PART-II
‘CENT SWABHIMAN’
REVERSE MORTGAGE LOAN TO SENIOR CITIZENS
(For Common Application Form & Acknowledgement-Please fill PART-I)

1. DETAILS OF THE PROPERTY/IES TO BE MORTGAGED
A. ADDRESS OF THE PROPERTY
B. OWNERSHIP OF PROPERTY NAME OF THE REGISTERED OWNER/S
1.
2.
3.
C. DESCRIPTION OF RESIDENTIAL PROPERTY Independent House/ Bungalow /Flat/ Other

D. Is the property being used wholly for residential purposes?
If No, please specify details Yes/No
E. Please indicate the Tenure of the property

If ‘Leasehold’, please indicate

Remaining Term

Name of the Lessor
Freehold/ Leasehold

_______________years.

________________________________
F. Permission of the Lessor for mortgage, if required Yes/No
G Type of Construction Brick Mortar/Cement Stone Timber frame

H. Age of the property _________Years

I. LSR DATE BY
J. VALUATION REPORT DATE BY
K. DETAILS OF OUTSTANDING MORTGAGE (IF ANY)
Lender’s Name & Address
Loan Reference Number
Outstanding Balance
Monthly Payment
Due date of repayment of existing mortgage
Is/was the mortgage in arrears Yes/No
If Yes, please give details

L. Have you or your spouse ever
• had a Court Judgement or any other Order for non-payment of a debt issued against you
• incurred mortgage, rent or loan arrears (including credit card)- been refused a mortgage or credit
• been declared insolvent
• entered into any arrangement with creditors or been party to a mortgage where the property has been taken into possession on either a voluntary or enforced basis Main Applicant Co-Applicant
Yes/No Yes/No
If Yes, please give details

If Yes, please give details
Order of discharge by the Insolvency Court, if applicable Enclosed / To follow
Please furnish details of all mortgages against the Residential Property to be mortgaged under reverse mortgage. In the event of the loan application being approved, it will be conditional that any existing mortgage must be redeemed in full. In case of more than one mortgage outstanding please provide details under Section VIII (Additional Information).
M. Is the property adequately insured against losses/damage caused by fire, flood and such other risks, as is usual for residential property?

Please provide details.

N. Does the owner of the Property include any person other than the borrower and his/her spouse
O.
Is any part of the property let or tenanted? Yes/No
P. Other Occupants
Please provide details of person(s) who is/are not a loan applicant(s) (besides the spouse) but will be living in the property during the life of the Applicant/Spouse of the Applicant.

Name(s) of other occupants relationship with borrowers(s)
2. LOAN REQUIRED a. Amount Rs.
b. Loan Purpose c.Period of
disbursement
d. Interest Rate
option Fixed/Floating e. Mode of payment Monthly/Quarterly/Half-yearly/Annual/Line of Credit /Lump sum
f. Initial Lump sum
required.
Rs.________ g. Periodic Cash
required Rs.________

3.
ELIGIBILITY NORMS
Age
Loan as proportion of realizable value of residential property.
60-65 yrs 40 %
66-70 yrs 50 %
71-75 yrs 60 %
FOR OPTION OF MONTHLY MODE OF DISBURSEMENT Regular fixed monthly payments in ____ months.
Chart containing the amount of monthly instalments (calculated on ‘Reverse Annuity Mortgage” basis) to be paid to the borrower for different tenors of loan per lakh of rupees is as under.
Tenor (yrs.) 10 11 12 13 14 15
Monthly Instalment (Rs.) 490 420 360 315 275 240
4. DATE UP TO WHICH UTILITIES /STATUTORY DUES (Municipal Tax, House Tax, Water and Sewerage Charges, Electricity Dues) ARE PAID. ATTACH CERFIED COPY OF RECEIPTS.
5. WHETHER ANY ‘WILL’ ON THE PROPERTY IS EXECUTED? IF SO, DETAILS THEREOF AND ATTACH CERFIED COPY.
6. NAME OF THE LEGAL HEIRS/EXECUTORS/ASSIGNEES TO RECEIVE THE SURPLUS AMOUT AFTER ADJUSTMENT OF LOAN. Name & Address of Legal Heir/ Executors/Assignee Relationship with Applicant (s) Contact details

Papers/documents submitted in support of my/our above submission.
(Please mark tick against each and give details wherever necessary)
a. Original Title Deeds of the property to be mortgaged.
b. Valuation –cum-life certificate from approved valuer.
c. Undertaking not to execute any fresh ‘Will’.
d. Photo ID or Proof of residence in the form of Number
Applicant Co-applicant
i. PAN Card
ii. Election ID card
iii. Pass port
iv. Govt/Defence ID card
v. ID card issued by employers

 
Declaration
I/We declare that all the particulars and information given in this loan application form are true, correct and that they shall form the basis of any loan that (Lender) may decide to sanction to me/us.

I/We have no insolvency proceedings/legal proceedings against me/us nor have I/We even been adjudicated insolvent.

I/We confirm that the said residential property which is used as my/our ‘permanent’ primary residence is self-acquired, self-occupied and not let out/tenanted and there is no third party interest. I/We also accept that the property will not be let out or no third party interest will be created without (Lender)’s prior written consent.

I/We confirm that I/we do not have more than one surviving legal spouse.

I/We acknowledge that the loan requested pursuant to this application will be secured by a mortgage of the property in such form and manner as may be required by the Lender and I/We agree that the loan will not be used for any illegal or prohibited purpose or use.

I/We agree that where a periodic loan disbursement has been requested such disbursements will be credited to the bank account nominated by me/us in Section V. I/We accept that the written consent of all the loan applicants will be required to change the above nominated Bank Account.

I/ We agree that Bank may take up such references and enquiries in respect of this application, as it may deem necessary.

I/We undertake to inform Bank regarding any change in my/our occupation/ employment.

I/We understand that I/We have read the brochure/ terms and conditions of the Reverse Mortgage Loan Scheme of Bank and understood the contents. I/We hereby agree to be bound by these terms and conditions. I/We further agree that my/our loan shall be governed by the rules of Bank that may be in force from time to time.

A draft of the loan agreement of Bank to be executed by me/us has been received and understood by me/us and I/We agree to execute the loan documents as per the terms of sanction of the proposed loan. I/We also confirm to abide by the same.

By signing this application form, I/We agree that any person interested now or in the future in the loan and the mortgage may rely upon the truth and accuracy of the information contained in this application and any supporting documentation, information or security.

Place:

Signature of Applicant Date Signature of Co-Applicant Date

X

X