HOUSING LOAN APPLICATION FORM (INDIVIDUAL)
PERSONAL AND EMPLOYMENT DETAILS
NAME
APPLICANT CO-APPLICANT
Surname First Name Middle Name Surname First Name Middle Name
Current Residential
Address
Pin code:
Pin code:
Phone No. Relationship with applicant
e-mail Adress
Date of Birth Age Yrs Age Yrs
Sex ı Male ı Female ı Male ı Female
Marital Status ı Single ı Married ı Single ı Married
Status ı Resident ı Non-Resident ı Resident ı Non-Resident
No. of Dependants ___ Children ___ Others ___ Children ___ Others
PAN Card No.
Qualifications Matric /Under-Graduate/Post-Graduate/ PhD Matric /Under-Graduate/Post-Graduate/ PhD
Occupation ı Employed ı Self-Employed ı Employed ı Self-Employed
Employer / Business
Name & Address
(Please mention the
address of the office
you are based at)
Pin code:
Pin code:
Designation and
Department
Employee No.
Employee No.
Office phone no. Ext. Fax: Ext. Fax:
Monthly Salary Income Rs. Rs.
Other Income Rs. Source Rs. Source
No. of years in present
Occupation
_______ Yrs
Retirement Age: _______ Yrs
_______ Yrs
Retirement Age: _______ Yrs
Status of present
accommodation
Own / Rented / Family / Employer
LOAN REQUESTED
Amount :
Rs.
Tenure :
Type of Loan
ı Home Loan
ı Home Extension
ı Home Improvement
Your monthly
Expenditure : Rs. _____________
Installment you and co-applicant (if any) can pay per
month : Rs. _____________
LOAN DETAILS
Purpose of loan
Construction ı
Purchase ı
Extension ı
Improvement ı
Estimate of Requirement of funds
1. Total purchase price/
Construction cost Rs _________
2. Incidental costs
(if any) Rs _________
3. Other costs Rs _________
Please specify
Total requirement of funds
A. (sum of 1 to 3) Total Rs _________
Estimate of Sources to meet
requirement of funds
4. Loan requested Rs _________
5. Savings from Bank Rs _________
6. Disposal of investments
(FDs/Shares etc.) Rs _________
7. Amt. already spent
(source________) Rs _________
8. Provident Fund
(refundable/non-ref.) Rs _________
9. Other (specify____)Rs ________
B. (sum of 4 to 9) Total Rs ______
Note: “A” which is the total requirement of funds, should equal estimate of sources, “B” which indicates the sources
from where the cost will be met.
FINANCIAL INFORMATION
Savings, Investments Etc.
Particulars Applicant Co-applicant
(Rs.) (Rs.)
Savings in Bank __________ ____________
Immovable property
(specify) ________________________________
Current balance in Provident Fund (your share)
__________ ____________
Other Assets (specify)
1. _________ ___________
2. _________ ___________
LIC Policy(ies) _________ ___________
Postal Life Insurance
Policy(ies) Amount _________ ___________
Maturity Dates _________ ___________
Loans Taken / Proposed
Please indicate below all loans taken / proposed from employer,
Provident Fund etc., and installment(s) payable per month
including interest against each loan.
Source Outstanding Monthly Term
Of Loan Amount Installment
Payable
(Rs.) (Rs.) (months)
Applicant:
Employer _________ _________ __________
Bank _________ _________ __________
Credit Society _________ _________ __________
Others _________ _________ __________
Co-applicant:
Employer _________ _________ __________
Bank _________ _________ __________
Credit Society _________ _________ __________
Others _________ _________ __________
BANK ACCOUNT DETAILS
Name of the Account Holder Name of the Bank Branch Name CD / SB a/c Account No.
DETAILS OF PROPERTY (TO BE PURCHASED / CONSTRUCTED / EXTENDED / IMPROVED)
PLEASE COMPLETE AS APPLICABLE
Address
Mention dwelling unit no, street, city and pin code
If not selected, mention intended location:
_______________________________________
_______________________________________
_______________________________________
_____________________ Pin ______________
Yes No
Do you propose to rent the
Dwelling unit? ı ı
Area of Land : Sq. mts.
Built-up area : Sq. mts.
Cost of Land : Rs.
Cost of construction / purchase/
Extension / improvement : Rs.
Stage of construction / extension /
improvement :
Yes No
Are you the sole owner of the dwelling unit ı ı
Is the legal title to the dwelling unit clear ? ı ı
Will UBI be able to obtain first mortgage of the
Dwelling unit ? ı ı
GENERAL [APPLICABLE TO APPLICANT AND CO-APPLICANT (IF ANY)]
Yes No
1. Have you or your souse earlier
Applied to UBI for a loan ? ı ı
If yes a) Loan a/c no. __________
b) Other details ____________
2. Have you or your spouse given
Guarantee(s) for any borrower
Of UBI ? ı ı
If yes, a) Loan a/c no._______
b) Name of the borrower/s___________
3. What other security will you be able to provide
_____________________________________
4. Please select the mode of repayment convenient to
you: Tick (
) against the appropriate box.
a) Deduction of monthly installment
By your employer ı
b) Post dated cheques ı
c) Standing instructions to bankers ı
d) Any other (please specify) ____________
Not applicable for employed applicants, whose employers
have a deduction at source arrangement with UBI?
Are you a citizen(s) of
India?
ı Yes ı No
Do you belong to
ı SC ı ST ı NA
AFFIX RECENT
PHOTOGRAPH OF
APPLICANT
WITH
SIGNATURE
AFFIX RECENT
PHOTOGRAPH OF
CO-APPLICANT
WITH
SIGNATURE
FOR OFFICE USE ONLY
Processing Fees : Rs ___________
Date : ___________
Initials : ___________
File No :__________________________
________________________________
REFERENCES (NAMES AND ADDRESSES OF TWO REFEREES WHO ARE NOT RELATED TO YOU)
UBI may make such enquiries
from the referees if it deems
necessary.
1. 2.
Phone: Off: Res: Phone: Off: Res:
DECLARATION
I / We declare that all the particulars and information given in the application form are true, correct and they shall form the basis of any loan UBI may decide to grant me / us. I / We confirm that I / We have had no insolvency proceedings against me / us nor have I / We ever been adjudicated insolvent and further confirm that I / We have read the brochure and understood the contents. I / We am / are aware that the Equated Monthly Installment comprising principal and interest is calculated on the basis of annual rests. I / We agree that UBI may take up such references and make such enquiries in respect of this application, as it may deem necessary. I / We undertake to inform UBI regarding any change in my / our occupation / employment and to provide any further information that you may require. I / We also undertake to authorise my / our employer(s) to deduct Equated Monthly Installments from my / our salary and remit the same to UBI directly every month. UBI may make available any information contained in this form, other documents submitted to UBI and information pertaining to the loan to any institution or body. UBI may seek / receive information from any source / person to consider this application. I / We further agree that my / our loan shall be governed by rules of UBI which may be in force from time
to time.
Applicant’s Signature Co-applicant’s Signature