (iba dadhaar to Ambit Finvest Private Limited (Company) ‘or the purpose of establishing my identity adress proo, to {uti Company’skYC requirements ave edacted/blacked ‘uty Andhaae umber onthe Aadhasr copy when being ‘Sharedaath the Company. Signature: Name: AppiAmbitoct 21¥er 1.0== AMBIT Finvest Pragati ke partner FINANCE SCHEME DETAILS: ms eae vice Model No of Uns | ‘Cort of Vehicle Total Loan Amount Cost of Body Tenure in Month ‘Year of Manufacture if Used) IR per Customer Tal cov per Unit Tal EM lean Amount per Unt (Rs) Ei per unis) INVESTMENT/ASSET DETAILS OTHER LOANS TAKEN (existing and Proposed) (Peas attach extra shee if required) ‘APPLICANT __|co-mmucumTicuaRanTon] APPLICANT — — ‘wpectcan | Set on ek an Shares &Secuies ) PE Balance Fixed Depots Oe Other Assents |cer Citwe wheter | [7]car two Wheeler = BANK ANC DETAILS (i Moce than One AC. Pleas attach en shee feared) APPLICANT. | CO-APPLICANT/GUARANTOR = RPS Name of AC Hater ame of AC Holder Name of bank Branch Name of Bonk Branch AE Ne. ‘AC Tipe RCN. NC Type Operative See Operative Se PROPERTY DETAILS [] (In ease of Mortgage Loan) [_](In case of Vehicle Finance Loan) PROPERTY-1 000 ON Type ot ropeny residents! C] commer] me Usage [1] Agrutue Land: Jz acre CJaaacee Cl>aacre Status ofthe Property Cisettoecupied rented] vacant Property Address [ OO Landa OO500 J city [ ] Pin code OD | Property Age Lvs Property Construction Area Property Land Area III oa. estimated Property va din 8) ‘Acknowledgement for Application Form: 128799 Nome of the Applicant ‘Application No: Date of Application: Location | AFPL Contact Person: Contact No: Date of Receipt: Signature of AFPL Official: AFPL would require @ processing time of approximately working days/woeks from the date of receipt of the completed application. 4 AppyambivOet 21)" 1.0== AMBIT Finvest Pragati ke partner ee er eee ee [REFERENCE DETAILS (ONE REFERENCE HAS TO BE NON - RELATIVE/NON - COLLEAGUE) Name : Relationship Adress Landa STD Code: Mabile Ne. Email if ay AppiAmbivoct 21Ver 1.0= AMBIT Finvest Pragati ke partner z x igo Wa Branch Name. DSA Code. Sales Manager Name Sales Executive Name. Date DSA Signature Sales Executive Signature Documents Received] Certified Copies KYC VERIFICATION CARRIED OUT BY Date Emp. Name: Emp. Code Emp. Designation i Emp. Branch : Employee Signature ‘CUSTOMER DECLARATION {We certify that all the information furnished by melusis true and correct. We undertake to inform you of ay changes therein immediately. There is no overdues/statutory dues against me/us promoters except as indicated inthe application; that no legal action has beens being taken against me/us. That We shall furnish all the other information that may be required by you in connection with my/our application; that ‘this may be exchanged by you with any agency you may deemed fit, and you, your representatives of RBlor any agency as authorised by you; may et any time, inspect, verify my/our asset books of accounts etc in your offcetactorybusiness premises as given ahove. The Borrower{s/Guarantor(s)agree(s) to have given his/her express consent to AFPL to discloseallthe information and data furished by them to receive information from Central KYC Registry third partes third partes including but net limited to vendors, outsourcing agencies, business correspondents for analyzing, processing, report generation, storing, record keeping orto various credit information companies / credit bureaus eg. Credit Information Bureau (India) Lt (CIBiL), or to information utilities under the Insolvency and Bankruptey Code 2016 through physical or SMS or Email or any other made. The Borrower(s)Guarantor(s) further agree(s) that they shall execute such addtional ddocumentsas may be necessary forthe purpose. Ve shal immediately inform the company when my/our residential status changes. {We confirm that Ye do not have any existing D/customer id apart fom the one mentioned above and incase found otherwise: Company reserves the right o consolidate the customer ids under a single custome id as itmay decide, without prior notice to meus We undertake the proceeds of this facity shall not be used for any illegal andor antisocial andlor speculative purpose including but not limited to participation in capital market. In cae of any falsification of information related to any applicable statute/aw including Goods and Services Tox (GT) mentioned herein, I/We would be solely responsible for consequences thereof. WWe also hereby undertake to indemnify [AFPL and its directors and officers with respect to all the statutory and other lablities/penaltiesfines that may be levied on AFPL or its directors or officers under such Actisaw\s} du to non-compliance/mis-representation by meus The rate of interest and the approach for gradations of risk and rationale for charging different rate of interest to different categories of borrowersis disclosed the Interest Rate policy of Ambit Finvest Private Limited available onits website wnweambit.co. \We arvarehereby submitting and shall submit the KYC documents, required by AFPL We also confirm that LWe have been explained the following. 1. AFPL may at its sole discretion sanction or decline the application. No| ‘commitment has been given to me/us with regard to sanction of theloan, 2. AFPLwilldecide and assign the oan limit and no commitmenthas been givento ‘Aopcant recent Co-apolant) Guarantor me /usforsame. pager cert passport size protograph Sze photograph 3. The Channel has not collected any commission / brokerage or any ather fee by| tobe pated to be pastes ‘way of cash or cheque other than the cheque no. towards tied as =tgpetooe in favour of! ‘Ambit Fnvest Pt Ltd 4. Processing Fees of will not be refunded in case of ‘ejection’withdrawal ofthecase 5. Schedule of charges has been given to metus for same. Slanature of Avlcant Srature of Co-eaplcanvGuarentor Place: Date: Campy Sia Sight tr emp et ei Applicant: Co-Applicant / Guarantor 6 ‘ApplAmbivOet 21ver 1.0