APPLICATION FORM FOR HOME LOAN
PNB 1054A (R2)
For office use only
Branch: ___________________
Recent Photograph Recent Photograph
Reference no.: _____________ of Applicant of Co-Applicant
Received on: ___/___/___
Personal Details
Co-Applicant
Information Applicant Relation with Applicant: Parent Spouse Other
Sh. Smt. Km. Others Sh. Smt. Km. Others
Specify others_____________ Specify others_____________
First Name
Middle Name
Last Name
Father’s/Husband's Name
Income Tax PAN No.*
AADHAR No.*
Identification no.(tick any one)*
Passport no. Voter ID
Driving License UID
d d m m y y y y Male Female d d m m y y y y Male Female
Date of Birth* and Gender
Third gender Third gender
Physical Ex-Serviceman Minority Physical Ex-Serviceman Minority
Category
Handicapped None of these SC/ST Handicapped None of these SC/ST
Other; Specify others_____________ Others; Specify others_____________
Undergraduate Graduate PG Undergraduate Graduate PG
Educational Qualification* Professional course Other Professional course Other
Specify others_____________ Specify others_____________
Marital Status and No. of
Single Married No. of Dependants Single Married No. of Dependants
dependents in the household
Email address
__ __
Phone details (STD code – Tel res.)
Mobile No.
Relative of Staff/ Director of bank? Yes No Yes No
Residential Address Applicant Co-Applicant
Residence Address* (Present)
City: State: City: State:
Pin: Country: Pin: Country:
Residence Address* (Permanent)
Same as above
City: State: City: State:
Pin: Country: Pin: Country:
Owned (Self/spouse/ dependent children) Owned (Self/spouse/ dependent children)
Owned (Parents) Rented by Self/Spouse Owned (Parents) Rented by Self/Spouse
Status of current residence
Leased by company/govt. Other Leased by company/govt. Other
Specify others_____________ Specify others_____________
Years at current residence Years Months Years Months
Address for correspondence Current Residence Permanent Residence Office Current Residence Permanent Residence Office
Work and Financial Details
Information Applicant Co-Applicant
Salaried Self employed Professional Other Salaried Self employed Professional Other
Employment Nature
Specify others_____________ Specify others_____________
CA Doctor Engineer/Architect Lawyer CA Doctor Engineer/Architect Lawyer
If professional Small/Marginal farmer Other agriculturist Other Small/Marginal farmer Other agriculturist Other
Specify others_____________ Specify others_____________
Govt./PSU Public Ltd. Co. Pvt. Ltd. Govt./PSU Public Ltd. Co. Pvt. Ltd.
Nature of Organization
Proprietorship Partnership Other Proprietorship Partnership Other
Specify others_____________ Specify others_____________
Period in Current Employment/
Years Months Years Months
Business
Total Employment/ Business Period Years Months Years Months
Date of Retirement (If salaried) Years Months Years Months
Name of Organization/Business
Designation
Office Address
City: State: City: State:
Pin: Country: Pin: Country:
__ __
Phone details (STD code – Tel off.)
If Self Employed/Professional
FY1 (20__ - 20__) FY 1 (20__ - 20__)
Income in last 3 Financial
years*(Rs.) FY 2 (20__ - 20__) FY 2 (20__ - 20__)
(As per Income Tax Return) FY 3 (20__ - 20__) FY 3 (20__ - 20__)
If Salaried/Other
Gross Gross
Annual Income (Rs.)
Net Net
Spouse Information
Name of Spouse Occupation/Profession:
IT assesse & paid tax last yr Non-IT assesse, IT assesse & paid tax last yr Non-IT assesse,
Spouse's financial information* earns but not formally IT assesse but no tax paid earns but not formally IT assesse but no tax paid
Does not earn Does not earn
Total Annual Income PAN no.
Bank Account Details
Account I Account II Account I Account II
(Details of PNB a/c if available)
Name of Bank
Branch
A/c No. (details of salary a/c. for
salaried)
Statement of Assets and Liabilities
Information Applicant Co-Applicant
Assets
Immovable Properties Amount (Rs.) Amount (Rs.)
Building/House
Land
Movable Properties
Cash
Deposits with banks
Investment in government
securities
Others
Total
*Supporting documents duly signed by the applicant should be attached
Statement of Assets and Liabilities (Contd.)
Information Applicant Co-Applicant
Liabilities
Outstanding Loans/Advances Amount (Rs.) Amount (Rs.)
Bank(s)
Employer
Provident Fund
Relatives and Friends
Others
Total
Net Worth (Actual in Rs.)
(Assets-Liabilities)
Information about other Loans taken (including previous loans from PNB)
Total Loan Limit (Rs.)
Total Monthly Repayment (Rs.)
Whether Regular Yes No Yes No
Proposed Loan Details
Information Applicant
Purchase of standalone Plot/land for residential house
Construction of house
Purpose for which loan is required Purchase of Built house/Residential flat/under construction flat
(Details as per enclosure 'A' or 'B') Purchase of plot/land and construction thereon
Carrying out Repairs/Renovation/Addition/Alteration to existing house/flat
Take over loan from other bank/FI
Total Cost of house/flat/construction/repair/renovation/ Total Cost (Rs.) Applicant's contribution/
addition and Applicant's contribution/Margin Margin (Rs.)
Loan Amount applied (Rs.) and Rate of Interest option Floating Fixed
Repayment Period proposed Years Months Moratorium/Holiday Period: Months
Day of every month (First EMI/Interest due date would not be beyond 30 days of account
EMI/Interest to be paid on
opening date)
Monthly Installment Mode Operative Account Standing Instructions Electronic Clearing System/NACH
Other Information
Information Applicant/Co-Applicant
Collateral security proposed Yes No
Type of collateral Property NSC/LIC Policy/Govt. Security Shares
Others
If yes Value of collateral (Rs.)
If yes, then furnish details in Part
Guarantor Available Yes No
II
Pending court cases of Banks/Financial Institutions against Yes No
Applicants/ As Partners/As Director: (Enclose details on an annexure, if needed)
Home Loan Lead Source Detail
Marketing Associates (MA) ; Specify Code _______________
Marketing Consultants (MC); Specify Code _______________
Lead Sourced By Retail Loan Counselors (RLC); Specify Code _______________
Staff; Specify Employee Id _______________
Others; Specify other _______________
*Supporting documents duly signed by the applicant should be attached
I/We hereby request for a loan as above and declare that: The information given in the loan application is true and nothing h as been concealed. The undersigned undertakes to inform the Bank any
change in my residence/office address and to provide any further information that the Bank may require. The undersigned has b een informed of the charges/fee to be levied by the Bank and agrees to
pay upfront fee, documentation charges, etc. as applicable ad charged by the bank. The undersigned hereby agree to be bound by these terms and conditions or by the revised addi tional terms and
conditions which may at any time hereafter be made while the loan obtained by me/us is still outstanding. I have read the attached Most Important Terms and Conditions (MITC) annexed to the
application form carefully and agree to the same.
Yours faithfully,
Signature of Applicant: ____________________________________ Signature of Co-Applicant:_________________________________
Name of Applicant: _______________________________________ Name of Co-Applicant: ____________________________________
Date: Date:
Place: Place:
Note: In case there is more than one co-applicant, he/she should fill up another form.
___________________________________________________________________________________________________________
ACKNOWLEDGEMENT
*Sl. No.________ Date:____________
Received application from Mr/Ms/M/S_____________________________ R/O/Office at_____________________________________________ for a
______________ (Type of Loan) loan/limit of Rs._____________________ for ______________________________ (State the purpose). The loan
application will be disposed-off and acceptance/ rejection would be intimated within ____ days from date of receipt of completed application form with
supporting documents.
Serial number and date of the acknowledgement should be quoted in all future correspondence.
Officer/Manager (Loans)/Incumbent
(Seal of the Receiving Branch)
ENCLOSURE - 'A'
ADDITIONAL INFORMATION REQUIRED TO BE GIVEN IF THE LOAN IS REQUIRED FOR CONSTRUCTION OF A HOUSE OR FOR CARRYING OUT
REPAIRS/RENOVATION/ADDITION /ALTERATION TO THE HOUSE/FLAT
(* applicable only in case of carrying out repairs/renovation/addition /alteration to the house/flat)
Purchase price/acquisition cost of land:
1.
(Please attach attested copy of sale deed /lease deed)
Address, location & surroundings of the house/flat (a rough plan indicating
2.
the location and surroundings of the house should be attached)
Name & Address of the seller(s) /dealer/Housing Society to whom the
3.
payment is to be made
4. Area of land (sq.metres)
5. Proposed built up area
Estimated cost of construction OR repairs/renovation/addition/alteration
6.
(Estimate from qualified Engineer/ Architect be attached)
Particulars of construction OR particulars of repairs /renovation/
7. addition/alteration be given
(Plan approved by the competent authority be attached)
Purchase price/original cost of house/flat as per the sale/title deed in case
the house was constructed by the present owner, the purchase price of
8.
the plot and cost of construction of the house should be separately stated.
(Please attach a certified copy of the sale/title deed) *
9. Present market value of the house/flat *
Whether the plot is free hold or lease hold (In case the plot is lease hold,
10. please state whether the lessee is authorised to mortgage the house -
copy of the letter of authority from the lessor be attached)
Has sanction for construction from the Competent authority been
11. obtained? (If yes, give details and attach copy of plan duly approved by
Municipal Body / Corporation concerned)
Whether the plot on which construction or House on which
12. repairs/renovation/addition/alteration is proposed is free from all
encumbrances whatsoever (Attach non encumbrance certificate)
Whether the place where the property is/will be situated is served by some
13.
Municipal Body/other agency?
14. Any other information
(Not Applicable for Standalone loan for purchasing solar power system)
ENCLOSURE - 'B'
ADDITIONAL INFORMATION REQUIRED TO BE GIVEN IF THE LOAN IS REQUIRED FOR PURCHASE OF A BUILT HOUSE / RESIDENTIAL
FLAT/UNDER CONSTRUCTION OR IF THE LOAN IS BEING TAKEN OVER FROM ANOTHER BANK/FI
Address, location and surroundings of the house proposed to be
1. purchased (Please attach a map/plan of the house)
Name & Address of the seller(s) /dealer/Housing Society to whom the
2. payment is to be made
3. Covered area of house/flat
4. Year in which the house/flat was Constructed /allotted
Whether completion certificate from the competent authority obtained
5. (If yes, attach copy)
Name & address of the present owner of the house / flat
6. (Attach proof)
The price at which the house/flat is proposed to be purchased (Attach
7. copy of agreement to sell / letter of allotment)
Whether the house is built on a lease hold plot. If so, whether
8. authority to mortgage the house is available to the lessee (copy of
letter of authority from the lessor be attached)
In case lease hold property is intended to be purchased on power of
attorney/agreement to sell basis (attach proof):
(a) Whether the vendor is original allottee of the house/flat:
9. (b) Whether the development authority/housing board, etc. which
allotted the property to vendor has a scheme in force for conversion of
lease hold property into free hold property
(c) Whether vendor is in possession of property
Whether the place where the property is/will be situated is served by
10. some Municipal Body/other agency?
Whether the house proposed to be purchased is free from all
11. encumbrances whatsoever (attach non encumbrance certificate)
Please provide the following Name of Bank/FI from which loan
details in case of a take-over is being taken over:
12. loan only Limit (Rs.):
Present Outstanding (Rs.):
(Not Applicable for Standalone loan for purchasing solar power system)
Place:
Date: Signature of the applicant(s)
