Key Fact Statement – Personal Loan

Date: 2023-09-15 Name of the Regulated entity: ICICI Bank Limited Applicant Name: SUJIT KUMAR NAYAK
Sr. Parameter Details
No.
(i) Loan amount (in Rupees) 600000
(ii) Total interest charge during the entire tenure of the loan (in Rupees) 11.5 %
Amount: Rs. 190500
(iii) Other Up‐Front Charges, if any (In Rupees)
(a) Processing fees, if any (in Rupees) Rs. 10620.0
(b) Insurance charges, if any (in Rupees) NA
(c) Others (if any) (in Rupees)
(iv) Net disbursed amount ((i)‐(iii)) (in Rupees) 589380
1
(v) Total amount to be paid by the borrower (sum of (i), (ii) and (iii)) (in Rupees) 801120
(vi) Annual Percentage Rate ‐ Effective annualized interest rate (in percentage)
(computed on net disbursed amount using IRR approach and reducing 12.22 %
balance method)
(vii) Tenure of the Loan (in months/days) 60
(viii) Repayment frequency by the borrower Monthly
(ix) Number of instalments of repayment 60
(x) EMI Start Date 10/10/2023
(xi) EMI Due Date 10 th day of each month
(xii) Amount of each instalment of repayment (in Rupees) 13175.0
Details about Contingent Charges (Excluding taxes. Taxes, as applicable, would be additional)
(xiii) Penal charges in case of delayed payments

Charges for late payment 2% per month on overdue account

(xiv) Other penal charges

Pre – Payment Charges a.3% on principal outstanding

amount.
b. Nil after 12 EMIs paid

Cheque /AD/ECS bounce charges Rs. 500/‐

Repayment mode swap charges Rs. 500/‐

Charges in case of default/overdues:

Cash transaction charge for repayment of EMI dues at Branches Rs. 100/‐

Charges incurred in filing legal suit/ Charges incurred in sending different At actuals
notices / Professional Charges

Non Maintenance of Mode of Payment charges Rs. 800/‐

 Other disclosures
(xv) Cooling off/look‐up period during which borrower shall not be charged any 15 days
penalty on prepayment of loan
(xvi) Details of LSP acting as recovery agent and authorized to approach the NA
borrower
(xvii) Name, designation, address and phone number of nodal grievance redressal Name : Mr. Vinayak M More
officer designated specifically to deal with FinTech/ digital lending related Designation : Principal Nodal Officer
complaints/ issues
Address :
ICICI Bank Ltd
Bandra Kurla Complex
Mumbai
400051

Email: digitallending@icicibank.com
Telephone No.: +91‐22‐39337979
1 The difference in repayment amount calculated from the total of instalments given under the detailed repayment schedule i.e.,
₹ 790500 (= 13175.0 * 60 ) (excluding 10620.0 (other up-front charges)) vis-à-vis the amount of
₹ 801120 (₹ 600000 (loan amount) + ₹ 190500 (Interest charges) + ₹ 10620.0 (other up-front
charges) mentioned under (v) is due to rounding off the instalment amount of ₹ 13174.5 to ₹ 13175 under the
detailed repayment schedule.
Please refer KFS: Annexure II (Repayment Schedule) attached separately for detailed repayment schedule.

Repayment Mode Direct Debit Mandate

Important Points:
1. Plus Applicable Taxes and other Statutory Levies if any.
2. The security mandate shall be banked only in case of default in your loan repayment.
3. Instances wherein Disbursement is delayed the EMI amount may change accordingly as the EMI amount varies
basis the gap between disbursement date and the first EMI date.
4. Part Prepayment facility is not available in Personal Loan.
5. Zero pre‐closure after 12 EMIs paid & if closed within 12 months, the pre‐closure charges will be 3% of the
outstanding principal outstanding plus GST.
172.16.9.17 2023-09-15 2023-09-15 15:28:18.393
AD P 0 4 2 3 7 4 6 8

Please use CAPITAL LETTERS only Please Tick wherever Applicable All fields are mandatory

FOR BANK USE ONLY

✔
Application Type: New Update | KYC Number (Mandatory for KYC update request)
✔
Account Type: Normal Simplified (for low risk customers)
PERSONAL DETAILS

Title ✔ Mr. Mrs. Miss Others_________ ✔ APPLICANT CO-APPLICANT

Name M R . S U J I T K U M A R N A Y A K
Maiden Name
Father's Name
Mother's Name R A J L A X M I
Date of birth 0 5 0 7 1 9 7 9 Gender: ✔ Male Female Transgender | Religion:
Customer Category ✔ General SC ST OBC Other _________________| Marital Status: ✔ Married Single Others_____________
Residence Address A - 5 / 7 2 , A I R I N D I A C O L O N Y , V A S A N T V I H A R
A - 5 / 7 2 , A I R I N D I A C O L O N Y , V A S A N T V I H A R
City/Town/Village District
Nearest Landmark
State Code D D PIN 1 1 0 0 5 7 Tel ( R ) - 9 1 9 8 7 3 6 2 3 4
Residence is Self Owned Rented (Monthly rent _______________) Company provided Other __________________
Residence Type Bunglow(B) Row House(R ) Flat(F) Other(O) __________________
No. of years at above residence Yrs Months Tick, if Permanent Address is same as the Residence Address
Permanent Address

City/Town/Village District
Landmark State code PIN
Tel ( R ) - Location Category Rural Semi Urban Urban Metro
Additional Address
District
City/Town/Village State code PIN
Nearest Landmark Tel ( R ) - 9 1 9 8 7 3 6 2 3 4

Mobile No. 9 1 9 8 7 3 6 2 3 4 Email ID SUJIT_NAYAK2001@YAHOO.COM

Gross Income (per annum) PAN No. A D A P N 5 9 0 1 G
Citizenship ✔ IN-Indian Others(ISO 3166 Country Code) No. of Dependents
Residential Status ✔ Resident Individual Non-resident Individual Person of Indian Origin Foreign National

DETAILS OF FACILITY REQUIRED*

Credit Facility Amount 600000 Tenure 60

M M Months

Purpose of Facility Education Travel Occasion in Family Purchase of Household/ Electronic Goods
Home Renovation / Extension ✔ Others ___________________
*Subject to Approval

OCCUPATIONAL DETAILS
Private Sector Public Sector Government Sector
Occupation ✔ Salaried Other ____________________

Company / Employer Name N o t A p p l i c a b l e

Official Email ID
 BANK DETAILS
Primary Bank
A. Name of Bank Branch N E W D E L H I
A/C. No. 0 2 5 0 0 1 5 0 6 0 2 5 UPI/VPA

END USE OF DECLARATION

I hereby represent, warrant and confirm that the loan has been taken for a valid purpose and is not speculative or illegal in any manner. I also declare that funds under
the facility will not be used towards purchase of gold in any form, including primary gold, gold bullion, gold jewellery, gold coins, units of gold exchange traded funds(ETF)
and units of gold, mutual funds etc.
The facility either in part or full will not be used for investment in capital market, land acquisition, acquiring equity shares of Indian company/ ies, buyback of shares of
Indian company, funding of promoters contribution in the project or any other purpose, which is prohibited or any illegal activity.
I further agree, confirm and undertake that the purpose of use of funds under the loan shall not be changed in any manner during the tenor of loan, or that such change
in purpose shall take place only with the prior written permission of ICICI Bank.
I agree that any breach or default in complying with all or any of the aforesaid undertaking(s) will constitute an event of default under the facility documents.
DECLARATION
I/We have no objection to ICICI Bank Limited, its group companies, agents/representatives to provide me/us information on various products, offers and services provided
by ICICI Bank Limited/ its group companies through any mode (including without limitation through telephone calls/ SMSs/emails) and authorize ICICI Bank Limited, Its
group companies, agents I representatives for the above purpose. Please tick Yes or No, as acceptable· Yes ✔ No

COMMON DECLARATIONS
1. I/We declare that all the particulars and information and details given/filled 8. II / We authorize ICICI Bank Limited (ICICI Bank) and their agents to
in this application form are true, correct, complete and up-to-date in all exchange, share or part with all information and data maintained with ICICI
respects and that I/We have not withheld any information whatsoever. Bank relating to my/ our existing account related information including
2. I hereby declare that the details furnished above are true and correct to the existing or prior loans and repayment history to other ICICI group
best of my knowledge and belief and I undertake to inform you of any companies, banks, financial institutions, credit bureau, agencies, mobile
changes therein, immediately. In case any of the above information is found network operators directly or indirectly, statutory bodies and other service
to be false or untrue or misleading or misrepresenting. Iam aware that I providers of ICICI Bank as may be required and I/We shall not hold ICICI
may be held liable for it. Bank (or any of its group companies) liable for sharing such information.
3. I hereby consent to receiving information from Central KYC Registry through I/We further authorize ICICI Bank to submit/disclose the ‘financial
SMS / Email on the above registered number/ email address. information’ as defined in Section 3(13) of the Insolvency and Bankruptcy
4. I/ We confirm that no insolvency proceedings or suits for recovery of Code, 2016 (“IBC”) (including all amendments and replacements made
outstanding dues or monies whatsoever and/ or any criminal proceedings thereto and all rules and regulations framed thereunder) in relation of the
have been initiated and/ or are pending against me/us and that I / we have loan facility availed by me/us to an Information Utility as defined in Section
been never adjudicated insolvent by any court or other authority. 3(21) of IBC. I/We further agree to promptly authenticate and verify the
5. No action nor other steps have been taken or legal proceedings started by ‘financial information’ submitted by ICICI Bank, as and when requested by
or against me/us in any court of law / other authorities for Winding up, Information Utilities
dissolution, administration or reorganization or for the appointment of a 9. I/We understand and acknowledge that ICICI Bank shall have the absolute
receiver, administrator, administrative receiver, trustee or similar officer or discretion, without assigning any reasons (unless required by applicable
for my/our assets. law), to reject our application and that ICICI Bank shall not be responsible/
6. I/We declare that I/we have not made any payment in cash, bearer cheque liable in any manner whatsoever to me/us for such rejection or any delay in
or kind along with or in connection with this application to the executive notifying me/us of such rejection and any costs, losses, damages or
collecting my/our application. I/We shall not hold ICICI Bank liable for any expenses, or other consequences, caused by reason of such rejection, or
such payment made by us to the executive collecting this application. any delay in notifying me/us of such rejection, of our application.
7. l/We understand and confirm that the Application Form and all other 10. Except to the extent disclosed to ICICI Bank herein, no Chairman /
documents submitted by me/us to ICICI Bank shall not be returned to me/us Managing Director or director or a relative/near relation, , of a Chairman /
and ICICI Bank shall have the right to retain the same. Managing Director or director of a banking company (including ICICI Bank
and its subsidiaries) or mutual funds/venture capital funds or a relative/near
relation, , of a senior officer of ICICI Bank, as specified by RBI, is: a partner
of our concern, or a trustee, member, director, manager, employee of our
concern, or of our subsidiary, or our holding company, or a guarantor on
my/our behalf, or holds substantial interest in our concern or my/our
subsidiary or holding company.
For the purpose of this clause the terms “relative”, “near relation” & “senior
officer” shall have the same meaning ascribed to them under the RBI
master circular on Loans and Advances dated July 1, 2015, para 2.2.1.8
and shall include any amendments made thereto.
Details of any such relation as referred to above
_________________________
MR . SU J I T KUMAR NAYAK
172.16.9.17
2023-09-15 15:28:18.393
172.16.9.17 2023-09-15 2023-09-15 15:28:18.393

For Bank Use Only

✔
Personal Loan Facility Application No.: AD P 0 4 2 3 7 4 6 8
Business Installment Loan Date: 1 5 0 9 2 0 2 3

CREDIT FACILITY APPLICATION FORM

(To be Filled by applicant only)
1. INTRODUCTION
1. ICICI Bank Limited (“ICICI Bank”) – Branch / Office address: ..............................................................................................................................
2. All applicants and co-applicants [collectively, “the Applicant(s)”, which expression shall, as the subject or context may admit or require, mean
any or each of the Applicant/s]- whether individuals, proprietary concerns, partnerships, Hindu Joint Family, societies, trusts or private/public
companies or any other bodies or associations (whether incorporated or not), who wish to either avail of financial assistance detailed below
(the “Facility”) from ICICI Bank for any purpose specified below in this Application Form (the “Purpose”) are required to fully fill-in and submit
this Application Form (and along with all other necessary details and documents) to ICICI Bank for applying for the same.
3. ICICI Bank shall be entitled at its sole and absolute discretion to reject/approve any Application Form submitted by the Applicant(s).
4. Upon consideration of the Application Form and all other additional documents necessary or required for consideration of the Application Form,
submitted by the Applicant(s), and if the same is to the satisfaction of ICICI Bank, ICICI Bank shall disburse the requested Facility to the
Applicant(s).
5. The Applicant(s)'s request for the Facility vide this Application Form, and the sanction of the same by ICICI Bank and/or disbursement of the
Facility, shall be subject to and governed by “ICICI Bank Limited's (All-India) Standard Terms & Conditions Governing Unsecured Loans (Regular
and Pre-Qualified Loans)” registered on Registered on April 15, 2009 with the Sub-Registrar-VII, New Delhi/Delhi vide Registration No. 266 in
additional Book No.4 Vol No. 1,402 on page 165 to 173 (hereinafter referred to as the “Standard Terms”), a copy of which has been handed
over to the Applicant, as well as the terms and conditions specified/referred to herein.
6. All capitalised terms used but not specifically defined in this Application Form shall have the respective meanings ascribed to them under the
Standard Terms.
IIA DETAILS OF THE APPLICANT
MR . S U J I T K UMA R N A Y A K Father's Name:..................................................................................................................
Name of Applicant :........................................................................................
A - 5 / 7 2 , A I R I N D I A C O L O N Y , V A S A N T V I H A R
Residence Address :..................................................................................................................................................................................................................................
1 1 0 0 5 7 Landmark:..............................................................................................................................................................
Pin:.............................................................................
919873623460
STD Code:....................................................Tel.:................................................... 9 1 9 8 7 3 6 2 3 4
Fax...................................................Mobile:...............................................................
S U J I T _ N A Y A K 2 0 0 1 @ Y A H O O . C O M
Email ID:....................................................................................................................................................................................................................................................
Address of communication ✔ Residence Office address as stated above (please select)

Facility in the nature of : Rupee Loan

600000
Facility amount: Not exceeding:............................................. Six Lakh
in Words......................................................................................................................................... only.
11.5
Rate of interest:............................................. ELEVEN POINT FIFTY
% per annum in Words......................................................................................................................................... only.
(plus applicable interest tax or other statutory levies ) payable on the date(s) specified in Sectiobelow in relation to the repayment of the Facility.
Tenure: 60
10620.0
Processing Fee: Rs ............................................. Ten Thousand Six Hundred and Twenty Rupees
(in words)......................................................................................................................................... only
(plus applicable taxes or other statutory levies, if any. )
Note: The processing fee is one time fee and is collected by ICICI Bank for the purpose of appraising the application for the
facilty and the same is independent of the outcome/ result of such appraisal.
Purpose of Facility:........................................................................................................................................
Facility is to be disbursed to:
M R . S U J I T K U M A R N A Y A K
Name:........................................................................................................................................................................................................................................................
Disbursement Mode :
Direct credit to ac no. 0 2 5 0 0 1 5 0 6 0 2 5

Note: Fees / charges paid by deducting the facility, then ICICI Bank shall disburse an amount reduced by the amount of fees/ charges; however
the Applicant shall be liable for the Entire Facility amount.

Repayment
13175.0
Amount of each Installment: ...................................................in Thirteen Thousand One Hundred and Seventy Five Rupees
Words........................................................................................................................................only
60
No. of installments ............................................ 10
Due dates(s) :............................................ day of each successive month

10/10/2023
First Due Date : ...................................... 10/09/2028
......Date ............................................
Last Due

Note: The Facility and applicable interest shall be payable/ repayable by the Applicants(s) to ICICI Bank as per aforementioned schedule notwithstanding the
dates(s) of disbursement by ICICI Bank to the person(s) mentioned above.
Mode of payment/ repayment of the Installments
✔ by direct debit from the applicant/'s bank account with the ICICI Bank (“ Direct Debit method/ Reduction against Salary “)

Prepayment Charges
Prepayment Charges: 3%+GST on the outstanding amount.

Charges per EMI Bounce Rs 500, ( Plus applicable taxes or statutory levies, if any.)
Repayment mode swap charges Rs 500, ( Plus applicable taxes or statutory levies, if any.)
Penal interest (applicable on payment defaults) 24% p.a., ( Plus applicable taxes or statutory levies, if any.)
Check Pick-up charges Rs 150, ( Plus applicable taxes or statutory levies, if any.)
Charges for EMI paid in Cash Rs 100, ( Plus applicable taxes or statutory levies, if any.)
Note:
(i) The charges / interest rate(s) specified in this Application Form and / or the other Transaction Documents in relation to the Facility are non- refundable in
nature and the rates are changeable, at the discretion of ICICI Bank, from time to time. ICICI Bank shall endeavour to give notice of such changes.
(ii) The charges for missed due date shall be payable by the Applicant/s to ICICI Bank under the Direct Debit method, or every instance that Installment/s is/
are not paid to/received by ICICI Bank in accordance with the repayment schedule specified above (irrespective of the reasons for such non-payment/
non-receipt).
(iii) The cheque re-presentation charges shall be payable in each instance that any post-dated cheque is dishonoured (under any of the payment modes) and
consequently represented OR in each instance that a post-dated cheque is presented when any Installment/s is/are not received by ICICI Bank by/upon
issue of debit instructions under the Direct Debit method selected by the Applicant/s for any reasons whatsoever.
(iv) GST an all other applicable taxes/ statutory levies, if any will be charged additionally.
(v) Part prepayment facility is not available in Personal Loan.
(vi) Zero FC after 12 EMIs & closure within 12 months will be 3% of the outstanding POS plus GST.

DECLARATIONS BY THE APPLICANT(S)

1. I/We declare that all the particulars and information and details given/filled in this 5. I/We confirm that I/we shall not use the Facility (or any part thereof) for any
Application Form are true, correct, complete and up-to-date in all respects and improper/illegal/unlawful/ speculative/ capital market related activities and shall
that I/We have not withheld any information whatsoever. apply the Facility (or any part thereof) only for the limited purposes 8. specified
2. In addition to the representations, declarations, warranties and confirmations herein. The Applicant shall use the proceeds of the Facility for the
given by me/us in this Application Form, I/we do hereby represent, warrant, make 6. Purpose and shall, if the Bank so desires, furnish a certificate and/ or such other
and confirm to ICICI Bank each of the representations, declarations, warranties valid proofs (including without limitation valid invoices, bills, receipts,
and confirmations set out in the Standard Terms (as defined below) and do acknowledgments, etc.) to the satisfaction of the Bank, in the format and manner
hereby further represent, warrant and confirm to ICICI Bank that each of such acceptable to the Bank, affirming that the Facility has been utilized for the Purpose.
representations, declarations, warranties and confirmations are, true, correct, If for any reason the Borrower finds itself unable to comply with this condition, it
valid and subsisting in every respect as of the date of this Application Form, and shall immediately inform ICICI Bank in writing of the same and the reasons there for
all such representations, declarations, warranties and agreements shall survive and shall, unless otherwise agreed to by ICICI Bank, repay forthwith the outstanding
the execution and delivery of this Application Form, the provision of the Facility balance of the Facility together with interest and all other monies payable in respect
pursuant to this Application Form and the repayment/payment in full of the thereof.
Facility and all monies in respect thereof. Except to the extent disclosed to ICICI Bank herein, no Chairman / Managing
3. I/We hereby expressly authorize and give consent to ICICI Bank to, disclose, Director or director or a relative/near relation of a Chairman / Managing Director or
transfer or part with any of my/our information, (including location), or any other director of a banking company (including ICICI Bank and its subsidiaries) or mutual
device information when ICICI Bank considers such disclosure as necessary, funds/venture capital funds or a relative/near relation of a senior officer of ICICI
with: Bank, as specified by RBI, is: a partner of our concern, or a trustee, member,
a. Agents of ICICI Bank, ICICI Bank’s group entities/ in any jurisdiction; director, manager, employee of our concern, or of our subsidiary, or our holding
b. Auditors, credit rating agencies/credit bureaus, statutory/regulatory company, or a guarantor on my/our behalf, or holds substantial interest in our
authorities, governmental/administrative authorities, Central Know Your Customer concern or my/our subsidiary or holding company. For the purpose of this clause the
(CKYC) registry or SEBI Know Your Client registration agency, having jurisdiction terms “relative”, “near relation” & “senior officer” shall have the same meaning
over ICICI Bank or its group entities; ascribed to them under the RBI master circular on Loans and Advances dated July
c. Service providers, or such person with whom ICICI Bank contracts or 1, 2015, para 2.2.1.8 and shall include any amendments made thereto.”
proposes to contract; (Collectively referred to as “Permitted Persons”) Details of any such relation as referred to above________________________.
For the purposes of: 7. I/We undertake to inform ICICI Bank regarding any changes whatsoever in my/our
addresses as specified here in above or my employment/profession and to promptly
a. Provision of the facility and completion of on-boarding formalities; or
provide such further information that ICICI Bank (or its designated group companies
b. Complying with KYC requirements; or
or agents or representatives) may require.
c. Compliance with applicable laws or any order (judicial or otherwise),
8. I / We authorize ICICI Bank and their agents to exchange, share or part with all
statutory/regulatory requirement; or
information and data maintained with ICICI Bank relating to my/ our existing
d. for credit review of facilities availed; or
account related information including existing or prior loans and repayment history
e. authentication or verification; or
to other ICICI group companies, banks, financial institutions, credit bureau,
f. research or analysis, credit reporting & scoring, risk management,
agencies, mobile network operators directly or indirectly, statutory bodies and other
participation in any telecommunication; or
service providers of ICICI Bank as may be required and I/We shall not hold ICICI
g. electronic clearing network and for use or processing of the said information/
Bank (or any of its group companies) liable for sharing such information
data.
9. I/We have fully read and understood the Standard Terms copy of which has been
h. Disclosing any default in payment, for the purposes of recovering such
been provided to me/us.
amounts.
10. I /We acknowledge and agree that the grant of the Facility by ICICI Bank to me / us
4. I/We confirm that no insolvency proceedings or suits for recovery of outstanding shall be subject to compliance by me / us of the Standard Terms and the terms and
dues or monies whatsoever or properties and/or any criminal proceedings have conditions set out under this Application.
been initiated and/or are impending against me/us and that I/we have never been 11. I/We further authorize ICICI Bank to submit/disclose the ‘financial information’ as
adjudicated insolvent by any court or other authority. I/ 7. we have not taken any defined in Section 3(13) of the Insolvency and Bankruptcy Code, 2016 (“IBC”)
action and no other steps have been taken or legal proceedings started by or (including all amendments and replacements made thereto and all rules and
against me/us in any court of law / other authorities for the appointment of a regulations framed thereunder) in relation of the loan facility availed by me/us to an
receiver, administrator, administrative receiver, trustee or similar officer or for Information Utility as defined in Section 3(21) of IBC. I/We further agree to promptly
my/our assets. authenticate and verify the ‘financial information’ submitted by ICICI Bank, as and
when requested by Information Utilities.
I/We further authorize ICICI Bank to submit/disclose the ‘financial information’ as defined in Section 3(13) of the Insolvency and Bankruptcy Code, 2016 (“IBC”)
(including all amendments and replacements made thereto and all rules and regulations framed thereunder) in relation of the loan facility availed by me/us to an
Information Utility as defined in Section 3(21) of IBC. I/We further agree to promptly authenticate and verify the ‘financial information’ submitted by ICICI Bank, as and
when requested by Information Utilities.

Following term stands amended as follows- “Transaction Documents” include all writings and other documents executed or entered into, or to be executed or entered into, by
the Borrower(s) or any other person or any other document executed or issued by ICICI Bank/Bank in relation, or pertaining, to the Facility and each such Transaction
Documents as amended from time to time.

For detailed privacy policy of ICICI bank, please visit https://www.icicibank.com/privacy.page

ADDITIONAL DECLARATION:
I/ We have read and understood the concepts and illustrations in relation to due dates, classification of borrowal accounts as SMA (special mention account), NPA
(nonperforming asset) as detailed in Annexure[1]. I/ We further understand that the clarifications/examples mentioned in Annexure are only illustrative in nature covering
common scenarios and the norms and clarifications provided by Reserve Bank of India from time to time will prevail.

Execution/Signature/Affixation of thumb print by/of the Applicant and Co-Applicant

172.16.9.17
MR . S U J I T K UMA R NAYAK
2023-09-15 15:28:18.393
 ICICI BANK DIRECT DEBIT EMI & SECURITY MANDATE FORM
DATE 2023-09-15

FROM
Customer Name MR.SUJIT KUMAR NAYAK
Customer Address PLOT 3657, PRACHI VIHAR
PO RASULGARH

TO
ICICI Bank Limited.,
---------, Branch, _______
BHUBANESWAR , City.

Ref: Account No.: 0 2 5 0 0 1 5 0 6 0 2 5

Dear Sir,
I/We would like to inform you that we have taken a Personal Loan Division pursuant to the Credit
Facility Application Form (No. _____ dated ____ 15-09-2023 _ (the "Application Form") OR
Facility/ Loan Agreement dated ________
15-09-2023 (the "Facility Agreement"), submitted to
ICICI Bank Ltd. You are hereby authorized to debit the above mentioned account and credit ICICI
Bank Ltd. -loan account number ________ on receiving instructions from ICICI
Bank Limited Personal Loan Division towards: (i) the repayment of the Facility, the Equated Monthly
Instalment, instalment(s), Pre EMI interest, all interest and other charges payable by me or to you
over the entire tenure of Facility ("EMI Mandate") and/ or (ii) any default committed by me in
repayment of dues ("Security Mandate"). The abovementioned account will be debited with the
amount Rs__________
13175.0 � per month for repayment of dues (Rupees
only) and/or with the amount ----------------------
Thirteen Thousand One Hundred and Seventy Five Rupees
Rs. ____
790500.0 _ (Rupees __________________
Seven Lakh Ninety Thousand Five Hundred Rupees only) for
default in repayment of dues, as the case may be, w.e.f. 10/10/2023 over the entire
tenure of the Facility.
In the event of the above account getting closed/transferred for any reason, I/We will intimate to
the bank the new account opened with the bank to debit the loan repayment amounts. Further,
I/We undertake to submit the fresh set of Mandate for such new account, in lieu of existing
instructions.
We are requesting and hereby authorizing ICICI Bank Limited Personal Loan Division to forward this
to you after affixing the signatures of their authorized person(s) to signify their approval for the
above instructions and agreement to give effect to the above.
Please note that the Security Mandate will be invoked & banked only in specific circumstances
such as customer failing under default, exceeding overdue limit, etc. In case of default, outstanding
amount including overdue interest, bounces and other charges, if applicable, will be debited.

Thanking you,
yours truly,
MR.SUJIT KUMAR NAYAK

Customer Name :
(Account Holder/s)
 ANNEXURE I

Classification as Special Mention Account and Non-Performing Asset-

Lending institution (i.e ICICI Bank) will recognize the incipient stress in loan accounts, immediately on default, by
classifying them as SMA.

The basis of classification of SMA category shall be as follows:

LOANS IN THE NATURE OF TERM LOANS LOANS IN THE NATURE OF CASH CREDIT/OVERDRAFT

SMA Sub-categories Basis for classification- SMA Sub-categories Basis for classification -
Principal or interest Outstanding balance remains
payment or any other continuously in excess of the
amount wholly or partly sanctioned limit or drawing
overdue power, whichever is lower for the
period of

SMA-0 Upto 30 days

SMA-1 More than 30 days and SMA-1 More than 30 days and up to 60
upto 60 days days

SMA-2 More than 60 days and SMA-2 More than 60 days and up to 90
upto 90 days days

Non-performing Asset-NPA ias a loan or an advance where:

• interest and/or instalment of principal remains overdue for a period of more than 90 days in respect of a term loan,
• the account remains ‘out of order’ as indicated below, in respect of an overdraft/cash credit(“OD/CC”),
• the bill remains overdue for a period of more than 90 days in the case of bills purchased and discounted,
• the instalment of principal or interest thereon remains overdue for two crop seasons for short duration crops,
• the instalment of principal or interest thereon remains overdue for one crop season for long duration crops.

‘Out of Order’ Status:

An account shall be treated as ‘out of order if:

• the outstanding balance in the OD/CC account remains continuously in excess of the sanctioned limit/drawing
power for 90 days;
• the outstanding balance in the OD/CC account is less than the sanctioned limit/drawing power but there are no
credits continuously for 90 days, or the outstanding balance in the OD/CC account is less than the sanctioned
limit/drawing power but credits are not enough to cover the interest debited during the previous 90 days
period.
Illustrative movement of an account to SMA category to NPA category based on delay I nonpayment of
dues and subsequent upgradation to Standard category at day end process:

Due date of Payment Payment covers Age of SMA/NPA SMA since NPA NPA
payment Date oldest Categorisation Date/SMA categorization Date
dues in class date
days
01.01.2022 01.01.2022 Entire dues up to 0 NIL NA NA NA
01.01.2022
01.02.2022 01.02.2022 Partly paid dues of 1 SMA-0 01.02.2022 NA NA
01.02.2022
01.02.2022 02.02.2022 Partly paid dues of 2 SMA-0 01.02.2022 NA NA
01.02.2022
01.03.2022 Dues of 01.02.2022 not 29 SMA-0 01.02.2022 NA NA
fully paid 01.03.2022 is
also due at EOD
01.03.2022
Dues of 01.02.2022 fully 1 SMA-0 01.03.2022 NA NA
paid, Due for 01.03.2022
not paid at EOD
01.03.2022
No payment of full dues 31 SMA-1 01.02.2022/ NA NA
01.02.2022 and 03.03.2022
01.03.2022 at EOD
03.03.2022
Dues of 01.02.2022 fully 1 SMA-0 01.03.2022 NA NA
paid. Due for 01.03.2022
not fully paid at EOD
01.03.2022
01.04.2022 No payment of dues of 60 SMA-1 01.02.2022/ NA NA
01.02.2022 03.03.2022
,01.03.2022 and
amount due on
01.04.2022 at EOD
01.04.2022
No payment of dues of 61 SMA-2 01.02.2022/ NA NA
01.02.2022 till 02.04.2022
01.04.22 at EOD
02.04.2022
01.05.2022 No payment of dues of 90 SMA-2 01.02.2022/ NA NA
01.02.2022 till 02.04.2022
01.05.2022 at EOD
01.05.2022
No payment of dues of 91 NPA NA NPA 02.05.2022
01.02.2022 till
01.05.2022 at EOD
02.05.2022
01.06.2022 01.06.2022 Fully Paid dues of 93 NPA NA NPA 02.05.2022
01.02.2022 at EOD
01.06.2022
01.07.2022 01.07.2022 Paid entire dues of 62 NPA NA NPA 02.05.2022
01.03.2022 &
01.04.2022 at EOD
01.07.2022
01.08.2022 01.08.2022 Paid entire dues of 32 NPA NA NPA 02.05.2022
01.05.2022 &
01.06.2022 at EOD
01.08.2022
01.09.2022 01.09.2022 Paid entire dues of 1 NPA NA NPA 02.05.2022
01.07.2022 &
01.08.2022 at EOD
01.09.2022
01.10.2022 01.10.2022 Paid entire dues of 0 Standard NA NA STD from
01.09.2022 & 01.10.2022 Account with 01.10.2022
No Overdues