DCB Vehicle Loan Application Form

Commercial Vehicle Loan Auto Loan

New Vehicle Loan Vehicle Re-Finance Loan Used Vehicle Loan

Application No. Application Date: D D M M Y Y Y Y

Co-applicant’s /
• Please complete the entire form (in capital letters only) Applicant’s Photo
• Tick as applicable • Enclose all applicable documents Guarantor’s
signed across
photo signed
Vehicle Loan across

Priority Sector Category: Mirco Service Enterprise Small Service Enterprise

Direct Agriculture Finance (Individual) Others

Location:

Branch Code: Region Code:

Product Code: Brand Code:

Personal

Applicant’s Name: Mr. Mrs. Ms. Dr. Prof.

(First Name) (Middle Name) (Last Name)

Date of Birth: D D M M Y Y Y Y Religion: SC ST

Gender: Male Female Third Gender Father’s / Spouse Name:

Marital Status: Single Married Mother’s Maiden Name:

Education: Post Graduate Professional Diploma Holder Graduate Under Graduate / Matriculate School Dropout

PAN: Issue Date: D D M M Y Y Y Y

Voter Id No.: Issue Date: D D M M Y Y Y Y
Driving License No.: Issue Date: D D M M Y Y Y Y
Passport No.: Issue Date: D D M M Y Y Y Y

Address

Current Residential Address:

City: Pin:

Landmark:

State: Country:

Telephone: Mobile No.:

(with STD Code)

Email:

No. of years at current residence: Rent p.m. (if rented ): `

Property Status: Self Owned Rented Company Provided Parental Others

Permanent Address:

City: Pin:

Landmark:

State: Country:

Telephone: Mobile No.:

(with STD Code)

Email:

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 Business Details
Self Employed
Business Name: Industry Type:

Nature of Business: Manufacturer Service Provider Trader / Shopkeeper Others

Status of Business: Proprietorship Partnership Firm Pvt. Limited Co. Others

Fleet Size: Free Fleet:

Date of Commencement: D D M M Y Y Y Y Years in Current Business: Years at Previous Business:

Property Status: Self owned Mortgaged Self owned - Free Total No. of years in business: No. of employees:

Parental Rented Others Preferred mailing Address: Residence Business

Business Address:

City: Pin:

Landmark:

State: Country:

Telephone: Ext. No.: Mobile No.:

(with STD Code)

Email:

Name of Director / Partners:

Co-Borrower / Guarantor

Name:

Date of Birth: D D M M Y Y Y Y Relationship:

Name of Employer / Business Name:

Business Address:

City: Pin:

Telephone: Mobile No.:

(with STD Code)

Permanent Address:

City: Pin:

Landmark:

State: Country:

Telephone: Mobile No.:

(with STD Code)

Email:

Existing DCB Bank Limited Relationship Details

DCB Vehicle Loan Agt No.: Date: D D M M Y Y Y Y

DCB Personal Loan Agt No.: Date: D D M M Y Y Y Y
DCB Home Loan Agt No.: Date: D D M M Y Y Y Y
DCB Savings A/c No.: Date: D D M M Y Y Y Y
Others (please specify): Date: D D M M Y Y Y Y
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 Liabilities
Name of institution where loan availed & type of loan Original Loan Amount Currents O/S Monthly EMI Loan Opening Date Bal. Tenor / Closure Date

Bank Account Details

Bank Name & Branch Account No. Account Type No. of years held

Credit Card Details

Issuer Name Card No. Issue Date Valid till

Reference 1 (From Business Associate)

Name:

Relationship:

Address:

City: Pin:

Telephone: Mobile No.:

(with STD Code)

Reference 2

Name:

Relationship:

Address:

City: Pin:

Telephone: Mobile No.:

(with STD Code)

Loan Request Details - New Vehicle

Proposed Loan Details Chassis Body New Vehicle Loan Details
Vehicle / Equipment Make Manufacture

Tenure Manufacture Code

Units Dealer Code

Invoice Price Year of Manufacture

Margin Money Structure

Loan Requested Scheme Name

Disbursement Favouring Instalment

Disbursement Favouring
No. of Advance EMIs
Location

Moratorium

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 Loan Request Details - Refinance / Used Vehicle Finance
Refinance Details

Manufacture

Year of Manufacture

Structure

Scheme Name

Instalment

No. of Advance EMIs

Moratorium

Value of Asset

Disbursement Favouring

Disbursement Favouring
Location

Vehicle Number

Penal Interest for late payment of EMI : @36% p.a. • Cheque Return Charges : ` 500/- + Service Tax • Swap Charges : ` 552/- per instance
Prepayment : Allowed after six months of date disbursement • Pre Payment Charges : 4.41 % of Principal outstanding + Service Tax

Interest Rate: % p.a. (with monthly rest reducing balance) Processing Fee (Non-refundable): %`

Fleet Expansion Working Capital Business Use Home Improvement Loan Transfer Others

Declaration
1. I / We declare that all the particulars and information and details given / filled in this application form are true, correct , complete and up-to-date in all respects and that I / we have not withheld any information
whatsoever.
2. I / We confirm that no insolvency proceeding or suit for recovery of outstanding dues or monies whatsoever or for attachment of my / our assets or properties and or proceeding have been initiated and /or are
pending against me / us and that I / We have never been adjusted insolvent by any court or other authority.
3. No action nor other steps have been taken or legal proceedings started by or against me / us in any court of law / other authorities for winding up, dissolution, administration or re-organization or for the appointment
of a receiver, trustee or similar officer or for my / our assets.
4. I / We understand and acknowledge that DCB Bank Limited shall have the absolute discretion without assigning any reason (unless required by applicable law), to reject my / our application and that DCB Bank
Limited shall not be responsible / liable in any manner whatsoever to me / us for such rejection or any delay in notifying me / us of such rejection / any costs, losses, damages or expenses, or other consequences,
caused by reason of such rejection, or any delay in notifying me / us of such rejection and any costs, losses, damages or expenses, or other consequences caused by reason of such rejection, or any delay in
notifying me / us of such rejection, of our application
5. DCB Bank Limited / its group companies reserves the right to retain the photographs and documents submitted and will not return the same to the applicant
6. I am / We are neither related to any of the directors of DCB Bank Limited nor I / We are his / her relatives as defined under section 6 r / w schedule IA of the Companies Act,1956
7. I / We hereby represent, warrant and confirm that the offers and purpose is a valid purpose and also agree and undertake to utilize the loan only for the above mentioned purpose and that the loan shall not be used for
any illegal and / or antisocial and / or speculative purpose including but not limited participating in stock market / IPOs
8. I / We have been explained the product features I / We have applied for. I / We have read and understood the terms and conditions of the loan product of DCB Bank Limited and I / We agree to abide by them
9. I / We further authorise DCB Bank Limited, and or its associates / subsidiaries / affiliates and has NO OBJECTIONs, to verify any information of otherwise at my office / residence and/or contact me and / or my family
members and / or my employer / Banker / Credit Bureau / CIBIL and also to conduct RCU checks for all my submitted documents and other informations pertaining to the policies of DCB Bank Limited.
10. I / We confirm my / our understanding that the Processing Fee paid by me / us is Non-refundable under any circumstances whatsoever including but not limited to decline / part disbursement / disbursement of the
Loan.
11. From time to time, DCB Bank Limited communicates various features / products / promotional offers which offer significant benefits to its customer and may use the services of third party agencies to do so. Do you
wish to be informed about such benefits ?
I / We expressly authorize DCB Bank Limited to use information or data relating to me / us, for communicating marketing offers as outlined above. (Please tick)
I / We do not wish to receive offers as outlined above. (Please tick)

Signature of Borrower _______________________ Signature of Co-Borrower / Guarantor _______________________

Name of Borrower: Name of Co-Borrower / Guarantor:

Date: D D M M Y Y Y Y Date: D D M M Y Y Y Y

DCB Bank Limited

DCB 24-Hour Customer Care

Call Toll Free: 1800 209 5363
Email: [email protected]
Web: www.dcbbank.com

DCB Bank Limited

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 Declaration - Micro Service Enterprise / Small Service Enterprise

To,
DCB Bank Limited
Date: D D M M Y Y Y Y
______________________________
______________________________

Dear Sir,
I / We confirm that we are a micro service enterprise/ small service enterprise having investment in equipment (original cost excluding land and building and furniture, fitting ) not exceeding
` 10 lakhs - ` 2 crores. The details of our investment in the equipments are as given under :
Sr. No. Date of Purchase Type of Equipment / Vehicle Registration No. in case of registered Original cost of purchase (`)

I / We hereby certify that the above details are correct and complete in all respect.

Thanking you
Yours sincerely

____________________ _______________________
Signature of Applicant Confirmed by
Signature of Bank Officer

Post - Sanction (All)

Agreement Signature Verification Post Dated Cheques

For Internal Use Only

Name of Dealer / Body-Constructor:

Branch:

Name of the Programme:

Bank Copy

Acknowledgment

Loan Application received on _______________. Complete Document set received on ______________. Request will be disposed and acceptance / rejection notification will be mailed with

in due course.

Date: D D M M Y Y Y Y Authorised Signatory Body-Constructor / Dealer stamp

Acknowledgment

Loan Application received on _______________. Complete Document set received on ______________. Request will be disposed and acceptance / rejection notification will be mailed with

in due course.

Date: D D M M Y Y Y Y Authorised Signatory Body-Constructor / Dealer stamp

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List of Documents

Pre-sanction Documents
Application Form Yes
Photograph signed across Yes
Bank Statement Last 6 months from Primary Business Account
Proof of Income 2 years of IT Returns with Computation of Income and Certificate of Financials
Proof of Turnover Latest Sales / Service Tax Returns / VAT Returns
Proof of Continuity / Current Employment / Business Stability (anyone) Trade Licence, Statutory Licences, Other Supporting Documents
Proof of Identity (anyone) Passport / Voters ID / Pan Card / Photo Credit Card
Proof of Residence (anyone) Passport / Ration Card / Utility Bill / LIC Policy / Lease Agreement / Leave & License Agreement
Proof of Age (anyone) Passport / Driving Licence / Birth Certificate / LIC Policy / School Leaving Certificate / PAN Card
Copy of Partnership Deed For Partnership Firm
MOA, AOA, Board Resolution, Certificate of Incorporation, CA Certificate For Companies

Nov 15 / 1.5

DCB Bank Limited