HOUSING LOAN APPLICATION FORM (INDIVIDUAL)

PERSONAL AND EMPLOYMENT DETAILS

APPLICANT CO-APPLICANT
Surname First Name Middle Name Surname First Name Middle Name
NAME
Current Residential
Address

Pin code: Pin code:

Phone No. Relationship with applicant
e-mail Adress
Date of Birth Age Yrs Age Yrs
Sex Male Female Male Female
Marital Status Single Married Single Married
Status Resident Non-Resident Resident 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 Employed Self-Employed Employed 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 _______ Yrs _______ Yrs
Occupation Retirement Age: _______ Yrs Retirement Age: _______ Yrs
Status of present Own / Rented / Family / Employer
accommodation

LOAN REQUESTED
Amount : Type of Loan Your monthly
Rs. Home Loan Expenditure : Rs. _____________
Home Extension Installment you and co-applicant (if any) can pay per
Tenure : Home Improvement month : Rs. _____________

LOAN DETAILS
Purpose of loan Estimate of Requirement of funds Estimate of Sources to meet
requirement of funds
Construction 1. Total purchase price/
Construction cost Rs _________ 4. Loan requested Rs _________
Purchase 5. Savings from Bank Rs _________
2. Incidental costs 6. Disposal of investments
Extension (if any) Rs _________ (FDs/Shares etc.) Rs _________
7. Amt. already spent
Improvement 3. Other costs Rs _________ (source________) Rs _________
Please specify 8. Provident Fund
(refundable/non-ref.) Rs _________
Total requirement of funds 9. Other (specify____)Rs ________
A. (sum of 1 to 3) Total 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.
 AFFIX RECENT AFFIX RECENT FOR OFFICE USE ONLY
PHOTOGRAPH OF PHOTOGRAPH OF Processing Fees : Rs ___________
APPLICANT CO-APPLICANT Date : ___________
WITH WITH Initials : ___________
SIGNATURE SIGNATURE File No :__________________________
________________________________

FINANCIAL INFORMATION
Savings, Investments Etc. Loans Taken / Proposed
Particulars Applicant Co-applicant Please indicate below all loans taken / proposed from employer,
(Rs.) (Rs.) Provident Fund etc., and installment(s) payable per month
including interest against each loan.
Savings in Bank __________ ____________
Immovable property Source Outstanding Monthly Term
Of Loan Amount Installment
(specify) ________________________________
Payable
(Rs.) (Rs.) (months)
Current balance in Provident Fund (your share)
Applicant:
__________ ____________ Employer _________ _________ __________
Bank _________ _________ __________
Other Assets (specify) Credit Society _________ _________ __________
1. _________ ___________ Others _________ _________ __________
2. _________ ___________ Co-applicant:
LIC Policy(ies) _________ ___________ Employer _________ _________ __________
Bank _________ _________ __________
Postal Life Insurance
Credit Society _________ _________ __________
Policy(ies) Amount _________ ___________ Others _________ _________ __________
Maturity Dates _________ ___________

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 Area of Land : Sq. mts.
Mention dwelling unit no, street, city and pin code Built-up area : Sq. mts.
If not selected, mention intended location:
_______________________________________ Cost of Land : Rs.
_______________________________________ Cost of construction / purchase/
_______________________________________ Extension / improvement : Rs.
_____________________ Pin ______________ Stage of construction / extension /
Yes No improvement :
Do you propose to rent the Yes No
Dwelling unit? Are you the sole owner of the dwelling unit
Is the legal title to the dwelling unit clear ?
Will UBI be able to obtain first mortgage of the
Dwelling unit ?

GENERAL [APPLICABLE TO APPLICANT AND CO-APPLICANT (IF ANY)]

Yes No 3. What other security will you be able to provide Are you a citizen(s) of
1. Have you or your souse earlier _____________________________________ India?
Applied to UBI for a loan ? 4. Please select the mode of repayment convenient to Yes No
If yes a) Loan a/c no. __________ you: Tick (
) against the appropriate box.
b) Other details ____________ a) Deduction of monthly installment Do you belong to
By your employer SC ST NA
2. Have you or your spouse given b) Post dated cheques
Guarantee(s) for any borrower c) Standing instructions to bankers
Of UBI ? d) Any other (please specify) ____________
If yes, a) Loan a/c no._______ Not applicable for employed applicants, whose employers
b) Name of the borrower/s___________ have a deduction at source arrangement with UBI?
REFERENCES (NAMES AND ADDRESSES OF TWO REFEREES WHO ARE NOT RELATED TO YOU)
UBI may make such enquiries 1. 2.
from the referees if it deems
necessary.

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