ANNEXURE I

COMMERCIAL SCHEDULE

Address of Borrower: Lokmanya nagar , pada no 4, Near old bus stop,jk gram, THANE, MAHARASHTRA -
Name of Borrower: MR.Om Shahapure
400606
URN: 7524082913202059 Branch: Thane CB-3098
Individual Loan Application no: 104989000002404 Disbursed Amount: 55000
Loan Account no: Details of Guaranator:
Facility: Emi (Frequency, Amount and number): As per Repayment Schedule
Tenor: 24 Months Rate of Interest: 25% / 28% p.a**
Penal Charges: incase of default, 24% pa on overdue
Documentation fees: INR 100 + GST (as applicable)
amount + GST
Processing fees (if any)* in case the sanctioned amount is >INR 25000: 2% of the loan amount + GST (as
Purpose of the facility: Asset Purchase for Business
applicable) - 1298

Insurance opted: Yes/ No - INR 877.8 Bank account no for SI:

Insurance Amount: 877.8 Security:

Details of SPDC: Bank account no of Disbursement:
Place of execution: Thane CB Date of Execution: 30/08/2024

Mode of Repayment: Please tick one and fill details –

• NACH
Effective annualized interest rate (in percentage) (computed on net disbursed amount using IRR approach
• Standing Instruction and reducing balance method): % p.a
• Cash
• UPI

NACH Bounce charges: Rs 500 + GST per instance Cash collection charges (Cases where EMI is paid in cash): Rs 50 per instance
No of cattle for Maintenance: No fo cattle for purchase:

INDIVIDUAL LOAN AGREEMENT

This Individual Loan Agreement (the “Agreement”) is made and executed at the place & date mentioned in the Commercial Schedule attached hereto between:

The Borrower whose details are as specified in the Commercial Schedule hereto (hereinafter referred to as “Borrower” which term shall be deemed to mean and include,
unless the context otherwise requires or permits, its successors, constituted attorneys and permitted assigns)

IN FAVOR OF

Jana Small Finance Bank Limited, a Company incorporated under Companies Act, 1956 and licensed by the Reserve Bank of India to carry
on business as a small finance Bank under the Banking Regulation Act 1949, having its registered office at The Fairway Business Park, Ground
and First Floor, Survey No. 10/1, 11/2 and 12/2B, Off Domlur, Koramangala Inner Ring Road, Next to Embassy Golf Links, Challaghatta,
Bangalore - 560 071, and having one of its branch office at the place specified in the Commercial Schedule hereto, hereinafter referred to as the
“BANK” which term shall be deemed to mean and include, unless the context otherwise requires or permits, its successors, constituted
attorneys and permitted assigns.

WHEREAS:

a. The Borrower has approached the Bank for the grant of the Individual Loan Facility (“Facility”).
b. At the request of the Borrower, the Bank has agreed to grant the Facility to the Borrower for such amount as set out in the Commercial
Schedule hereto subject to (a) execution of Facility Documents and this Agreement, (b) terms & conditions stipulated in the Facility
Documents and this Agreement.
c. All the commercial details in relation to the Facility are captured in the Commercial Schedule attached hereto.
eSigned using Aadhaar
(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
1. DEFINITIONS:

a. “EMI” shall mean the periodical instalments as may be computed by the Bank from time to time in relation to the Facility (rounded off
to the next rupee).
b. “Due Date” shall mean the date(s) on which any amounts in respect of the Facility are payable by the Borrower to the Bank.
c. “Facility Documents” shall include application form, sanction letter, this Agreement and all other agreements, instruments,
undertakings, indentures, deeds, writings and other documents executed or entered into, or to be executed or entered into, by the
Borrower and the Bank, in relation, or pertaining, to the Facility and the transactions contemplated therein, and includes all
modifications and amendments thereto.
d. “Guarantor” shall mean and include the Borrower’s spouse or defined blood relatives (in case of single/widow/divorced Borrower)
more specifically mentioned in the Commercial Schedule hereto.
e. “RBI” shall mean the Reserve Bank of India.

2. Disbursal of the Facility

a. The Borrower authorises the Bank to disburse proceeds of the Facility to such as specified in the Commercial Schedule.
b. The Borrower understands that the Bank may withhold release of further tranches under the Facility at its sole discretion, if the
performance of the Facility is not satisfactory and/or if there is breach of any terms of the Facility Documents.
c. The Borrower authorises the Bank to appropriate the Facility or part of the Facility for adjusting the overdues and /or place a debit hold
on the bank account as mentioned in the Commercial Schedule at its sole discretion in respect of any of its current or future
indebtedness with the Bank.

3. RATE OF INTEREST:

a. The Borrower shall pay interest on the Facility at the rate of interest (“Interest”) and on the relevant Due Date as specified in the
Commercial Schedule hereto.
b. The Interest payable by the Borrower shall be subject to the changes based on RBI’s guidelines and/or directives that the Bank is
obliged to give effect to.
c. The Bank shall inform the Borrower regarding any change in respect of Interest rate or any conditions herein by way of publishing a
notice displayed on the notice board of a Bank’s branch or on the Website and the same shall be deemed as sufficient notice of change
to the Borrower.
d. The Interest rate shall be calculated at 365/366 days, as may be applicable.

4. REPAYMENT:

a. The Borrower shall promptly repay the Facility and the due interest in accordance with the terms set out in the repayment schedule
(“Repayment Schedule”). However, for the convenience of the Borrower, the Bank has agreed that the authorized officials of the Bank
may collect the EMI from the Borrower on such dates as laid down in the Repayment Schedule. . No interest will accrue from the date
of payment of EMI, if the same is paid before the due date.
b. The Bank confirms and the Borrower understand that there shall be a moratorium for the initial period before the first EMI becomes
due. Therefore, if the Facility is disbursed after the 7th day of the respective month, a moratorium for the subsequent month shall be
provided to the Borrower and the first instalment shall become due on the last day of the month after the moratorium ends. E.g. If the
disbursement date is 15th October, the first instalment shall become due on 31st December. Interest for such period will be capitalized
on the principal.
c. The Borrower can avail moratorium of upto two EMIs per year of the tenure of the Facility (“Payment Holiday”). Opting for the
Payment Holiday is optional and the Borrower shall submit a separate request for availing the same. The Bank may provide Payment
Holiday to the Borrower as per the criteria stipulated in its policies.
d. The Borrower and the Guarantor undertake that they have perused, understood and accepted the Bank’s method of calculating EMIs and
also the appropriation thereof into principal and interest.
e. In the event the Borrower and the Guarantor fail to pay/repay the outstanding amounts on the respective Due Date, the Borrower and the
Guarantor shall be liable to pay penal charges on the outstanding amounts at such rate as specified in Commercial Schedule hereto. For
example, if the Due Date is 2nd day of every month and the Borrower and the Guarantor pay the EMI on 30th of the month, the Bank
shall levy penal charges starting from 3rd uptil the 30th of the particular month. In a second scenario, if the Borrower and the Guarantor
do not pay on the Due Date and EMI remains unpaid for a continuous period of 30 days, the Bank shall have the right to (a) levy penal
charges; or (b) report the Borrower and the Guarantor as an SMA-0. If the Borrower and the Guarantor further continue to default in
repayment from a period of 30 days upto 60 days, the Bank shall report the Borrower and the Guarantor as SMA-1 and levypenal
charges. If the Borrower and the Guarantor further continue to default in repayment from a period of 60 days and no later than 90 days,
the Bank shall report the Borrower and the Guarantor as SMA-2 and levy penal charges.
f. If the Borrower and the Guarantor further continue to default in repayment for more than 90 days, the Bank shall report the Borrower
and the Guarantor as NPA and levy penal charges. eSigned using Aadhaar
(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
 g. It is clarified that levying of penal charges is in addition to other rights that the Bank has under the Facility Documents, and the Bank
reserves all of, its rights under this Agreement, the Facility Documents and/or applicable law.

5. MODE OF PAYMENT:

a. The Facility may be repaid by the Borrower and the Guarantor through any of the modes specified in the Commercial Schedule.
b. In case of the repayment through standing instruction (“SI”), the Borrower authorises the Bank to debit his/her bank account (as
provided in the Commercial Schedule) towards the EMI.
c. The Borrower shall also provide the security post-dated cheques (“SPDC”) to enable the Bank to recover the overdue/outstanding
Facility amount. The details of the SPDC is captured in the Commercial Schedule (if applicable).
d. The Borrower shall not be entitled to cancel or issue stop payment instruction with the respect to the mode of payment as opted/provided
by the Borrower as long as the Facility is outstanding and any such act of the Borrower shall be deemed to an act of criminal breach of
trust and cheating the Borrower. Further, the Bank shall be entitled to initiate appropriated criminal proceedings including but not
limited proceedings under Negotiable Instruments Act, 1881 and Indian Penal Code, 1860 against the Borrower.

6. PREPAYMENT

a. Subject to payment of applicable prepayment charges (if any), the Borrower shall be entitled to pre-close the Facility by remitting the
principal, the interest and any other costs and charges as may be outstanding at the time of such pre-closure. No interest shall be due
and payable for the remaining period.

7. UNDERTAKINGS OF THE BORROWER:

The Borrower and the Guarantor hereby undertake that:

a. The proceeds of the Facility shall be utilized by them only for the purpose set out in the Commercial Schedule. The Facility shall not be
used for any other purpose of any nature whatsoever.
b. Under no circumstance shall the Facility be used, directly or indirectly for: (i) subscribing to or purchasing any shares or other
securities; (ii) investment in the real estate business, capital markets or purchase of land; (iii) entering into any speculative transactions
or activities; or (iv) carrying out any activities not eligible for credit facility as per RBI guidelines; and/or (v) any purpose that will
violate any provisions of any applicable law.
c. They shall comply with the provisions of Child Labour (Prohibition and Regulation) Act 1986, Minimum Wages Act, 1948 and
Environment Protection Act, 1986 and all other applicable laws and all its subsequent amendments and re-enactments thereof.
d. The Borrower is not a specified near relative of any officer of the Bank.
e. They have read, understood and accepted the terms and conditions stipulated in this Agreement, Facility Documents and all the other
terms and conditions relating to the Facility and other services, on www.janabank.com (the “Website”). The Bank may display any
revision in these terms and conditions on the Website. The Borrower and the Guarantor hereby agree that it shall be the duty of the
Borrower and the Guarantor to ensure that they keep themselves updated of any such changes or variations by visiting the Website.

8. PROCESSING FEES/GST AND OTHER APPLICABLE CHARGES:

a. If applicable, the Borrower agrees to pay a one-time, non-refundable processing fee at such rate as specified in the sanction letter and the
Commercial Schedule herein. Such processing fee shall be deducted during disbursement and the Borrower shall be provided with the
balance amount. The Borrower agrees to incur stamp duty charges and documentation charges (if any) as provided in the Commercial
Schedule. GST, wherever applicable, shall be charged extra as per the applicable rates, on all the applicable charges and fees.

9. EVENT OF DEFAULT:

The following are the events of default under this Agreement (“Event of Default”):

a. Failure by the Borrower and the Guarantor to repay the outstanding amounts (or part thereof) or any other amounts due and payable by
any of the Borrower to the Bank, in the manner stipulated in this Agreement.
b. Breach/ non-performance of any representation, warranty, covenant, undertaking or obligations under this Agreement and the Facility
Documents (including non-submission of documents or execution thereof), or any change in the information furnished by any of the
Borrower and the Guarantor to the Bank, if deemed material by the Bank.
c. The Borrower or the Guarantor commit default in relation to any indebtedness or statutory taxes and dues owed, or enters into any
compromise with its creditors, or admits any inability in payment of its other debts.
d. The performance of obligations under this Agreement and the Facility Documents becomes void or illegal on part of either the Borrower
or Guarantor or the Bank.
e. Any event which, with the passage of time, is likely to become an Event of Default.

10. CONSEQUENCES OF EVENT OF DEFAULT:

eSigned using Aadhaar
(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
 On the happening of any Event of Default, the Bank may at its sole discretion, without prejudice to other rights and claims under this
Agreement, exercise any or all of the following rights:

a. Terminate the Facility Documents and this Agreement

b. Declare the Facility to become immediately due and payable
c. Levy penal charges on the overdue amount from the date when the Event of Default occurs until the date when the Event of Default has
ceased to exist.
d. Exercise any other rights or remedies available to the Bank under applicable law.

11. CROSS COLLATERALISATION

a. If applicable, any security furnished by the Borrower under any agreement, including security created under the two wheeler loan
availed from the Bank, shall be deemed to be security (ies) under this Agreement as well and the same shall not be discharged by the
Bank until all the outstanding dues/loans availed by the Borrower from the Bank are fully repaid to the satisfaction of the Bank. The
Borrower expressly agrees and accepts that in the event any default is committed by the Borrower under any other agreement with the
Bank, the same may be considered as an Event of Default under this Agreement. Further, the Bank shall be entitled to enforce such
security interest and exercise its rights in any Event of Default under this Agreement or otherwise. Any amount due and payable under
this Agreement and/or under any other facilities availed by the Borrower shall be appropriated by the Bank at its own discretion without
any order of priority.

12. INSURANCE:

a. The Borrower understands that he/she can opt to get either himself/herself or his/her spouse or defined blood relatives (in case of
single/widow/divorced borrower) or both to get insured against the sanctioned loan amount for the time period equal to the loan tenure.
b. If such insurance is opted, the premium shall be deducted accordingly from the Facility amount during disbursement and the remaining
amount shall be disbursed to the Borrower in the account maintained by the Borrower with the Bank.
c. The Borrower and Guarantor understand that the insurance is a third-party product and the Bank makes no representation or warranty
regarding the insurance policy opted by them. The Borrower and the Guarantor further understand that the claims in relation to the
insurance voluntarily opted by them shall be done at the sole discretion of the insurance company and neither the Bank nor its officers
are in any way responsible for the same.

13. INDEMNITY:

a. The Borrower and the Guarantor shall indemnify and hold harmless the Bank and its directors, officers and agents, from and against any
and all costs, expenses, direct or indirect claims, liabilities, demands and/ or claims whatsoever, including any third-party claims for
damages incurred as a consequence of any breach of the terms of this Agreement and/ or the Facility Documents or acts of omission and
commission on the part of the Borrower or the Guarantor or otherwise on account of the Facility.

14. DISCLOSURE AND CROSS SELL:

a. The Borrower and the Guarantor authorize the Bank to disclose any information in relation to the Facility to (i) RBI; (ii) credit
information companies/ bureaus and information utilities; (iii) any governmental / regulatory / statutory authority (iv) other financial
institutions and industry bodies; (v) affiliates and group companies of the Bank; and (vi) service providers, potential assignees, and
necessary third parties (“Authorities”) for purpose of servicing the Facility granted herein. Further, the Borrower and the Guarantor
agree that the Bank and such Authorities may publish the details of Borrower’s default and such data, subject to applicable laws.
b. The Borrower and the Guarantor hereby give specific consent to the Bank for disclosing the ‘financial information’ to any ‘Information
Utility’ ( ‘IU’ ), as mandated by the Insolvency and Bankruptcy Code, 2016 ( ‘Code’), and as amended from time to time.
c. The Borrower and the Guarantor authorize the service providers and the third-parties identified by the Bank to contact them to cross-sell
Bank’s services and products as per applicable laws.
d. To the extent applicable, the Borrower authorizes the Bank to apply for Udyam Registration Certificate on his/her behalf. In such
scenario, the Borrower further agrees to submit the Udyam Registration Certificate to the Bank.

15. RIGHT TO DELEGATE

a. The Bank shall, without prejudice to its rights to perform such activities itself or through its office employees, be entitled to appoint one
or more person(s) (“Service Providers”) as the Bank may select and to delegate to such Service Providers all or any of its functions,
rights and powers under the Facility Documents including the rights and authority of a collection agency to receive on behalf of the
Bank from the Borrower, all the outstanding amounts and to perform and execute all lawful acts, deeds, matters and things connected
therewith and incidental thereto.
b. It is clarified that the Bank shall be accountable for inappropriate behavior by the Service Providers and shall facilitate timely redressal
of grievance to the Borrower. The Borrower may contact the call center of the Bank at 1800 2080 (24*7), 1800 4200 (7am to 10pm) or
write an email to customercare.com. The Borrower may further contact the nodal officer of the Bank if they are not satisfied with the
eSigned using Aadhaar
(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
 response offered by the call center.

16. ASSIGNMENT:

a. The Borrower and the Guarantor accept that the Bank has the authority to sell, assign or securitize the Facility or any rights under this
Agreement without providing any notice to the Borrower, to any person(s), collection agency(ies) or institution/ institutions and the
Borrower and the Guarantor agrees to repay the outstanding Facility amounts as per the terms and conditions of this Agreement to such
other person, agency or institution as directed by the Bank. The Borrower or the Guarantor shall not assign or transfer all or any of its
rights, benefits or obligations under this Agreement.

17. SET-OFF:

a. The Bank shall have the paramount right of lien and set off, irrespective of any other lien or charge, present or future on the deposits of
any kind and nature held or balances lying in any accounts of the Borrower or the Guarantor, whether held singly or jointly, and on any
monies, securities, bonds and other assets, documents and properties held by /under the control of the Bank to the extent of all
outstanding dues arising under this Agreement. The Bank shall be entitled to exercise such set-off or lien without prior notice to the
Borrower or the Guarantor. The Bank’s right hereunder shall not be affected by the Borrower’s or Guarantor’s insolvency or
bankruptcy.

18. ELECTRONIC SIGNATURE:

a. The Borrower and the Guarantor hereby agree that this Agreement may be executed digitally by way of electronic signature which shall
be considered an original signature for all purposes and shall have the same effect and force as ink signature. The Borrower and the
Guarantor shall not challenge the validity of this Agreement on the ground that the same has been electronically executed.
b. The Bank may generate physical copies of this Agreement from its system or produce this Agreement in any other form at its discretion
and the same shall be fully binding on the Borrower and the Guarantor.
c. The Borrower and the Guarantor shall have no objection to such copies produced by the Bank in evidence in any court, tribunal or
otherwise, to evidence the acceptance/ execution as well as the terms between the Borrower, Guarantor and the Bank.

19. GOVERNING LAW & JUSRISDICTION:

a. All the disputes between the Borrower, Guarantor and the Bank in connection with the Facility and/or the Facility Documents or as to
the rights and liabilities of the parties shall be settled by a sole arbitrator as appointed by the Bank, in accordance with the Arbitration
and Conciliation Act, 1996, or any statutory amendments thereto. The arbitration proceedings shall be in English language and the place
of arbitration shall be Bengaluru. Cost of arbitration shall be borne by the Borrower. Notwithstanding the foregoing, the Bank reserves
the right to approach any court, tribunal or other appropriate forum of competent jurisdiction as the Bank deems fit in connection with
any dispute arising out of the Facility and/or the Facility Documents. This Agreement shall be governed by laws of India.

**if the loan purpose is Agri/Agri Allied activites/HIM/Business then the interest rate applicable is 25%. if the loan purpose is Debt Consolidation then the interest rate
applicable is 28%.

Signature/Thumb Impression of the Borrower

Signature of the Authorised Signatory of the Bank

Signature/Thumb impression of the Guranator

eSigned using Aadhaar

(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
 INDIVIDUAL SANCTION LETTER

Date: 30/08/2024

Dear, Borrower Name: MR.Om Shahapure Guarantor Name:

Address: Lokmanya nagar , pada no 4, Near old bus stop,jk gram, THANE, MAHARASHTRA - 400606

This is with reference to your Loan Application No. 104989000002404 (“Loan Application”) submitted to Jana Small Finance Bank Limited (the “Bank”). Based on the
representations and undertakings made by you in in the Loan Application, we are pleased to sanction the Individual Loan Facility (the “Facility”) to you subject to the
commercial terms stated in Annexure I enclosed herewith.Kindly share with us an accepted and duly signed copy of this Sanction Letter indicating your acceptance and
enabling us to proceed with the documentation thereafter. Completion of documentation is necessary for the Bank to move to the disbursement further, subject to conditions.

We look forward to our continued business relationship.

Thank You.

For and on behalf of Jana Small Finance Bank Limited Authorised Signatory

ANNEXURE I

COMMERCIAL SCHEDULE

Address of Borrower: Lokmanya nagar , pada no 4, Near old bus stop,jk gram, THANE, MAHARASHTRA -
Name of Borrower: MR.Om Shahapure
400606
URN: 7524082913202059 Branch: Thane CB-3098
Individual Loan Application no: 104989000002404 Disbursed Amount: 55000
Loan Account no: Details of Guaranator:
Facility: Emi (Frequency, Amount and number): As per Repayment Schedule
Tenor: 24 Months Rate of Interest: 25
Penal Charges: incase of default, 24% pa on overdue
Documentation fees: INR 100 + GST (as applicable)
amount + GST
Processing fees (if any)* in case the sanctioned amount is >INR 25000: 2% of the loan amount + GST (as
Purpose of the facility: Asset Purchase for Business
applicable) - 1298

Insurance opted: Yes/ No - INR 877.8 Bank account no for SI:

Insurance Amount: 877.8 Security:

Details of SPDC: Bank account no of Disbursement:
Place of execution: Thane CB Date of Execution: 30/08/2024

Mode of Repayment: Please tick one and fill details:

• NACH
Effective annualized interest rate (in percentage) (computed on net disbursed amount using IRR approach
• Standing Instruction and reducing balance method): % p.a
• Cash
• UPI

NACH Bounce charges: Rs 500 + GST per instance Cash collection charges (Cases where EMI is paid in cash): Rs 50 per instance
No of cattle for Maintenance: No fo cattle for purchase:

Note: The terms in this Sanction Letter are intended to summarize certain basic commercial terms of the proposed Facility. It is not intended to be a definitive list of all
requirements of the Bank in connection with the proposed Facility. The rates, charges and fees mentioned herein are subject to change from time to time. The terms and
conditions stipulated in this Sanction Letter, Loan Agreement and all the other terms and conditions relating to the Facility and other services, are uploaded on
www.janabank.com (the “Website”) in the language understood by the Borrower and the Guarantor. The Borrower and the Guarantor hereby agree that it shall be the duty
of the Borrower and the Guarantor to ensure that they keep themselves updated of any such changes or variations by visiting the Website.

Accepted Borrower Accepted by Guranator eSigned using Aadhaar

(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
 Name: MR.Om Shahapure Name:

Date: 30/08/2024 Date: 30/08/2024

Place: Thane CB Place: Thane CB

Signature/Thumb Impression: Signature/ThumbImpression

eSigned using Aadhaar

(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
 Member Consent Form For lClCl Pru Shubh Raksha Credit

(A Non-Linked Non-Participating Group Micro lnsurance Product)

Loan type: Furnishing

Cover type: Level Cover (death benefit will remain constant throughout the coverage term)

Details Full name Age/DOB Gender Loan Account No Occupation Relationship State/Pin code

Member 104989000002404 400606

Nominee MR.Om Shahapure 20/01/1998 Male 104989000002404 400606

Appointee*

*If Nominee is less than 18 years, Appointee is mandatory. Appointee should be more than 18 years of age.

Sum assured Coverage term Premium amount (inclusive of applicable taxes)

55000 24 877.8

I am aware that Jana Small Finance Bank is the holder of the life insurance Master Policy issued by lClCl Prudential Life insurance company Ltd for Group Micro lnsurance
product and I am a member of this group.

I understand the features of this product and agree with the terms and conditions and hereby consent to avail the benefits under the lClCl Prudential life insurance group
policy.

Do you wish to continue your cover till the coverage tem even after you foreclose your loan or transfer your loan to another financial institution or you voluntarily surrender
the group membership? Yes [ü] No [ ]

Declaration of Good Health

Have you been hospitalized in the last 5 years or have suffered or suffer from diabetes, heart disease, cancer, HIV, AIDS or any major medical illness which requires regular
follow up or treatment ? Yes [ ] No [ü]

COVID -19 Questions

1. In the last 3 months have you or your family member been tested positive for COVID-19 or have been self-isolated with symptoms on medical advice? Yes [ ] No [ü]

2. ln the last 1 month have you or your family members been advised to isolate due to COVID-19 (excluding mandatory government orders to remain at home) or had a
persistent cough, fever, raised temperature or been in contact with an individual suspected or confirmed to have COVID-19? Yes [ ] No [ ü]

3. Have you or your family member travelled overseas post 1st Jan 2020 or planned to travel during the next 6 months? Yes [ ] No [ü]
eSigned using Aadhaar
(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
Name of the member: Signature of the member________

Date 30/08/2024 Place Thane CB

Consent for allowing split payment (applicable only for Regulated entities for ICICI Pru Shubh Raksha Credit)

I hereby provide my consent to allow ICICI Prudential to initiate split payment of the claim amount. on the happening of any contingent event, to the extent of the
outstanding loans in the name of Jana small Finance Bank. In this regard, the remaining proceeds of the claims due may accordingly be addressed in the name of the
nominee.

The above declaration and other details as furnished by me are true to the best of my knowledge.

Signature of the member __________ Name of the member:

Date 30/08/2024 Place Thane CB

Vernacular

Declaration to be made by a third person where: (a) the member has affixed his/her thumb impression, or (b) The member has signed in vernacular.

I hereby declare that I have explained the contents of this application form to in language and have truthfully recorded the submissions provided to me. I further declare that
_____________________ has signed /affixed his/her thumb impression in my presence.

Signature/Thumb impression of Witness _________________

Name & Address of witness_______________

Date: 30/08/2024

To,

Bajaj Allianz Life Insurance Company Limited,

Pune

Through,

Jana Small Finance Bank Ltd.

Dear Sir,

Sub: Declaration for settlement of claim amount under Group insurance scheme in favour of Jana Small Finance Bank Ltd.for Loan Account No/Customer
ID 104989000002404

This is to inform you that I ( Name of the Policy holder /Applicant/Member) W/O MR.Om Shahapure ( Spouse name ) have availed a loan from Jana Small Finance Bank
Ltd.herein after referred to as MPH, and to secure the loan amount, in the event of an unforeseen eventuality I have opted to enroll under the Group Insurance Scheme
administered by MPH. I intend that in the event of any eventuality with me, which gives rise to a claim, I authorize Bajaj Allianz Life Insurance Co. ltd (BALIC) to make
claim payment to the extent of outstanding loan balance amount to MPH. Balance of claim amount left, if any, may be paid by BALIC to my nominee/beneficiary as the case
may be.

BALIC shall, in the event of any claim arising out of my membership under the group insurance scheme administered by MPH, be discharged to the extent of amount paid to
the MPH towards outstanding loan balance amount for the loan availed by me. It shall be my sole responsibility to bring to the notice of BALIC, in the event I intend to make
a change in our declaration as made herein above.

The contents of this application has been explained to me by the representative of Jana Small Finance Bank Ltd. inthe language understood by me and I have fully understood
the content and purport of the same.

Thanking You

Yours truly,

Customer Name and Address : , Room No.06,Sadguru Apartment, Pada,

No.4, Near Old Bus Stop, Lokmanya,
Nagar,Thane West,,
THANE,
MAHARASHTRA.
eSigned using Aadhaar
(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
Witness Name and Address : MR.Om Shahapure , Room No.06,Sadguru Apartment, Pada,
No.4, Near Old Bus Stop, Lokmanya,
Nagar,Thane West,,
THANE,
MAHARASHTRA.

VERNACULAR DECLARATION

I, (name of the Representative of Master Policyholder) do hereby declare that the contents of this application have been explained to the customer named herein above in the
language understood by him/her and he/she has fully understood the contents and purport of the same. He has affixed his signature, in presence of the witness, after being
fully satisfied with the authorization.

Signature and Stamp of the Representative of MPH

eSigned using Aadhaar

(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
 Loan-Cum-Savings Account Form

Loan Information
Branch Code:3098 Branch: Name: Thane CB-3098
Customer URN: 7524082913202059 App No:104989000002404
Product Name: Individual Loan 802 Product Code:1559205
Loan Purpose: Furnishing Loan Amount: 55000
Loan Tenor: 24 ROI: 25
CREM Name: RohanWaman FSE Name:PrashantNinaji Ingle
Lat & Long:19.2091989 72.9493083 Nach presentation date: 5th of Every Month

Borrower Data
Existing Jana Bank Customer: Yes URN: 7524082913202059
Name: Om Shahapure Father's name:Raju shahapure
Spouse Name: Mother's Maiden Name:Anita shahapure
Loan Purpose: Furnishing Marital Status:Bachelor
DOB: 20/01/1998 Caste:OTHER BACKWARD CLASSES
Gender: Male Education:Graduate
Religion: HINDU Politically Exposed Person:NO
Current Address: Room No.06,Sadguru Apartment, Pada, No.4, Near
Whether opting for insurance:877.8 Old Bus Stop, Lokmanya, Nagar,Thane West,, THANE,
MAHARASHTRA - 400606
Permanent Address: Room No.06,Sadguru Apartment, Pada,
No.4, Near Old Bus Stop, Lokmanya,
Nagar,Thane West,,
THANE,
MAHARASHTRA.

Borrower KYC Details

Aadhaar Acknowledgement/ UID /VID Number: PAN Available:
PAN No.: Additional ID Proof Type:
Additional ID Proof No.:

Jana Account Details

Account Holder Name: MR.Om Shahapure Account No:
Nature of Account: Term Loan

Bank Account Details (For NACH)

Bank Name: BANK OF MAHARASHTRA Beneficiary Name: Om raju shahapure
Account Number: 60178991295 IFSC Code:MAHB0000642
Frequency: Monthly Account Type: SB

Guarantor Data
eSigned using Aadhaar
Gurantor Name: Date Of Birth: (Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
Gender: Marital Status:
Relationship with Borrower: Father/Spouse's Name:
Education Status: Mobile Number:
Email-ID: Politically Exposed: NO
Current Residence Address: Room No.06,Sadguru Apartment, Pada,
Whether opting for insurance: Yes No.4, Near Old Bus Stop, Lokmanya, Nagar,Thane West,, THANE,
MAHARASHTRA - 400606
Permanent Address : Room No.06,Sadguru Apartment, Pada,
No.4, Near Old Bus Stop, Lokmanya,
Nagar,Thane West,,
THANE,
MAHARASHTRA,
400606.

Guarantor KYC Details

Aadhaar Acknowledgement/ UID /VID Number: PAN Available:
PAN No.: Additional ID Proof Type:
Additional ID Proof No.:

Applicant Relationship Disclosure

1. Relationship (Details of relationship of Applicant with other banks) Applicant is director of any bank or is a relative of directors of other banks Yes / No Nature of
relationship ..........................................
2. Relationship (Details of relationship of applicant with the Jana Small Finance Bank) Applicant is a director / senior officer / relative of director or senior officer of
Jana Small Finance Bank Ltd. Yes / No Nature of relationship ..........................................

SL. No. Name of Directors / Senior Officer(s) Designation Relationship

Vernacular Declaration

I confirm that the Primary Applicant MR.Om Shahapure (name of applicant) and the Guarantor are illiterate(s) and I have, in _________________ language
spoken/understood by them, explained to them the process of the loan and the amount of loan being distributed to the Primary Applicant. I further confirm that they have
understood the terms and conditions of the loan being extended to them. Subscribed below are the signature/left thumb mark in proof of the same.

Signature of Primary Applicant Signature of Guarantor

Declaration

1. I/We hereby authorise Jana Small Finance Bank Ltd. (the “Bank”) to disburse the loan/credit facility to my/our account with the Bank and for this purpose I/we
authorise the opening of the account with the Bank.
2. In case of an already existing account with the Bank, I/we authorise the Bank to disburse the loan/credit facility in my/our account
no………………………………...[JS1]
3. I/We have read, understood and accepted the terms and conditions and Schedule of Charges governing the opening of the account with the Bank and those relating
to various services including, but not limited to ATMs / Debit card / Net banking/ Phone banking/Jana Cash Wallet mentioned hereunder and as stipulated at
www.janabank.com (“Website”).
4. I/We agree to be bound by all terms and conditions including excluding / limiting Bank's liability, and the changes thereto in terms and conditions from time to time
eSigned using Aadhaar
(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
 relating to my/our account as communicated and made available on the Website.
5. I/We agree that the Bank shall have the right to modify/amend any of the terms and conditions from time to time, at the Bank's own discretion, which may be
hosted and noticed on the Website and the same shall be sufficient notice to me/us regarding such modification/amendment and I/we shall be bound by such
modification/ amendment.
6. I/We understand that the BSBDA customers are not be eligible to open any other savings account with the Bank.
7. I/We understand that if the customer has any other existing savings account in the Bank, it will be required to be closed within 30 days from the date of opening a
BSBDA. In case of failure to do so, the Bank reserves the right to close the existing savings account along with all facilities linked to it and credit the closure
proceeds to the BSBDA.
8. In the event of death of the depositor / any one of the depositors, premature encashment of term deposits would be allowed to the surviving account holder in joint
account / nominees as per the policy of the Bank, such payment to survivors / nominees gives valid discharge to the Bank. The survivor/nominee would be
receiving the payment from the Bank as trustee of the legal heirs of the deceased depositor i.e. such payment to survivors shall not affect the right or claim which
any person may have against the survivor(s) to whom the payment is made. Such premature withdrawal shall not attract any penal charges as on date. The same is
subject to review from time to time.
9. I/We understand that loan savings account enjoys certain benefits, and the loan savings account will be migrated to a regular savings account with applicable
charges upon closure/completion of the loan tenure and shall be governed by terms of regular savings account. I/We further understand that if there is no balance or
transactions in the savings account for a period of more than 6 months, then the Bank may, in its discretion, close such savings account post intimating me/us of the
same.
10. I/We have furnished the relevant details and documents for opening my/our account with the Bank. I/We have cross checked the details and confirm that the same
are true, correct and complete.
11. That I/we have shown the original KYC documents to the representative and provided self-attested copies of the same.
12. I/We hereby voluntarily authorize the Bank to carry out e-KYC/online authentication/offline authentication of my/our Aadhaar for the purpose of establishing
my/our identity/address.
13. I/We hereby confirm that the Bank has informed me/us about all the options available for establishing my/our identity/address for KYC.
14. I/We have made the nomination (for account opening) of my/our own free will and with full conviction and the same has been captured in the TAB/system. [JS2]
15. It is stated that any and all claims, matters and disputes are subject to be governed by the laws of India and jurisdiction of the competent courts in Bengaluru only.
16. The Bank, its agents, representative, subsidiaries, affiliates, and any other person/entity authorized by it may contact me/us regarding the products/services/offering
updates, marketing promotions, smart rewards, special offers or any such information from time to time. This consent will override any registration for NC/NDNC
(National Do Not Call Registry). I/We hereby give my/our consent to receive such information through Phone Calls: [__] Y [__] N SMS: [__] Y [__] N Email: [__]
Y [___] N WhatsApp: [__] Y [__]N. [JS3]
17. I/We agree that the Bank may send communications/letters etc. to me / us, through courier/messenger/mail or through any other mode at its discretion and the Bank
shall not be liable for any delay arising therefrom.
18. I/We authorise the Bank to share/ disclose my/our Aadhaar / KYC or customer information and any other information/data whatsoever and/or any other loan/credit
facility documents, any default in discharge of obligations therein, as the Bank may deem fit or for any commercial, banking, administrative, business or funding
purposes, with any third party, including but not limited to:
1. To (or through) whom the Bank assigns or transfers (or may potentially assign or transfer) all or any of its rights and obligations under the Loan/ Facility
Documents.
2. Central KYC Registry / Credit Bureaus /any rating agency, insurer or insurance broker/direct or indirect provider of credit protection to the Bank or its
affiliates;
3. Any court or tribunal or regulatory, supervisory, statutory, governmental or quasi-governmental authority with jurisdiction over the Bank or its affiliates;
4. To whom such disclosure, is made by the Bank in its own interest.
19. I/We hereby agree that in the event of any default by the borrower in repayment of facility, interest or any outstanding balance or dues, the Bank and/or the Reserve
Bank of India shall have an un-qualified right to disclose or publish my/our name/s (along with photograph and any other information) and through such medium as
the Bank or the Reserve Bank of India in their absolute discretion may think fit.
20. I/We authorize the Bank and all its affiliates/group companies and their agents to exchange, share or part with all the information and details relating to my
Guarantor/s existing loans/financial assistances and/or repayment history to the Bank’s affiliates/group companies, banks, financial institutions, credit bureaus,
agencies, statutory authorities etc., as may be required or as the Bank may deem fit.
21. I/We shall not hold the Bank or its affiliates/ group companies and its/their agents/representatives liable for any use/disclosure/ sharing of such information.
22. I/We understands and agrees that:
1. the Credit Information Bureau (India) Limited and any other agency so authorized may use, process the said information and data disclosed by JSFB in
the manner as deemed fit by them; and
2. the Credit Information Bureau (India) Limited and any other agency so authorized may furnish for consideration, the proposed information and data of
products thereof prepared by them, to banks / financial institutions and other credit grantors or registered users, as may be specified by the Reserve Bank
of India in this behalf.
23. I/We understand that the clauses herein shall not be deemed to constitute, an express or implied agreement between me/us and the Bank.
24. I/We agree that the Bank may, in its sole discretion, engage services for extension of banking and financial services so as to ensure greater financial inclusion and
increasing the outreach of the banking sector.
25. I/We hereby affix my/our signature/s as confirmation of the above.
26. I/We hereby understand that the signature captured can be used to authorise/verify all future transactions. I/We agree that the above/below signature can be used as
the specimen signature also.
27. I/We understand that in order to process my/our loan application, the Bank may open a Savings Account in my/our name. I/We hereby declare that in case my/our
application is rejected by the Bank for any reason whatsoever, the Bank shall be entitled to close the aforesaid savings account without any intimation to me/us or
further consent from me/us.

Signature of Primary Applicant Signature of Guarantor

DATE: 30/08/2024

FATCA- CRS Declarations

eSigned using Aadhaar
(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
Please tick the applicable tax resident declaration (Any one)*

I/We am/are a tax resident of India and not a tax resident of any other country [__] Y [__] N

(If no, Separate FATCA Declaration form need to be filled)

The Central Board of Direct Taxes has notified on 7th August 2015 Rules 114F to 114H, as part of the Income-tax Rules, 1962, which Rules require Indian financial
institutions such as the Bank to seek additional personal, tax and beneficial owner information and certain certifications and documentation from all our account holders. In
relevant cases, information will have to be reported to tax authorities / appointed agencies / withholding agents for the purpose of ensuring appropriate withholding from the
account or any proceeds in relation thereto. Should there be any change in any information provided by you, please ensure you advise us promptly, i.e. within 30 days. If you
have any questions about your tax residency, please contact your tax advisor. If you are a US citizen or resident or green card holder, please include United States in the
foreign country information field along with your US Tax $ Identification Number. It is mandatory to supply a TIN or functional equivalent if the country in which you are
tax resident issues such identifiers. If no TIN is yet available or has not yet been issued, please provide an explanation and attach this to the form.

I have understood the information requirements of this Form (read along with the FATCA / CRS Instructions and Terms & Conditions) and hereby confirm that the
information provided by me/us on this Form is true, correct, and complete and hereby accept the same.

Date : ..................... Place : ..................... Signature : .....................

Nomination (only one individual nominee permitted for account opening)

[__] I wish to nominate [__] I do not wish to nominate****

Nomination under Section 45 ZA of the Banking Regulation Act, 1949 and Rule2 (1) of the Banking Companies (Nomination) Rules 1985 in respect of bank deposits.

I/We (Name) MR.Om Shahapure (Address) Lokmanya nagar , pada no 4, Near old bus stop,jk gram, THANE, MAHARASHTRA - 400606

nominate the following person to whom in the event of my/our/minor's death the amount of deposit in the above account may be returned by JANA SMALL FINANCE
BANK

Name Address: [__] Same as Primary Applicant

[__] If different from Primary Applicant ................................................................................... ........................................................

Relationship with depositor, if any....................................................... Age [__] Years Date of Birth of nominee...........................

*As nominee is minor I/We appoint (name)........................................................................Relationship with minor*............................

Address: [__] Same as Primary Applicant [__] If different.............................................................................................................

to receive the amount of deposit on behalf of the nominee in the event of my/our/ minor's death during the minority of the nominee.

Nominee Mobile Number: 7738513244

Signature of Primary Applicant**.................... Signature of the Joint Applicant(s)...................

*Strike out if nominee is not a minor. ** Where account is opened in the name of a minor, the nomination should be signed by a person lawfully entitled to act on behalf of
the minor. *** In case of thumb impression, nomination to be filled in as an annexure. [JS4] **** I have understood the benefits of nomination and still do not wish to
nominate

Inactive and Dormant Account Activation Request

I/We MR.Om Shahapure confirm that I/we have not operated my/our above Account no._______________________ for the following reason
_____________________________________________________________________________________________. I/We request you to activate my/our above account.

eSigned using Aadhaar

(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
Signature of Primary Applicant Signature of Guarantor

Acknowledgement - Applicant's copy

Loan Application Number: 104989000002404 Date: 30/08/2024

Applicant Name:Om Shahapure

We acknowledge the receipt of the above Loan-cum-Savings Account Form ............................ requesting for a loan of INR ______/- We undertake to convey the decision
within 15 days, subject to the submission of all relevant documents as required by Jana Small Finance Bank Ltd.

Name and signature of the Applicant Name and signature of the Bank official

______________________ ______________________

Registered Office: The Fairway, Ground & First Floor, Survey No. 10/1, 11/2 & 12/2B, Off Domlur, Koramangala Inner Ring Road, Next to Embassy Golf Links Business
Park, Challaghatta, Bangalore -560071. CIN:U65923KA2006PLC040028 Website: www.janabank.com

eSigned using Aadhaar

(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
 Member Consent Form For lClCl Pru Shubh Raksha Credit

(A Non-Linked Non-Participating Group Micro lnsurance Product)

Loan type: Furnishing

Cover type: Level Cover (death benefit will remain constant throughout the coverage term)

Details Full name Age/DOB Gender Loan Account No Occupation Relationship State/Pin code

Member MR.Om Shahapure 20/01/1998 Male 104989000002404 400606

Nominee 104989000002404 400606

Appointee*

*If Nominee is less than 18 years, Appointee is mandatory. Appointee should be more than 18 years of age.

Sum assured Coverage term Premium amount (inclusive of applicable taxes)

55000 24 877.8

I am aware that Jana Small Finance Bank is the holder of the life insurance Master Policy issued by lClCl Prudential Life insurance company Ltd for Group Micro lnsurance
product and I am a member of this group.

I understand the features of this product and agree with the terms and conditions and hereby consent to avail the benefits under the lClCl Prudential life insurance group
policy.

Do you wish to continue your cover till the coverage tem even after you foreclose your loan or transfer your loan to another financial institution or you voluntarily surrender
the group membership? Yes [ü] No [ ]

Declaration of Good Health

Have you been hospitalized in the last 5 years or have suffered or suffer from diabetes, heart disease, cancer, HIV, AIDS or any major medical illness which requires regular
follow up or treatment ? Yes [ ] No [ü]

COVID -19 Questions

1. In the last 3 months have you or your family member been tested positive for COVID-19 or have been self-isolated with symptoms on medical advice? Yes [ ] No [ü]

2. ln the last 1 month have you or your family members been advised to isolate due to COVID-19 (excluding mandatory government orders to remain at home) or had a
persistent cough, fever, raised temperature or been in contact with an individual suspected or confirmed to have COVID-19? Yes [ ] No [ü]

3. Have you or your family member travelled overseas post 1st Jan 2020 or planned to travel during the next 6 months? Yes [ ] No [ü]

Name of the member: MR.Om Shahapure Signature of the member________

eSigned using Aadhaar
(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
Date 30/08/2024 Place Thane CB

Consent for allowing split payment (applicable only for Regulated entities for ICICI Pru Shubh Raksha Credit)

I hereby provide my consent to allow ICICI Prudential to initiate split payment of the claim amount. on the happening of any contingent event, to the extent of the
outstanding loans in the name of Jana small Finance Bank. In this regard, the remaining proceeds of the claims due may accordingly be addressed in the name of the
nominee.

The above declaration and other details as furnished by me are true to the best of my knowledge.

Signature of the member __________ Name of the member: MR.Om Shahapure

Date 30/08/2024 Place Thane CB

Vernacular

Declaration to be made by a third person where: (a) the member has affixed his/her thumb impression, or (b) The member has signed in vernacular.

I hereby declare that I have explained the contents of this application form to MR.Om Shahapure in language and have truthfully recorded the submissions provided to me. I
further declare that _____________________ has signed /affixed his/her thumb impression in my presence.

Signature/Thumb impression of Witness _________________

Name & Address of witness_______________

Date: 30/08/2024

To,

Bajaj Allianz Life Insurance Company Limited,

Pune

Through,

Jana Small Finance Bank Ltd.

Dear Sir,

Sub: Declaration for settlement of claim amount under Group insurance scheme in favour of Jana Small Finance Bank Ltd.for Loan Account No/Customer
ID 104989000002404

This is to inform you that I MR.Om Shahapure ( Name of the Policy holder /Applicant/Member) W/O ( Spouse name ) have availed a loan from Jana Small Finance Bank
Ltd.herein after referred to as MPH, and to secure the loan amount, in the event of an unforeseen eventuality I have opted to enroll under the Group Insurance Scheme
administered by MPH. I intend that in the event of any eventuality with me, which gives rise to a claim, I authorize Bajaj Allianz Life Insurance Co. ltd (BALIC) to make
claim payment to the extent of outstanding loan balance amount to MPH. Balance of claim amount left, if any, may be paid by BALIC to my nominee/beneficiary as the case
may be.

BALIC shall, in the event of any claim arising out of my membership under the group insurance scheme administered by MPH, be discharged to the extent of amount paid to
the MPH towards outstanding loan balance amount for the loan availed by me. It shall be my sole responsibility to bring to the notice of BALIC, in the event I intend to make
a change in our declaration as made herein above.

The contents of this application has been explained to me by the representative of Jana Small Finance Bank Ltd. inthe language understood by me and I have fully understood
the content and purport of the same.

Thanking You

Yours truly,

Customer Name and Address : MR.Om Shahapure , Room No.06,Sadguru Apartment, Pada,
No.4, Near Old Bus Stop, Lokmanya,
Nagar,Thane West,,
THANE,
MAHARASHTRA.
eSigned using Aadhaar
(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024
Witness Name and Address : , Room No.06,Sadguru Apartment, Pada,
No.4, Near Old Bus Stop, Lokmanya,
Nagar,Thane West,,
THANE,
MAHARASHTRA.

VERNACULAR DECLARATION

I, MR.Om Shahapure (name of the Representative of Master Policyholder) do hereby declare that the contents of this application have been explained to the customer named
herein above in the language understood by him/her and he/she has fully understood the contents and purport of the same. He has affixed his signature, in presence of the
witness, after being fully satisfied with the authorization.

Signature and Stamp of the Representative of MPH

eSigned using Aadhaar

(Leegality.com - ig5avQ7)
Om Shahapure
Date: Fri Aug 30 15:18:58 IST
2024