Fields marked in are mandatory

Sourcing Channel Branch DST DSA PBK Web Referral Sales Other Channel (Specify)
Source 1 Source 2 Source 3 Source 4
Branch Code Sales Promo Code

GSTN No.
I wish to apply for below ticked (a) loan and request you to process New Car Two Wheeler Application date D D M M Y Y
the loan application as per details provided in the form Used Car

Existing App1 App 2 App 3

Customer Cust Id Cust Id Cust Id CKYC No. (If available- ETB/NTB Customer)
Savings/ Current
A/C no. Loan no.

Title Mr. Ms. M/S. Others __________ Applicant Co-Applicant Guarantor

Applicant Name
Maiden Name
(If any)

Nationality Indian Others __________________________ Residential Status Resident Individual Non Resident Indians Overseas Citizenship Foreign National Person of Indian Origin
of India (OCI)
Proof of identity Passport Date of Expiry D D M M Y Y Y Y Letter issued by
(Document to be Election / Voter’s ID Card NREGA Job ID Card Aadhaar Card Letter
Driving the National
submitted as detailed) Date of Expiry D D M M Y Y Y Y Population Others (Notified by central Govt.)_______________
Licence
Proof of Identity - Identification Number for mentioned proof (other than Aadhaar) Register Proof of Identity - Identification Number for Aadhaar

X X X X X X X X
Father's/
Husband's Name
Date of Birth/ Gender M Third Gender Status Single Married No. of Dependents
Incorporation D D M M Y Y Y Y F
SC ST Physically Disabled Yes No
Educational Details Undergraduate Graduate Post Graduate & above Others _________ Religion ____________ OBC Other________

Present /
Current
Address
(Residence)

Landmark Years at current city Y Y M M

Village City
District Years at current residence Y Y M M
State Country
Tel (R) S T D - Mobile no. 91
Tick if permanent address is same as above
Present Address is Owned Parental Company provided Rented (Monthly Rent in r________________) Tick if current/present address is different from Aadhaar Address
Permanent
Address
(Residence / Regd
Office)

Landmark
City
State Country Aadhaar Card No.
Tel (R /O) S T D - Mobile no. 91
Please tick if Address Type Residential Business Registered Office Proof of Passport Election / Voter’s ID Card NREGA Job ID Card
is other than Residential Residential & Business Unspecified Address Driving Licence UID (Aadhaar Card) Others: __________________

Occupation Salaried Self employed Self employed professional Retired Housewife Student Other___________
If self employed professional Doctor Consultant Architect Lawyer Other___________
If self employed Type of company Pvt. Ltd. Partnership Proprietor Public Ltd. Ltd. liability co. Other___________
businessman /
Constitution Nature of business Manufacturer Agriculturist Service Provider Trader/Distributor Comm. Agent Retailers Other___________
Type of company Pvt ltd. Partnership Proprietor Public Ltd. Retailers PSU Govt. MNC Other___________
If Salaried
Automobiles Agriculture based Banking BPO Capital goods Telecom IT Retail
Type of industry
Real estate Consumer Durables FMCG NBFC Marketing / Adv. Pharma Media Other___________
Employer / Business Details Designaton:_________________ Exp in Current Job/Business Yrs Months T otal Exp in Job/Business Yrs Months
Company /
Employers Name
Company /
Employers
Page 1

Address Landmark
City
State Country
T el (O) S T D - E X N T Preferred Mailing Address Residence Office
Official
 Proprietor / Partner / Directors Details (For Partnership / Private Ltd. / Public Ltd. Co. Only)
Name Contact details Date of birth Education background Profit sharing/stakeholder % Total experience

Monthly salary R U P E E S Annual turnover R U P E E S Net profit R U P E E S Other R U P E E S

income
Other income Rental Agricultural Other ________________
source
A/c No. Bank Name Branch
Applicant’s
Primary Cust ID Opened In Y Y Y Y Account Type
A/c Details Credit
Card No. Issuing Bank

Existing Loan Details:

1) Bank / Co. name ________________________________ Loan Type ____________________ Loan Account No. __________________ Amount (r) _____________ EMI(r) _____________Tenure _______Start date _________

2) Bank / Co. name ________________________________ Loan Type ____________________ Loan Account No. __________________ Amount (r) _____________ EMI(r) _____________Tenure _______Start date _________

D. VEHICLE PRICING AND LOAN DETAILS

Ex-showroom Price ( r ) EMI Amount ( r )
(+) Insurance Cost ( r ) No. of advance EMI
(+) Registration Tax ( r ) Loan Tenure Months
(+) Accessories Amount ( r ) Asset Make __________________________
Model __________________________
(-) Dealer Discount ( r )
Usage Personal Commercial Top Up
(-) Manufacturer Discount ( r )
Purpose of Loan Home Renovation Marriage Travel
= On Road Vehicle Cost / Valuation Price ( r )
Education Business Expansion Agriculture/Farming
(-) Margin Money ( r )
Transportation of Agri Produce Other______________________
(-) Total Advance EMI Amount ( r )
Dealer __________________________
(-) Car Trade in Value ( r ) VEHICLE OWNED DETAILS
= Gross Loan Amount Manufacturer __________________________
(-) Other Discounts ( r ) Model __________________________
(=) Net Loan Amount ( r ) Brought in Year Y Y Y Y Financed Y N
Scheme LPO Repayment Income F4 NIP On - road Others_____________________

1) Name____________________________________________________________________ 2) Name____________________________________________________________________
Relationship with applicant ____________________________________________________ Relationship with applicant ____________________________________________________
Residential address _________________________________________________________ Residential address _________________________________________________________
__________________________________City______________State__________________ __________________________________City______________State__________________

Nature of Relationship:
Applicant is a director of any Bank* or is a Firm in which any director is interested as partner / guarantor
Relationship with or is a relative of directors of other banks or is a firm in which relatives of directors are interested as partner or director.
Other bank (*including director of Scheduled Co-operative Banks, directors of subsidiaries/trustees of mutual funds/venture capital funds)

__________________________________
Relationship with
Financing bank Applicant is a Director / Sr. Officer / relative of director or Sr. Officer of the Bank.

*That no director of the Bank is a director, manager, managing agent, employee or guarantor of the Borrower, or of a subsidiary of the Borrower, or of the holding company of the Borrower, or holds substantial interest, in the
Borrower or a subsidiary or the holding company of the Borrower and no directors of any other bank holds substantial interest or is interested as director or as a guarantor of the Borrower;
*That no relative (as specified by Reserve Bank of India (“RBI”) of a Chairman/Managing Director or director of banking company (including the said Banks) or a relative of senior officer (as specified by RBI) of the Bank,
hold substantial interest or is interested as a director or as guarantor of the Borrower.
Politically Exposed Person (PEP)Declaration
Politically Exposed Person are individuals who are or have been entrusted with prominent public function in India or in foreign country, e.g. Heads of States or of Governments, senior government / judicial / military officers, senior
executives of state-owned corporations important political party officials, etc.
Please tick Yes / No: 1st Applicant PEP/Relatives and close Associate of PEP Yes NO Co Applicant PEP or Relatives and close Associate of PEP Yes NO

Additional Details Required for NRI Applicant :

Country Name ______________________________________________________________________________________________________________________ Country Code __________________________________

If applicant resident for tax purposes in Jurisdiction outside India [ ] Yes [ ] No Jurisdiction of residence _______________________________________________________________________________________

Tax identification Number or equivalent (If issued by jurisdiction) _________________________ Country of Birth ____________________________________ City/ Place of Birth ___________________________________

If address in jurisdiction where application is resident is same as Current/Permanent/ Overseas or Correspondence/ Local address details [ ] Yes [ ] No

Address in Jurisdiction_______________________________________________________________________________________________________________________________________________________________

City/Town/Village_____________________________________________________________ State__________________________________________________________ Country Zip/Post code ____________________

Page 2
 (Important : If applicant belongs to any of the below category, pls tick the box)
Agri Farm Credit / Direct Agri (Agriculturist / Farmer / Agri allied activities like, dairy farming, poultry farming, fishery, bee-keeping etc)
Land (acres) <3 3 to 5 >5 to 10 >10 to 15 > 15 Specify (acres):____________ Location:_________________________________ Pin Code:______________

Manufacturing Enterprises and Enterprises rendering Services

Declaration: I/We hearby declare/confirm that the vehicle purchased/ to be
Investment in Plant and Machinery or Equipment: Not more than Rs.1 crore purchased / loan availed / to be availed by me/us shall be used
Micro For the purpose of Agriculture and /or assist of agriculture input and farm
Annual Turnover ; not more than Rs. 5 crore
product
Investment in Plant and Machinery or Equipment: Not more than Rs.10 crores For the purpose of Business: I/We are aware that it is on the faith of this
Small representation, declaration and confirmation that you have agreed to consider
Annual Turnover ; not more than Rs. 50 crores
my loan application for financial assistance under the category of Priority
Investment in Plant and Machinery or Equipment: Not more than Rs.50 crore sector advances.
Medium I/We indemnify and keep the Bank indemnified for any claims, costs, damages
Annual Turnover ; not more than Rs. 250 crore
incurred by the Bank and make good the loss that may be suffered by the Bank
Value of Investment ( ) __________________________________ on account of any false / incorrect declaration by me/us as stated above.

I/We agree and confirm: (1) to the applicable schedule of charges informed to me by HDFC Bank Ltd. (Bank) and as more particularly mentioned in "Schedule of Charges" of this Application
(2) that the bank's representative/staff will not receive any payment in cash/ bearer cheque or kind along with or in connection with this loan application from me/us. (3) that no discount or free
gift or any other commitment whatsoever is given to me/us by the Bank or any of its authorized representative(s) other than what is not documented in this Form or the loan agreement. (4) the
bank shall not process incomplete / defective application form, for which if any loss or delay is caused to me/us, I/We will not hold the Bank liable for such loss or delay. (5) that Loan
processing and disbursement will take at least 7 working days post submission of all requisite documents and information as may be required by Bank as per Bank's criteria. (6) that
submission of loan application to your bank does not imply automatic approval by the Bank and the Bank will decide the quantum of the loan at its sole discretion. (7) the Bank reserves its
right to reject the loan application and retain the loan application form along with the photograph and documents. (8) that I/We shall furnish any additional documents as and when required by
the Bank. (9) that I/We have not taken any loan from any other bank / finance company unless specifically declared by me / us. (10) that there is no pending litigation against me/us filed by any
other financier / bank. (11) that the funds shall be used for the purpose for which loan has been applied and will not be used for speculative or antisocial purpose. (12) I/We do not have any
existing customer ID or customer ID apart from the one mentioned above, and in case found otherwise, Bank reserves the right to consolidate the customer lds under a single customer ID as
it may decide, without any prior notice to me/us. (13) that the information furnished by me/us above is true and accurate and I undertake to inform you of any changes therein, immediately, In
case any of the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it. I/We authorize HDFC Bank Ltd. to make any
enquiries regarding my application. I/We have read and understood the contents of all the four (4) pages of the loan application form and accept the same.

(Bank Copy)
I / we confirm having submitted the following self attested documents (ticked below) along with this loan application form to the Bank representative
Photograph Proof of Identity Proof of residence Latest 2 salary slips 3/6 months bank statement ______Post Dated Cheques
Proof of continuity of current job Proof of office Proof of qualification Loan Agreement Signature Verification
Loan a/c statement for balance transfer / balance transfer &
______Security Post-dated cheques Proof of turnover (latest sales/services tax returns) top up / repayment / retention cases

I. Schedule of Charges communicated to me / us by the Bank representative Type of Loan Car Loan TW Loan
1) Stamp Duty: As per State laws. 2) Interest rate of _______% p.a.(monthly reducing). 3) Non Refundable Processing
Fees of (SC) Z________. 4) Documentation Charges (SC) : Z_________ 5) Payment Return Charges (AL & TW)- R.450/- 6) Due date of EMI 5th / 7th 6th / 10th
Overdue EMI Interest : 2% per month from unpaid EM I (For TWL - 2.5%) 7) CI B I L Report Copy Charges: Z 50 per copy Prepayment not allowed
up to payment of 06 EMI 03 EMI
(SC) 8) PDD Collection Charges*: Z._________. (For AL & TWL ), 9) Legal, repossession and Incidental Charges: At actual
10) Loan re-booking/re-shedulement charges (SC) : AL - R.500/- & TW- R.525/- 11) Duplicate NOC - Rs. 500/- & Special Prepayment 7-12 Months of EMI 4-12 Months of EMI
NOC Charges (SC) - R. 250/- 12) Amortization Schedule Charges Z. 50/- (SC) 13) Repayment mode change charges: Z. Charges Repayment - 6% Repayment - 6%
500/- (SC) 14) Valuation / Asset Verification Charges : Z. 500/- (SC), 15) RTO Transfer charges At actuals [on Principal 13-24 Months of EMI 13-24 Months of EMI
Note : Visit http://www.hdfcbank.com for detailed fees and charges under the Outstanding] Repayment - 5% Repayment - 5%
respective loan product. Changes in charges from time to time are updated on
bank's website. >24 Months of EMI 24 Months of EMI
PDD Collection/Collateral charges refundable incase of loan cancellation. Customer Signature Repayment - 3% Repayment - 3%
*Applicable Government taxes and other levies will be charged additionally on
Cheque/SI/ECS Return and Collateral, Documentation and Valuation charges. Applicable Government taxes and other levies will be charged on foreclosure charges.
*10% discount to senior citizens on all the service charges (SC)

" " " "

(Customer Copy)
I / we confirm having submitted the following self attested documents (ticked below) along with this loan application form to the Bank representative
Photograph Proof of Identity Proof of residence Latest 2 salary slips 3/6 months bank statement

Page 3
Proof of continuity of current job Proof of office Proof of qualification Loan Agreement Signature Verification Proof of turnover (latest sales/services tax returns)
______Post Dated Cheques ______Security Post-dated cheques Loan a/c statement for balance transfer/balance transfer & top up/repayment/retention cases

I. Schedule of Charges communicated to me / us by the Bank representative

1) Stamp Duty: As per State laws. 2) Interest rate of _______% p.a.(monthly reducing). 3) Non Type of Loan Car Loan TW Loan
Refundable Processing Fees of (SC) Z________. 4) Documentation Charges (SC) : Z_________ 5) Due date of EMI 5th / 7th 6th / 10th
Payment Return Charges (AL & TW)- R.450/- 6) Overdue EMI Interest : 2% per month from unpaid EM Prepayment not allowed
I (For TWL - 2.5%) 7) CI B I L Report Copy Charges: Z 50 per copy (SC) 8) PDD Collection Charges*: up to payment of 06 EMI 03 EMI
Z._________. (For AL & TWL ), 9) Legal, repossession and Incidental Charges: At actual 10) Loan re-
booking/re-shedulement charges (SC) : AL - R.500/- & TW- R.525/- 11) Duplicate NOC - Rs. 500/- & Prepayment 7-12 Months of EMI 4-12 Months of EMI Repayment - 6%
Special NOC Charges (SC) - R. 250/- 12) Amortization Schedule Charges Z. 50/- (SC) 13) Charges Repayment - 6% 13-24 Months of EMI Repayment - 5%
Repayment mode change charges: Z. 500/- (SC) 14) Valuation / Asset Verification Charges : Z. 500/- [on Principal 13-24 Months of EMI 24 Months of EMI Repayment - 3%
(SC), 15) RTO Transfer charges At actuals Outstanding] Repayment - 5%
Note : Visit http://www.hdfcbank.com for detailed fees and charges under the respective loan >24 Months of EMI
product. Changes in charges from time to time are updated on bank's website. Repayment - 3%
PDD Collection/Collateral charges refundable incase of loan cancellation.
*Applicable Government taxes and other levies will be charged additionally on Cheque/SI/ECS
Return and Collateral, Documentation and Valuation charges. Applicable Government taxes and other levies will be charged on foreclosure charges.
*10% discount to senior citizens on all the service charges (SC)

Name of the Applicant__________________________________________________________ To get the status of your loan application you can reach us at below Contact Numbers
Type of Loan Applied___________________________________________________________
Delhi & NCR 011 61606161 Chandigarh 0172 6160616
Branch Code :___________________ Date & Time of Receipts__________________________ Ahmedabad 079 61606161 Jaipur 0141 6160616
Branch Contact Person Name_________________________ Contact No_________________ Bengaluru 080 61606161 Chennai 044 61606161
Cochin 0484 6160616 Hyderabad 040 61606161
Follow us on Indore 0731 6160616 Lucknow 0522 6160616
Mumbai 022 61606161 Kolkata 033 61606161
Pune 020 61606161

Watch us on Andhra Pradesh, Assam, Gujarat, Haryana, Karnataka, Kerala, MP / Chhatisgarh,

Maharashtra (except Mumbai & Pune) / Goa, Orissa, Punjab, Rajasthan, Tamil Nadu /
Signature of Executive / Bank Staff
Pondicherry, UP / Uttarakand, Bihar/Jharkhand, West Bengal / Sikkim, J & K / HP,
Meghalaya/Tripura, Arunachal Pradesh, Nagaland/Mizoram / Dadra & Nagar Haveli / Daman &
Diu / Lakshadeep / Telangana: 1860 267 6161
Please visit www.hdfcbank.com or below link for checking application status
“https://leads.hdfcbank.com/applications/misc/LST/loantracker.aspx”
 J. Other declarations : I / We : (1) shall advise the HDFC Bank Ltd. (Bank) in writing of any change in my / our residential or employment address. (2) I hereby confirm that am
a major and a resident of India / non resident of India and I have read and I hereby accept the Privacy Policy of the Bank available at Bank Website. (3) I seek from the Bank
various financial assistance, other products and services for which I may be found eligible by the Bank from time to time, at any time in future, including after closure of any of
my existing or future relationships, accounts, products, facilities, loans, services with or from the Bank from time to time, for which purpose I authorize the Bank to share any
of my Information (as defined hereinafter) with any credit information companies and obtain various scores, reports and information for determining my credit worthiness
from them, and accordingly to contact me or cross sell to me from time to time. (4) I hereby further expressly consent to and authorise the Bank (whether acting by itself or
through any of its service providers, and whether in automated manner or otherwise), to do and undertake any of the following, in relation to my application details, personal
data and sensitive information about me, information, papers and data relating to know your customer (KYC), credit information, and any other information whether about
me or not as may be deemed relevant by the Bank for its purposes (collectively, “Information”): i) to collect the Information from me and other physical or online sources
including accessing the same from credit information companies, information utilities, websites, data bases and online platforms (whether public or not); to get the
authenticity, correctness, adequacy, etc. of the Information verified from any sources and persons including from online data bases; and to act for and on my behalf for such
accessing, collecting or verifying of the Information including using my log in and password credentials on the online platforms; such collection, access and verification may
be done without any notice to me; ii) process Information including by way of storing, structuring, organizing, reproducing, copying, using, profiling, etc. as may be deemed fit
by the Bank; iii) to store the Information for such period as may be required for contract, by law or for the Bank’s evidential and claims purposes, whichever is longer; iv) to
share and disclose the Information to service providers, consultants, credit information companies, information utilities, other banks and financial institutions, affiliates,
subsidiaries, regulators, investigating agencies, judicial, quasi-judicial and statutory authorities, or to other persons as may be necessary in connection with the contractual
or legal requirements or in the legitimate interests of the Bank or as per the consent; v) any of the aforesaid may be exercised by the Bank for the purposes mentioned above,
for the purposes of credit appraisal, fraud detection, anti-money laundering obligations, for entering into contract, for direct marketing, for developing credit scoring models
and business strategies, for monitoring, for evaluating and improving the quality of services and products, for other legitimate purposes or for any purposes with consent. (5)
I expressly agree to and subject me to the automated processing, automated profiling and to the automated decision making by or on behalf of the Bank. (6) I expressly
agree to the Bank and/or its affiliates for using the Information and for cross-selling to me their various products and services from time to time. (7) shall credit all sums
received by you in either or all the names of this account. (8) hereby confirm having received, read and understood the terms and conditions applicable to this loan and
accept the same. (9) hereby unconditionally, agree that these terms and conditions may be changed by the Bank at any time and I/We will be bound by the amended terms
and conditions. (10) Confirm that I/We are citizen of India. (11) hereby consent to receiving information from Central KYC Registry through SMS/Email on the register
number / email address.
I / We also confirm that the executive collecting my loan Application / Document has informed me / us : (1) that GST is applicable and will be charged in
connection with the loan. (2) all the commission/s (in the form of up front and trail commissions) payable to HDFC Bank for the insurance policy recommended to
me/us. (3) In case of loan cancellation, the applicable pro-rata interest charges on any outstanding loan amount will have to be borne by me / us. I understand that
Processing Fee, Stamp Duty and RTO charges (UCL / Re-finance/Rewards) are non-refundable charges and would not be waived/re-funded in case of loan
cancellation. (4) that all post dated cheques are to be issued favouring HDFC Bank Limited A/c < Mention Product Name > only. (5) that the Bank is only a finance
provider and subsequent to vehicle/asset finance disbursement to the dealer, Bank has no liability towards condition / colour / make / performance /quality of
vehicle/asset at the time of delivery/delay in delivery of vehicle/accessories/spare-part from the dealer or availability of specific colour/model/quality/version at the
dealership. (6) that any discount in pricing of the asset is purely an offer by the manufacturer / dealer. (7) that loan related information like “welcome letter”,
“repayment schedule” , “loan agreement”, “disbursal advice”, will be sent on the e-mail id mentioned by me/us in this loan application form. (8) that I / We can log on to
HDFC Bank Net Banking (www.hdfcbank.com) to view the welcome letter and repayment schedule. I/We may also request for a physical copy of Welcome Letter and
Repayment Schedule separately if need be. (9) I/We agree that the rate of interest offered is valid for a period of 30 days from the date of application. HDFC Bank Ltd
reserves the right to revise the interest rates, if the loan is disbursed post this period OR in case of any changes in Base Rate or Risk Based Price. In such case, the
revised interest rate as communicated under revised Schedule cum Key Fact sheet will be applicable. (10) I/We hereby undertake that any discount / subvention offered
by the dealer / manufacturer / DSA would be upfront deducted from the Asset Cost and funding would be net of such discount. (11) I/We explicitly understand that the Bank is
not involved in any kind of discount / subvention negotiations with the dealer / manufacturer / DSA and the loan scheme does not factor such discounts in the interest rate
computation. (12) I/We declare that the Invoice Price of Vehicle mentioned above is post deducting such discounts availed by me/ us from the dealer / manufacturer / DSA.
K. DO NOT CALL REGISTRY : I understand that in case I do not wish to receive promotional information through telephone calls / email / sms on products and services not
currently availed by me, I can register for "Do Not Call" service through the Bank's website www.hdfcbank.com or through PhoneBanking or other channels that the Bank
may offer. I agree that this service will not apply to receipt of advice and information regarding products and services currently availed by me, to help me in fully realising
the benefits of the range of financial solutions designed to make my banking relationship value added and more convenient.
I/We have read and verified the entire contents of the aforesaid Loan Application Form including the information, the Most Important
Terms and Conditions , the Declarations being Part A to Part K and I/We hereby irrevocably represent, confirm and declare that all the
information given thereunder are completely true and correct and further agree, acknowledge, accept and confirm the same.
Do not sign this form if it is BLANK. Please ensure all relevant sections and columns are completely filled to your satisfaction and
Please Paste then only sign the form.
Latest Passport Size
Photograph

Applicant's/Co-applicant's Signature

Name: ____________________________________ Date:___________________ Place:________________

_

" " " "

(Customer Copy)
I/We agree and confirm: (1) to the applicable schedule of charges informed to me by HDFC Bank Ltd. (Bank) and as more particularly mentioned in "Schedule of Charges" of this Application (2) that the bank's representative/staff
will not receive any payment in cash/ bearer cheque or kind along with or in connection with this loan application from me/us. (3) that no discount or free gift or any other commitment whatsoever is given to me/us by the Bank or any
of its authorized representative(s) other than what is not documented in this Form or the loan agreement. (4) the bank shall not process incomplete / defective application form, for which if any loss or delay is caused to me/us, I/We
will not hold the Bank liable for such loss or delay. (5) that Loan processing and disbursement will take atleast 7 working days post submission of all requisite documents and information as may be required by Bank as per Bank's
criteria. (6) that submission of loan application to your bank does not imply automatic approval by the Bank Limited and the Bank will decide the quantum of the loan at its sole discretion. (7) the Bank reserves its right to reject the
loan application and retain the loan application form along with the photograph and documents. (8) that I/We shall furnish any additional documents as and when required by the Bank. (9) that I/We have not taken any loan from any
other bank / finance company unless specifically declared by me / us. (10) that there is no pending litigation against me/us filed by any other financier/ bank. (11) that the funds shall be used for the purpose for which loan has been
applied and will not be used for speculative or antisocial purpose. (12) that the information furnished by me/us above is true and accurate and I undertake to inform you of any changes therein, immediately, In case any of the above
information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it. I/We authorize HDFC Bank Ltd. to make any enquiries regarding my application. I/We have read and understood
the contents of all the four (4) pages of the loan application form and accept the same. (13) shall advise the HDFC Bank Ltd. (Bank) in writing of any change in my / our residential or employment address. (14) ) I hereby confirm that
am a major and a resident of India and I have read and I hereby accept the Privacy Policy of the Bank available at Bank Website. (15) I seek from the Bank various financial assistance, other products and services for which I may be
found eligible by the Bank from time to time, at any time in future, including after closure of any of my existing or future relationships, accounts, products, facilities, loans, services with or from the Bank from time to time, for which
purpose I authorize the Bank to share any of my Information (as defined hereinafter) with any credit information companies and obtain various scores, reports and information for determining my credit worthiness from them, and
accordingly to contact me or cross sell to me from time to time. (16) I hereby further expressly consent to and authorise the Bank (whether acting by itself or through any of its service providers, and whether in automated manner or
otherwise), to do and undertake any of the following, in relation to my application details, personal data and sensitive information about me, information, papers and data relating to know your customer (KYC), credit information,
and any other information whether about me or not as may be deemed relevant by the Bank for its purposes (collectively, “Information”): i) to collect the Information from me and other physical or online sources including accessing
the same from credit information companies, information utilities, websites, data bases and online platforms (whether public or not); to get the authenticity, correctness, adequacy, etc. of the Information verified from any sources
and persons including from online data bases; and to act for and on my behalf for such accessing, collecting or verifying of the Information including using my log in and password credentials on the online platforms; such collection,
access and verification may be done without any notice to me; ii) process Information including by way of storing, structuring, organizing, reproducing, copying, using, profiling, etc. as may be deemed fit by the Bank; iii) to store the
Information for such period as may be required for contract, by law or for the Bank’s evidential and claims purposes, whichever is longer; iv) to share and disclose the Information to service providers, consultants, credit information
companies, information utilities, other banks and financial institutions, affiliates, subsidiaries, regulators, investigating agencies, judicial, quasi-judicial and statutory authorities, or to other persons as may be necessary in
connection with the contractual or legal requirements or in the legitimate interests of the Bank or as per the consent; v) any of the aforesaid may be exercised by the Bank for the purposes mentioned above, for the purposes of credit
appraisal, fraud detection, anti-money laundering obligations, for entering into contract, for direct marketing, for developing credit scoring models and business strategies, for monitoring, for evaluating and improving the quality of
services and products, for other legitimate purposes or for any purposes with consent. (17) I expressly agree to and subject me to the automated processing, automated profiling and to the automated decision making by or on
behalf of the Bank. (18) I expressly agree to the Bank and/or its affiliates for using the Information and for cross-selling to me their various products and services from time to time. (19) shall credit all sums received by you in either or
all the names of this account. (20) hereby confirm having received, read and understood the terms and conditions applicable to this loan and accept the same. (21) hereby unconditionally, agree that these terms and conditions may
be changed by the Bank at any time and I/We will be bound by the amended terms and conditions. (22) That I/We are citizen of India. (23) hereby consent to receiving information from Central KYC Registry through SMS/Email on
the registered number/ email address
I / We also confirm that the executive collecting my loan Application / Document has informed me / us : (1) that GST is applicable and will be charged in connection with the loan. (2) all the commission/s (in the
form of up front and trail commissions) payable to HDFC Bank for the insurance policy recommended to me/us. (3) In case of loan cancellation, the applicable pro-rata interest charges on any outstanding loan
amount will have to be borne by me / us. I understand that Processing Fee, Stamp Duty and RTO charges (UCL / Re-finance/Rewards) are non-refundable charges and would not be waived/re-funded in case of loan
cancellation. (4) that all post dated cheques are to be issued favouring HDFC Bank Limited A/c < Mention Product Name > only. (5) that the Bank is only a finance provider and subsequent to vehicle/asset finance
disbursement to the dealer, Bank has no liability towards condition / colour / make / performance /quality of vehicle/asset at the time of delivery/delay in delivery of vehicle/accessories/spare-part from the dealer or
availability of specific colour/model/quality/version at the dealership. (6) that any discount in pricing of the asset is purely an offer by the manufacturer / dealer. (7) that loan related information like “welcome letter”,
“repayment schedule” , “loan agreement”, “disbursal advice”, will be sent on the e-mail id mentioned by me/us in this loan application form. (8) that I / We can log on to HDFC Bank Net Banking (www.hdfcbank.com)
to view the welcome letter and repayment schedule. I/We may also request for a physical copy of Welcome Letter and Repayment Schedule separately if need be. (9) I/We agree that the rate of interest offered is
valid for a period of 30 days from the date of application. HDFC Bank Ltd reserves the right to revise the interest rates, if the loan is disbursed post this period OR in case of any changes in Base Rate or Risk Based
Price. In such case, the revised interest rate as communicated under revised Schedule cum Key Fact sheet will be applicable. (10) I/We hereby undertake that any discount / subvention offered by the dealer /
manufacturer / DSA would be upfront deducted from the Asset Cost and funding would be net of such discount. (11) I/We explicitly understand that the Bank is not involved in any kind of discount / subvention negotiations
with the dealer / manufacturer / DSA and the loan scheme does not factor such discounts in the interest rate computation. (12) I/We declare that the Invoice Price of Vehicle mentioned above is post deducting such discounts
availed by me/ us from the dealer / manufacturer / DSA. 13) End to End disbursal TAT for manned location is 5 days & 7 days for non-manned location.

Important Information for Customer – Form No IL

1) Anti-Rebating Warning : As per Section 41 of the Insurance Act 1938, as amended, the practice of rebating is prohibited, as follows: No person shall allow or offer to allow, either directly or indirectly, as an inducement to
any person to take out or renew or continue an insurance policy in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the premium show
on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, except such rebate as may be allowed in accordance with he published prospectus or tables of the insurer. Violations of
Section 41 of the insurance Act 1938, as amended, shall be punishable with a fine which may extend to five hundred (500) Rupees.
2) Insurance is the subject matter of the solicitation.
3)For any loss reported under the section of Credit Shield Cover of Sarva Suraksha Plus/Star, the Loss will be paid by Insurance Partner to HDFC Bank Ltd under “Assignee Clause”
4)On receipt of request from HDFC Bank Ltd, for cancellation of Insurance, due to for example , cancellation of loan, forfeiture of loan, payment default etc.,and also policy cancellation by the Insurance Partner to cancel the
policy and pro rata premium for the remining tenure of the loan would be refunded to HDFC Bank Ltd. And the insurance would cease to exist
 MEMBER ENROLMENT FORM
Credit Assurance Plan (CAP)

Date

Loan Tenure Months Customer Signature

Health Assurance Plan (HAP)
"Insurer
ABHI BAGIC HDFC ERGO ICICI LOMBARD NIVA BUPA
(Arranged Alphabetically)"
"(A) EMI Protect 4 EMIs covered per policy year | Borrower and Co-Borrower can be covered in Policy | Age Entry - 18
(Your EMI will be paid by Insurance to 60 years |1st EMI paid on hopitalization of 2 days and every additional EMI payable on hospitalization
Company in case of hospitalization*)" of additional 2 days | Multiple Hospitalizations allowed | Initial waiting period of 30 days.
⃝ ⃝ ⃝ ⃝ ⃝
Premium Amount (with GST)

"Insurer
ABHI BAGIC HDFC ERGO ICICI LOMBARD NIVA BUPA
(Arranged Alphabetically)"
(B) Critical Illness (Basis diagnosis of any
Sum Insured upto 1 cr| Borrower and Co-Borrower can be covered in Policy | Age Entry - 18 to
listed diseases, your outstanding loan
60 years
amount is covered*)
"Insurer
ABHI BAGIC HDFC ERGO ICICI LOMBARD NIVA BUPA
(Arranged Alphabetically)"
⃝ ⃝ ⃝ ⃝ ⃝
Premium Amount (with GST)
*For benefits refer to the next page

I hereby authorize HDFC BANK to pay the premium in on my behalf and the same to be included in the loan amount from the bank and recovered
from me in EMIs.

Nominee Name Relationship with Proposer

Declaration: I hereby declare that the above statements are true and complete in all respects and there is no other information which is relevant
to my application of insurance that has not been disclosed to you. I agree that this proposal and the declaration shall be the basis of the contract
between me and the selected insurance company and I agree to accept the policy subject to the condition prescribed by selected insurance
company.

Good Health Declaration: Are you in good health and/or not suffering from any mental/physical impairment and/ ⃝ ⃝
or deformity and/or disablement since or after birth? Yes No

Signature of Customer
 APPLICATION FOR INSURANCE

Sarv Surksha
⃝ ⃝ ⃝ ⃝
“Insurer
(Arranged Alphabetically)” BAGIC HDFC ERGO ICICI LOMBARD
ABHI (Suraksha Kavach) (Sarv Suraksha) (Universal Protection)
Premium Amount (with GST)

Sarv Suraksha Plus The selected Insurance Partner for the tenure of __________ months, the premium amount being r ______________ /-.

Date _____/ _____ / _________ Period of Coverage : ______________ months

Nominee Name : ______________________________________________Relationship with Proposer________________________

Declaration: I hereby declare that the above statements are true and complete in all respects and there is no other information which is relevant to my application of
insurance that has not been disclosed to you.I agree that this proposal and the declaration shall be the basis of the contract between me and selected insurance
partner and I agree to accept the policy subject to the condition prescribed by the selected insurance partner.
Motor Insurance Premium R_____________________________ Signature of Proposer

Members Information Form Premium Amount r

Name : _________________________________________________ D D M M Y Y Y Y Gender M F Identification Mark : ___________________________________________

Death Benefit : Level term assurance Sum Assured (loan amt) r : ___________ Term : ______ Age proof: Driving license Passport Leaving certificate Others ____________

Short Medical Questionnaire - Health Details of Member (tick the box for your answer) Yes No

1 Have you ever suffered or are currently suffering from:

(a) Chest Pain or heart attack or any other heart disease
(b) Cancer, tumor, growth or cyst of any kind
(c)Stroke, paralysis, Epilepsy, any psychiatric / mental disorder, disorder of brain/nervous system or any kind of physical disabilities
(d)Asthma, Tuberculosis or other lung disorder
(e) Diseases or disorder of muscles, bones or joints, arthritis or blood disorder (anemia) or any endocrine disorder
(f) Diseases of the kidney, digestivesystem(stomach, pancreas, gall bladder, intestine), liver, Hepatitis B or C or HIV/AIDS infection
(g) Diabetes, high blood pressure.

2 During the last 5 years have you undergone any major surgery or been hospitalized for more than one week?

3 Do you take part in any adventurous sports or hobbies? (like paragliding, mountaineering, deep sea diving , motor racing, bungee jumping, etc.)

4 Do you smoke more than 10 cigarettes a day?

5 Has more than one of your parents and siblings died before the age of 60 years as a result of heart attack, stroke, cancer, diabetes, HIV?

6 Are you taking any medication or has a doctor ever attended to you for any conditions, diseases or impairment not mentioned above (except for cough or
cold)?

7 For Female Lives: (a) Are you presently pregnant? (b) Do you have a history in the past of an abortion, miscarriage or caesarian section due to complications
during pregnancy or due to any other cause? (c) Have you given birth to a child with any congenital disorder such as Down Syndrome, congenital heart
disease, etc? (d) Have you ever had any disease of breast, uterus, cervix, ovaries or any other part of the reproductive system?

8 Have you ever been declined, deferred, and accepted at special terms, had cover reduced or had exclusion imposed for any life , health or accident insur-
ance cover?

9 Do you have any history of conviction under any criminal proceedings in India or abroad?

COVID-19 Questionnaire: Yes No

1 Have you / any of your immediate family members travelled outside India in the last 45 days or do you plan to travel outside India during the next 6 months?

2 Have you / any of your immediate family members been tested positive for COVID -19 or are awaiting results of such a test or been advised to be under
quarantine due to COVID-19?

3 Are you / any of your immediate family members, currently suffering from or in the last 2 months, have suffered from fever, persistent cough, sore throat,
breathing difficulties, gastro-intestinal symptoms (vomiting/diarrhea)?

Please note that it is important to answer the above questions correctly. Any false information will lead to rejection of the application or the claim in future.
Details of Nominee :
Name :______________________________________________________________ D D M M Y Y Y Y Gender M F Relationship with Member : _______________________
I/We,_________________________________________ , do hereby declare that I/ we have received a loan of r_____________________________ from HDFC Bank Limited ("Master Policyholder"). In order to secure the
said loan I/ we have taken the above referenced policy from HDFC Life Insurance Company Limited ("HDFC Life"). In consideration of receiving the said loan I hereby authorize HDFC Life to make payment of
Outstanding Loan Balance amount to Master Policyholder by deducting from the claim proceeds payable on happening of the contingent event covered by the Group Life Insurance Scheme/ Policy referenced above.
Request you to kindly take note of the above mentioned request and update your records accordingly.
Declaration: I understand, Agree & confirm that these statement & this declaration are basis of contract between the insurer & the policyholder. If any untrue statements are contained herein or there has been any non disclosure of any
material fact, the policy to be issued by the insurer in the name of policyholder may be treated as void as far as I am concerned. I confirm that I have read & understood, the rules & any additional rules of HDFC Life Group Credit Protect
Insurance Plan, the standard Policy provisions & any additional provisions that govern the policy to be issued by insurer by insurer in the name of the Policyholder and on my life, & I
agree & confirm that same shall be binding on me. I authorize the policy holder to disclose to the insurer such particulars as they may require including the details given above & any
changes to the same pay the premium payable on my behalf / collected from me to the insurer. I understand that any statutory levy or charges including any indirect tax may be
charged to me either now or in future by the insurer and I agree to pay the same. I understand that HDFC Life has the right to reject the proposal without giving reasons thereto and
client to give an undertaking thereof that he shall not raise any claims thereof. I understand the significance of the contract and the contract will be governed by provisions of the
Insurance Act 1938 and that the same will not commence until written acceptance of this application by the insurer issued on its normal terms & conditions is received.

Name : ____________________________________________ Date :_______________ Place :_______________ HDFC Bank is master policy holder of this policy
 Asset Protection

Date
Loan Tenure Months Customer Signature

Motor Insurance

"Insurer ⃝ ⃝ ⃝
(Arranged Alphabetically)" BAGIC HDFC ERGO ICICI LOMBARD
Premium Amount (with GST)
Extended Warranty

"Insurer ⃝ ⃝ ⃝
(Arranged Alphabetically)" BAGIC HDFC ERGO ICICI LOMBARD
Premium Amount (with GST)
I hereby authorize HDFC BANK to pay the premium in on my behalf and the same to be included in the loan amount from the bank and recovered
from me in EMIs.
Nominee Name Relationship with Proposer
Declaration: I hereby declare that the above statements are true and complete in all respects and there is no other information which is relevant to my
application of insurance that has not been disclosed to you. I agree that this proposal and the declaration shall be the basis of the contract between
me and the selected insurance company and I agree to accept the policy subject to the condition prescribed by selected insurance company.

Good Health Declaration: Are you in good health and/or not suffering from any mental/physical impairment and/ ⃝ ⃝
or deformity and/or disablement since or after birth? Yes No

Signature of Customer

Declaration to be made by 3rd person: (a) The insured member has affixed his/her thumb impression : or(b)The insured person has signed in vernacular :or, (c)
The insured person has not filled in the application
I hereby declare that i have explained the contents of this application form to the insured member in_______________________ language and have truthfully
recorded the answers provided to me I further declare that the insured member has signed/affixed his/her thumb impression in my presence

Name and Address of Declarant ____________________________ Signature of Declarant ________________________

For further details please refer to the Insurers Website
Product Descriptions for Health Assurance Plan
Product Features ABHI BAGIC HDFC ERGO ICICI LOMBARD Niva Bupa

Maximum EMI Covered Per Policy year 4 EMIs per Year 4 EMIs per Year 4 EMIs per Year 4 EMIs per Year 4 EMIs per Year

2.5 lakhs per EMI (5

Maximum per EMI amount 2.00 lakhs per EMI 1.00 lakhs per EMI No Upper Cap 25 lakhs per EMI
lakhs per policy year)
"Length of Stay - No. of "Length of Stay - No. of "Length of Stay - No. of "Length of Stay - No. of
"Length of Stay - No. of EMI's to be Paid
EMI's to be Paid EMI's to be Paid EMI's to be Paid EMI's to be Paid
2 - 3 days - 1
2 - 3 days - 1 2 - 3 days - 1 2 - 3 days - 1 2 - 3 days - 1
Conditions for Claims - (Hospitalization) 4 - 5 days - 2
4 - 5 days - 2 4 - 5 days - 2 4 - 5 days - 2 4 - 5 days - 2
6 - 7 days - 3
6 - 7 days - 3 6 - 7 days - 3 6 - 7 days - 3 6 - 7 days - 3
7 and above - 4"
8 and above - 4" 7 and above - 4" 7 and above - 4" 7 and above - 4"
Grid applicable on every Grid applicable on every Grid applicable on Grid applicable on every
Grid applicable on every hospitalization
hospitalization hospitalization every hospitalization hospitalization

Intial Waiting Period 30 days 30 days 30 days 30 days 30 days

EMI Protect
PED Waiting Period Waived Off Waived Off Waived Off Waived Off Waived Off

Specific Waiting Period Waived Off Waived Off Waived Off Waived Off Waived Off

Survival Period 0 days 0 days 0 days 0 days 0 days

"Tenure ( In years) - Final "Tenure ( In years) - Final "Tenure ( In years) "Tenure ( In years)
"Tenure ( In years) - Final Premium Per
Premium Per Thousand - Premium Per Thousand - - Final Premium Per - Final Premium Per
Thousand - Per Person
Per Person Per Person Thousand - Per Person Thousand - Per Person
1 - 60
1 - 60 1 - 60 1 - 60 1 - 60
Premium per Thousand (excluding GST) 2 - 120
2 - 120 2 - 120 2 - 120 2 - 120
3 - 180
3 - 180 3 - 180 3 - 180 3 - 180
4 - 240
4 - 240 4 - 240 4 - 240 4 - 240
5 - 300"
5 - 300" 5 - 300" 5 - 300" 5 - 300"

Maximum SI Upto Rs. 1 Crs Upto Rs. 1 Crs Upto Rs. 1 Crs Upto Rs. 3 Crs Upto Rs. 1 Crs

No. of Critical Illness covered 35 40 50 25 41

Intial Waiting Period 30 days 90 days 90 days 90 days 30 days

PED Waiting Period 24 Months 24 Months 48 Months 48 Months 24 Months

Survival Period 0 days 0 days 7 days 0 days 0 days

Critical Illness
"Tenure ( In years)
"Tenure ( In years) - Final "Tenure ( In years)
"Tenure ( In years) - Final Premium Per "Tenure ( In years) - Final - Final Premium
Premium Per Thousand - - Final Premium Per
Thousand - per Individual Premium Per Thousand Per Thousand - per
per Individual Thousand
1-4 1-4 Individual
1-4 1-4
Premium per Thousand (excluding GST) 2-8 2-8 1-4
2-8 2-8
3 - 11 3 - 11 2-8
3 - 11 3 - 11
4 - 13 4 - 13 3 - 11
4 - 13 4 - 13
5 - 15" 5 - 15" 4 - 13
5 - 15" 5 - 15"
5 - 15"
 Annexure 1

To
HDFC Bank Limited,
HDFC Bank House,
Senapati Bapat Marg,
Lower Parel, Mumbai 400 013

Subject: Express Consents and Undertakings

I, the undersigned, declare, confirm and consent to HDFC Bank Limited (“Bank”) and its service providers, as under:
1) I hereby confirm that am a major and a resident or non resident of India and I have read and I hereby accept the
Privacy Policy of the Bank available at Bank Website.
2) I seek from the Bank various financial assistance, other products and services for which I may be found eligible by
the Bank from time to time, at any time in future, including after closure of any of my existing or future relationships,
accounts, products, facilities, loans, services with or from the Bank from time to time, for which purpose I authorise
the Bank to share any of my Information (as defined hereinafter) with any credit information companies and obtain
various scores, reports and information for determining my credit worthiness from them, and accordingly to
contact me or cross sell to me from time to time.
3) I hereby further expressly consent to and authorise the Bank (whether acting by itself or through any of its service
providers, and whether in automated manner or otherwise), to do and undertake any of the following, in relation to
my application details, personal data and sensitive information about me, information, papers and data relating to
know your customer (KYC), credit information, and any other information whether about me or not as may be
deemed relevant by the Bank for its purposes (collectively, “Information”):
i) to collect the Information from me and other physical or online sources including accessing the same from credit
information companies, information utilities, websites, data bases and online platforms (whether public or not); to
get the authenticity, correctness, adequacy, etc. of the Information verified from any sources and persons
including from online data bases; and to act for and on my behalf for such accessing, collecting or verifying of the
Information including using my log in and password credentials on the online platforms; such collection, access
and verification may be done without any notice to me;
ii) process Information including by way of storing, structuring, organising, reproducing, copying, using, profiling,
etc. as may be deemed fit by the Bank;
iii) to store the Information for such period as may be required for contract, by law or for the Bank’s evidential and
claims purposes, whichever is longer;
iv) to share and disclose the Information to service providers, consultants, credit information companies, information
utilities, other banks and financial institutions, affiliates, subsidiaries, regulators, investigating agencies, judicial,
quasi-judicial and statutory authorities, or to other persons as may be necessary in connection with the
contractual or legal requirements or in the legitimate interests of the Bank or as per the consent;
v) any of the aforesaid may be exercised by the Bank for the purposes mentioned above, for the purposes of credit
appraisal, fraud detection, anti-money laundering obligations, for entering into contract, for direct marketing, for
developing credit scoring models and business strategies, for monitoring, for evaluating and improving the quality
of services and products, for other legitimate purposes or for any purposes with consent.
4) I expressly agree to and subject me to the automated processing, automated profiling and to the automated
decision making by or on behalf of the Bank.
5) I expressly agree to the Bank and/or its affiliates for using the Information and for cross-selling to me their various
products and services from time to time.

Name: ___________________________

Signature: ______________________
92545/05.08.2022_M258