Application Form DMI
Application Form DMI
Application Form DMI
Applicant Co-Applicant
Date / / Loan requested for:- Scheme HL LAP P+C
Loan Amount ROI PF Tenure
PERSONAL DETAIL
Full Name
Father’s Name
Husband’s Name
Mother’s Name
Religion
Caste General OBC SC/ST General OBC SC/ST
Current Residential Address
City
State Pin Code Pin Code
Land Mark
Mobile No.
Phone No. with STD code
E-mail ID.
Date of Birth (dd/mm/year)
Qualification
Marital Status Married Single Married Single
No. of Family Members Children Others Children Others
No. of Earning Members
PAN No.
Passport No.
Voter ID.
Driving License
UID No.
Relationship Co-applicant Applicant
Present Accommodation Rented Own Family Employer Rented Own Family Employer
Period of Stay If Rented, Rent p.m. If Rented, Rent p.m.
Permanent Address
District
State Pin Code Pin Code
Mobile/Land Line No.
OCCUPATIONAL DETAIL
Occupation Salaried SENP* SEP** Salaried SENP* SEP**
Company/Business Name
Address
City
State Pin Code Pin Code
Land Mark
Phone No. with STD Code
Mobile No.
Total Work Experience
Designation Dept. Dept.
Date of Joining
Date of Commencement of Business
If Professional (Specify) Doctor Engineer CA/ICWA/CS Doctor Engineer CA/ICWA/CS
Architect Others Architect Others
Monthly Salary / Income Rs. Rs.
* SENP - Self Employed Non Professional ** SEP - Self Employed Professional
LOAN REQUIREMENT DETAILS
Property Selected Yes No
Property Address
City
State Pin Code
Land Mark
ADDITIONAL INFORMATION
EXISTING LOAN DETAILS
Name of Institution Purpose of Loan Loan Amount EMI Balance Term Balance Outstanding
Reference 1 Reference 2
Name Name
Address Address
Contact No. Contact No.
Email ID. Email ID.
Occupation Occupation
Customer Declaration
I/We declare that all the particulars and information given in this application form are true, correct, complete and up to date in all respects and no information has been withheld. If at any stage of processing this application, it comes to the knowledge of DMI Housing
Finance Private Limited (DMI HFC) that, I/we have provided any incorrect information, fabricated documents, or fake documents, they will be treated by DMI HFC as having been manipulated by me/us and DMI HFC shall have a right to forthwith reject this loan
application. I/We understand that the information given in this application shall form the basis of any loan that DMI HFC may decides to grant to me/us. I/We confirm that I/we have/had no insolvency proceedings initiated against me/us nor have I/we been
adjudicated insolvent. I/We also confirm that no criminal/civil proceedings are initiated against me/us nor have I/we been convicted in any criminal proceedings. I/We further confirm that I/we have read the brochure and understand the contents of the same and
am/are aware of all terms and conditions of availing finance from DMI HFC. I/We authorize DMI HFC to make reference and inquires relating to information in this application which DMI HFC considers necessary. I/We authorize DMI HFC to exchange, part with/share
all information relating to my/our loan details and repayment history with other banks/financial institutions etc. as may be required and shall not hold DMI HFC liable for use of this information. I/We undertake to inform DMI HFC regarding any changes in my/our
residence/occupation/employment and to provide any further information that DMI HFC may require. I/We agree that my/our loan shall be governed by the rules of DMI HFC which may be in force from time to time and which may be changed at the sole discretion of
DMI HFC. I/We understand that DMI HFC has the right to reject my/our application at any stage of processing the application, without assigning any reason whatsoever. I/We agree to have given my/our express consent to DMI HFC to disclose all information and data
furnished by me/us to Credit Information Bureau (India) Limited (CIBIL) or any other credit bureau permitted to operate in India. I/We further agree to execute such additional documents as may be necessary for the purpose. I/We waive the confidentiality obligations
with respect to the information provided by me/us to DMI HFC. I/We undertake that the proceeds of this facility shall not be used for investment in the capital markets. I/We, would like to know through telephonic calls, or SMS on my mobile number mentioned in the
Application Form as well as in this undertaking, or through any other communication mode, transactional information, various loan offer schemes or loan promotional schemes or any other promotional schemes which may be provided by DMI HFC and hereby
authorize DMI HFC and their employee, agent, associate to do so. I confirm that laws in relation to the unsolicited communication referred in “National Do Not Call Registry” (the “NDNC Registry”) as laid down by TELECOM REGULATORY AUTHORITY OF INDIA will not be
applicable for such communication/calls/SMSs received from DMI HFC its employees, agents and/or associates. I/we do hereby expressly and irrevocably authorize DMI HFC to collect, store, share, obtain, disclose and authenticate any aspect of my personal
information / KYC either directly or through any of the authorized agencies. In this regard, I / we expressly and irrevocably authorize DMI HFC to collect, use, verify and authenticate my / our personal identity information / KYC as may be required under applicable
laws/regulatory guidelines without any notice to me / us.
I/We also confirm that I/we have been explained the following and I/we agree that:
1. DMI HFC may, at its sole discretion, sanction or decline the application. No commitment has been given to me/us with regard to sanction of the loan.
2. DMI HFC will decide and assign the loan limit and no commitment has been given to me/us for the same.
* All loan applications shall be disposed off within a period of
3. DSA/DST has not collected any commission/brokerage or any other fee by way of cash or cheque other than the Processing Fees deposited to the DMI HFC.
60 days from the date of application or as may by mentioned
4. The Processing Fees will not be refunded in case of rejection /withdrawal of the loan application.
in the Fair Practice Code of the Company.
5. I/ we hereby voluntarily provide my/ our consent to DMI Housing Finance Private Limited for verification of my/ our Aadhaar to establish its genuineness through Quick Response (QR)
code embedded in the Aadhaar Card and/ or through OTP based authentication or through any such other acceptable method(s) as allowed by the UIDAI or any other Act or law in force from time to time.
I/We have understood all the details of the application form.
□ Adhar UID □ Pan Card □ Driving License □ Bank Passbook with stamp on photo Overdue charges on default 2% per month on outstanding As and when applicable
□ Voter ID Card □ Employee ID Card issued by Govt PSU, defense Establishment installment ( EMI / Pre EMI) dues
□ Photo on Ration Card □ Valid Photo credit or debit card (with signature printed)
Recovery (Legal / repossession & As per Actual As and when applicable
□ Passport
Incidental charges)
6) SIGNATURE VERIFICATION (any one of the below)
Cheques / ACH swapping Rs. 590 inclusive of GST After disbursement if applicable
□ Photo Pan Card □ Driving License □ Bank Verification □ Passport (Per Set)
□ Valid credit or debit card (With signature printed) □ Copy of registered title deed
Duplicate Interest certificate Rs. 236 per copy except one copy As and when applicable
7) INCOME PROOF (any one of the below) in a year inclusive of GST
□ Last 3 month salary slips for the salaried □ Last form 16 for the salaried Duplicate no dues certificate Rs. 236 inclusive of GST As and when applicable
□ Last 3 year ITR for SENP computation of P & L and B/S for SENP
Copy of Property Papers Rs. 590 minimum charges upto After disbursement if applicable
8) BANK STATEMENT 20 pages and Rs. 1 per page
□ Last 6 month bank statement for salaried cases extra would be charged inclusive
□ 12 month bank statements for Self Employed Cases (Current and Saving) of GST
10) OBLIGATION IF ANY AND RUNNING EMI STATEMENT □ Document Retrieval Charges Rs. 590 inclusive of GST At the time of Loan closure
ADDITIONAL DOCUMENTS FOR SELF EMPLOYED Duplicate Statement of Account Rs. 236 inclusive of GST As and when applicable
11) PROOF OF OPERATING ADDRESS (any one of the below) Charges
□ Sale Tax Certificate □ Service Tax Certificate □ Vat Registration certificate Duplicate Fore closure Letter Rs. 590 inclusive of GST As and when applicable
□ Shop and Establishment License □ Telephone Bill □ Electricity Bill
List of Documents Rs. 590 inclusive of GST As and when applicable
□ Latest Bank Account Statement in the name of entity with full address which
matches with application form □ IT Assessment Order Custodian Fees Rs. 590 per month inclusive of If property papers are not taken
□ Leave and License agreement (notarized / registered) in the name of the entity if the GST within 60 after Loan closure
entity is operating business from a rented premises
12) 3 YEARS BUSINESS CONTINUITY PROOF (any one of the below)
□ Shop Establishment Certificate □ ITR’s □ Receipt of GST / Any other Mandatory
License □ Any other Documents
Property Documents if Property has been finalized :
1. All charges/fees to be paid through DMI Branches/Representatives by A/C payee cross
COPY OF CHAIN TITLE DEEDS □
cheque in favour of ‘DMI HOUSING FINANCE PVT LTD’
COPY OF MAP / PERMISSION □ 2. Cash payment to be made Only at DMI Branches against valid receipt issued by DMI
COPY OF REVENUE RECORD □ officials.
3. DMI does not charge any amount over and above the charges mentioned above and will not
ESTIMATE OF CONSTRUCTION FOR CONSTRUCTION CASE □ be liable or responsible for making payment of any amount made to unauthorized person
13) All loan applications shall be disposed off within a period of 60 days from the date of without proper receipts.
application or as may by mentioned in the Fair Practice Code of the Company. 4. Govt. taxes will be charged extra in case the charge is non- inclusive of taxes.
Verification
I, _______________________________________________ do hereby declare that what is stated above is true to the best of my knowledge and
belief. I further declare that I do not have a Permanent Account Number and my/ our estimated total income (including income of spouse, minor child etc. as
per section 64 of Income-tax Act, 1961) computed in accordance with the provisions of Income-tax Act, 1961 for the financial year in which the above
transaction is held will be less than maximum amount not chargeable to tax. Verified today, the ______________ day of ______________ 20_____
Place: ____________ (Signature of declarant)
Note:
1. Before signing the declaration, the declarant should satisfy himself that the information furnished in this form is true, correct and complete in all respects. Any person making a false
statement in the declaration shall be liable to prosecution under section 277 of the Income-tax Act, 1961 and on conviction be punishable,
(I) in a case where tax sought to be evaded exceeds twenty-five lakh rupees, with rigorous imprisonment which shall not be less than six months but which may extend to seven
years and with fine;
(ii) in any other case, with rigorous imprisonment which shall not be less than three months but which may extend to two years and with fine.
2. The person accepting the declaration shall not accept the declaration where the amount of income of the nature referred to in item 22b exceeds the maximum amount which is not
chargeable to tax, unless PAN is applied for and column 21 is duly filled.
Instruction: 19. Consumer gas card/book or piped gas bill (Not more than 3 months old) 19 No Yes
(1) Documents which can be produced in support of identity and address 20. Bank Account Statement (Not more than 3 months old) 20 No Yes
(not required if applied for PAN and item 20 is filled): - 21. Credit Card statement (Not more than 3 months old) 21 No Yes
Proof of Address 22. Depository Account Statement (Not more than 3 months old) 22 No Yes
Sl. Nature of Document Proof of Identity 23. Property registration document 23 No Yes
Document Code 24. Allotment letter of accommodation from Government 24 No Yes
A For Individuals and HUF 25. Passport of spouse bearing name of the person 25 No Yes
1. AADHAR card 01 Yes Yes 26. Property tax payment receipt (Not more than one year old) 26 No Yes
2. Bank/Post office passbook bearing photograph of the person 02 Yes Yes
3. Elector's photo identity card 03 Yes Yes B For Association of persons (Trusts)
Copy of trust deed or copy of certificate of registration issued by
4. Ration/Public Distribution System card bearing photograph of the person 04 Yes Yes Charity Commissioner 27 Yes Yes
5. Driving License 05 Yes Yes
6. Passport 06 Yes Yes C For Association of persons (other than Trusts or Body of Individuals or Local authority
or Artificial Juridical Person)
7. Pensioner Photo card 07 Yes Yes Copy of Agreement or copy of certificate of registration issued by Charity Commissioner or
8. National Rural Employment Guarantee Scheme (NREGS) Job card 08 Yes Yes Registrar of Cooperative society or any other competent authority or any other document
9. Caste or Domicile certificate bearing photo of the person 09 Yes Yes originating from any Central or State Government Department establishing identity and
address of such person. 28 Yes Yes
10. Certificate of identity/address signed by a Member of Parliament or
Member of Legislative Assembly or Municipal Councillor or a
Gazetted Officer as per annexure A prescribed in Form 49A 10 Yes Yes
(2)In case of a transaction in the name of a Minor, any of the above mentioned documents as proof of
11. Certificate from employer as per annexure B prescribed in Form 49A 11 Yes Yes Identity and Address of any of parents/guardians of such minor shall be deemed to be the proof of
12. Kisan passbook bearing photo 12 Yes No identity and address for the minor declarant, and the declaration should be signed by the
13. Arm's license 13 Yes No parent/guardian.
14. Central Government Health Scheme /Ex-servicemen (3)For HUF any document in the name of Karta of HUF is required.
Contributory Health Scheme card 14 Yes No
15. Photo identity card issued by the government./ Public Sector undertaking 15 Yes No (4)In case the transaction is in the name of more than one person the total number of persons should be
16. Electricity bill (Not more than 3 months old) 16 No Yes mentioned in Sl. No. 18 and the total amount of transaction is to be filled in Sl. No. 16.
17. Land line Telephone bill (Not more than 3 months old) 17 No Yes
In case the estimated total income in column 22b exceeds the maximum amount not chargeable to tax
18. Water bill (Not more than 3 months old) 18 No Yes the person should apply for PAN, fill out item 21 and furnish proof of submission of application.
COST & CHARGES DOCUMENT REQUIRED
Customer Copy (All documents to be self-attested) Customer Copy
Fee Type Amount When Payable
1) PHOTOGRAPH OF APPLICANT & CO-APPLICANT □
Operational & Administrative Home Loan 1.5%+GST of the a. Rs. 5000 +GST. to be paid
Cost-Non Refundable sanctioned loan amount. along with loan application
2) PHOTO PAN CARD (if not available, form 60 to be submitted).
Loan Against Property : 2%+GST b. Balance to be paid before 3) DATE OF BIRTH PROOF (any one of the below)
of the sanctioned loan amount disbursement of loan.
□ Photo Pan Card □ Aadhar UID □ Driving License □ Voter ID card (having complete
Processing Fee 0.5%+GST of the sanctioned Paid before disbursement of loan Date of Birth) □ 10th Pass Certificate □ School Leaving Certificate □ Passport
loan amount.
4) ADDRESS PROOF (any one of the below)
Legal Verification Rs. 1500 inclusive of Taxes At the time of disbursement • OVD (Officially valid documents)
(Non refundable)
□ Adhar UID □ Driving License □ Voter ID card □ Passport
Technical Verification Rs. 1500 inclusive of Taxes At the time of disbursement •Other Documents (incase current address mismatch with OVD)
(Non refundable) □ Latest Telephone Bill (Land Line / Post Paid mobile) □ Gas Connection Bill Showing
full Address □ Copy of Leave and Licensed / Rent Agreement registered or notarized (in
Subsequent Technical Verification Rs. 500 inclusive of Taxes At the time of disbursement case of rented premises) □ Copy of title deed in case the premises are owned □ □
(Non refundable)
□ Property tax receipt □ Water Bill □ Bank passbook with first page having full
CERSAI Rs. 59 for loans up to 5 lacs At the time of disbursement address that matches with applicant address on application form □ Ration Card □
Rs. 118 for loans more than 5 □ Latest Electricity bill
lacs inclusive of GST
I hereby declare to submit revised OVD with current address with in three months from
Cheque / ECS / ACH bounce per Rs. 590 inclusive of GST As and when applicable date of application.
Transaction
5) ID PROOF (any one of the below)
Overdue charges on default 2% per month on outstanding As and when applicable □ Adhar UID □ Pan Card □ Driving License □ Bank Passbook with stamp on photo
installment ( EMI / Pre EMI) dues □ Voter ID Card □ Employee ID Card issued by Govt PSU, defense Establishment
Recovery (Legal / repossession & As per Actual As and when applicable
□ Photo on Ration Card □ Valid Photo credit or debit card (with signature printed)
Incidental charges) □ Passport
6) SIGNATURE VERIFICATION (any one of the below)
Cheques / ACH swapping Rs. 590 inclusive of GST After disbursement if applicable
(Per Set) □ Photo Pan Card □ Driving License □ Bank Verification □ Passport
□ Valid credit or debit card (With signature printed) □ Copy of registered title deed
Duplicate Interest certificate Rs. 236 per copy except one copy As and when applicable
in a year inclusive of GST 7) INCOME PROOF (any one of the below)
Duplicate no dues certificate Rs. 236 inclusive of GST As and when applicable □ Last 3 month salary slips for the salaried □ Last form 16 for the salaried
□ Last 3 year ITR for SENP computation of P & L and B/S for SENP
Copy of Property Papers Rs. 590 minimum charges upto After disbursement if applicable
20 pages and Rs. 1 per page 8) BANK STATEMENT
extra would be charged inclusive
□ Last 6 month bank statement for salaried cases
of GST
□ 12 month bank statements for Self Employed Cases (Current and Saving)
Prepayment / Part Payment Nil Nil 9) PROCESSING FEE CHEQUE/ DD □
Document Retrieval Charges Rs. 590 inclusive of GST At the time of Loan closure 10) OBLIGATION IF ANY AND RUNNING EMI STATEMENT □
Duplicate Statement of Account Rs. 236 inclusive of GST As and when applicable ADDITIONAL DOCUMENTS FOR SELF EMPLOYED
Charges
11) PROOF OF OPERATING ADDRESS (any one of the below)
Duplicate Fore closure Letter Rs. 590 inclusive of GST As and when applicable □ Sale Tax Certificate □ Service Tax Certificate □ Vat Registration certificate
List of Documents Rs. 590 inclusive of GST As and when applicable
□ Shop and Establishment License □ Telephone Bill □ Electricity Bill
□ Latest Bank Account Statement in the name of entity with full address which
Custodian Fees Rs. 590 per month inclusive of If property papers are not taken matches with application form □ IT Assessment Order
GST within 60 after Loan closure □ Leave and License agreement (notarized / registered) in the name of the entity if the
entity is operating business from a rented premises
1. All charges/fees to be paid through DMI Branches/Representatives by A/C payee cross 12) 3 YEARS BUSINESS CONTINUITY PROOF (any one of the below)
cheque in favour of ‘DMI HOUSING FINANCE PVT LTD’
□ Shop Establishment Certificate □ ITR’s □ Receipt of GST / Any other Mandatory
2. Cash payment to be made Only at DMI Branches against valid receipt issued by DMI License □ Any other Documents
officials.
Property Documents if Property has been finalized :
3. DMI does not charge any amount over and above the charges mentioned above and will not
be liable or responsible for making payment of any amount made to unauthorized person COPY OF CHAIN TITLE DEEDS □
without proper receipts.
COPY OF MAP / PERMISSION □
4. Govt. taxes will be charged extra in case the charge is non- inclusive of taxes.
COPY OF REVENUE RECORD □
ESTIMATE OF CONSTRUCTION FOR CONSTRUCTION CASE □
13) All loan applications shall be disposed off within a period of 60 days from the date of
application or as may by mentioned in the Fair Practice Code of the Company.
Applicant Signature Co-Applicant Signature