Branch

Repco Home Finance Limited

(Promoted by REPCO Bank - Govt of India Enterprise)
Regd. Office : No.33, North Usman Road, T Nagar, Chennai - 600 017.
Home Finance
Corp. Office : Alexander Square, No.2 (Old No. 34 & 35) 3rd Floor,
CIN No.: L65922TN2000PLC044655 Sardar Patel Road, Guindy, Chennai - 600 032.

GUARANTOR FORM
This is part of Guarantor Photo
Application ID Loan Amount Rs.

From :
Passport
Mrs. / Mr. Size Photograph
with Signature across

Pincode :
To :
Customer ID
Repco Home Finance Limited
Branch
Sir / Madam,
I offer to stand us guarantor for the loan facilities extended / to be extended by you to Mrs. / Mr,
and furnish the particulars here below

Personal Details
Particulars Guarantor
Name
Father’s / Spouse Name
Relationship with Applicant / Co-Applicant
Date of Birth Educational Qualification :

Age & Gender Age : Gender: Marital Status :

E-mail ID : Residential Address

Mobile :.......................................
PAN No.:......................................
AADHAR No................................ No. of years in current residence :................
Community : GEN / OBC / SC / ST Residence type : Owned / Rented / Quarters

Repatriate - Yes / No. If yes, give Membership No.

Employment / Business Details

Particulars Guarantor

Occupation □ Salaried □ Self Employed □ Business

Name of Employer / Business Designation :

Office / Business Address

& Phone No.

Official / Business Email ID

No. of years in present service/ Business Vintage : years Name of the Bank.
Monthly Income Rs. Account No
Declaration
I/ we hereby declare that the particulars furnished by me / us herein above are true to the best of my / our knowledge and belief
l/we have read and verified the entire contents of the Loan Application Form, Guarantor Form and further agree, acknowledge, accept and confirm the same.

Date
Signature of Guarantor
Place :
RH-4 Guarantor Form 1
V

Repco Home Finance Limited

Repco (Promoted by REPCO Bank - Govt of India Enterprise)
Regd. Office : No.33, North Usman Road, T Nagar, Chennai - 600 017.
Home Finance
Corp. Office : Alexander Square, No.2 (Old No. 34 & 35) 3rd Floor,
CIN No.: L65922TN2000PLC044655 Sardar Patel Road, Guindy, Chennai - 600 032.

Details of Assets & Liabilities - Net Worth statement of Guarantor

Name of the Guarantor

(A). Assets
1. Details of Immovable Properties

Building/Flat/Plot Number Market Value Encumbrance

Property Address / Location
& Area (in sqft) (Rs.) (if any)
a).

b).

c).

2. Value of Movable assets (Car/Two wheeler/Commercial Vehicle etc) Rs.

3. Other Liquid Assets

Fixed Deposits Rs Gold Ornaments Rs. Mutual Funds / Shares Rs

PF/PPF : Rs LIC (Surrender Value) : Rs. Cash in hand / Bank Rs

(Others) Please specify. Rs Total Rs.

A). Total value of Assets (1 +2+3) = Rs. Lakhs.

(B). Liabilities
Type of Loan / Name of Sanctioned Date of Balance Rate of EMI / Monthly Account
Facility Institution Amount Sanction Outstanding Interest Repayment Status
Rs. Rs. (%) Rs. (Regular/0D)

Total

B). Total Liabilities : Rs. Lakhs.

Net Worth

A). Total Value of Assets Rs Lakhs

B). Total value of Liabilities Rs Lakhs

Net Worth (A-B) Rs. Lakhs

RH-4 Guarantor Form 2