Home Loan Application Form
Home Loan Application Form
APPLICATION FORM
“All fields have to be filled, please tick on appropriate options and same can be multiple ticks if applicable.
For physical/offline submission of application form - Form to be filled in English and BLOCK letters with black pen only”
Application Form No :
Product Type Home/Mortgage Loan Commercial Business Loan Car Loan Two Wheeler Loan Personal Loan
Section-I
Date of Birth D D M M Y Y Email-ID
Section-II
First Name Middle Name Last Name
Name (Same as ID proof)
Father's Name
Mother's Name
Spouse Name
Gender Male Female Transgender Person with Disability Yes No Marital Status Single Married Others
Category General Scheduled Caste (SC) Scheduled Tribes (ST) Most Backward (MBC) Other Backward (OBC)................................................
Religion Hindu Muslim Sikh Zoroastrian Buddhist Christian Jain Others................................................
Residential Status Indian NRI Nationality (if other than India), Country Name……………….................... ISO-3166 Country Code IN-Indian Other
Passport Number Citizenship IN-Indian Others, Country Name ................................................
Occupation Details
Salaried Self Employed Student Housewife Retired Pensioner
A) Salaried/Self Employed
Entity/Employer Type Proprietorship Partnership Private Ltd. Public Ltd. Public Sector Government LLP Multinational
Department/Division
Office Address
Landmark
b) Professional Doctor CA/CS/CMA Architect Lawyer Consultant Engineer Others (Please Specify)
Current Address
House/Plot No Floor Apartment/Building Name
Street/Road
Landmark City
Permanent Address [Same as Current Address Yes No (if no, please fill below)]
House/Plot No Floor Apartment/Building Name
Street/Road
Landmark City
Entity Name
Date of Incorporation D D M M Y Y
Constitution Partnership Private Ltd. Public Ltd. Public Sector Government LLP Multinational
Nature of Business Manufacturing Trading Services Retailing Agriculture Stock Broker Real Estate
Contact Details
PAN Number
Name of other partners/trustees/directors/adult members of HUF
Address
Address
Address
Address
Address
Principal /Registered Address (Address, Pin, Landmark, State, Fax)
House/Plot No Floor Apartment/Building Name
Street/Road
Landmark City
Country Name
Business/Communication Address [same as Principal / Registered Address Yes No (if No, please fill below)]:
House/Plot No Floor Apartment/Building Name
Street/Road
Landmark City
Country Name
Type of Industry
Small Business Farming Retail Trade Steel Cement Real Estate & Construction Transportation Import/Export Gems & Jewellery
Textile Hospitality FMCG Mining Financial Service Telecom Power Electronic Sector Health Care
Others.........................................
Home Improvement Loan Top Up LAP-Residential LAP-Commercial Non Residential property Lease Rental Discounting
Others
B) Car/Two Wheeler Loan I. Type of Product New Used BT/Top-up Refinance II. Use of Vehicle Personal Use Commercial Use
C) Personal Loan Education Travel Occasion in Family Purchase of Household/Electronic Goods Home Renovation/Extension Medical
D) Business Loan Business Expansion Working Capital Purchase of Plant & Machinery Others ( Please specify)......................................
E) Commercial Business Loan Commercial Vehicle Loan : New Used Construction Equipment Loan : New Used
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F) Education Loan iSmart : Domestic International Excluding iSmart Institutes PO Program Education Loans
Subsidy Schemes : CSIS Padho Pradesh Dr. Ambedkar Others ( Please specify)......................................
G) Credit Card : Commercial Credit Card Business Credit Card Corporate Credit Card
Existing LAN
1. All the information (including any indebtedness and statutory dues related information), documents and details provided by me/us in the application form (whether submitted electronically or physically)
are true, complete and up-to- date in all respects and no material information has been withheld or concealed by me/us. I /We undertake to keep ICICI Bank (“Bank”) informed of any changes in any of
the information/ details provided by me/ us.
2. I/ We am/ are aware that loan (if sanctioned) shall be governed and subje t to the terms and conditions as contained in the loan agreement and other transaction documents.
3. The Bank has the sole discretion to accept or reject my/ our application as per its internal policies and the applicable laws. I/We agree that the Bank shall not be held responsible for such rejection and/
or any costs, losses or other consequences caused because of such rejection.
4. I/We authorize Bank, its group companies, representatives, agents and any third parties appointed by the Bank to conduct enquires and verification in relation to the application form as it/ they may
consider necessary.
5. No insolvency proceedings and/ or any criminal proceedings have been initiated and/ or are impending against me/ us and that I/ We have never been adjudicated insolvent by any court or other
authority.
6. I/We consent for receiving information from the central Know Your Customer (KYC) registry through available modes of communications including SMS/ WhatsApp/ email on my/ our registered number/
email address.
7. No payment(s) either in cash or otherwise in any other manner has/ ave been made by me/ us to the executive collecting this application form or to any other representative of the Bank.
8. Except to the extent disclosed to the Bank, no Chairman / Managing Director or directo or a relative/near relation, as specified by RBI, of a Chairman / Managing Director or director of a banking
company (including the Bank and its subsidiaries) or mutual funds/venture capital funds or a relative/near relation, as specified by RBI, of a senior officer of the Bank, as specified by RBI, is: a partner
of its concern, or a trustee, member, director, manager, employee of its concern, or of its subsidiary, or its holding company, or a guarantor on its behalf, or holds substantial interest in its concern
or its subsidiary or holding company. (Please tick Yes, No as acceptable): Yes No
For the purpose of this clause the terms “relative”, “near relation” & “senior officer” shall have the same meaning ascribed to them under the RBI master circular on Loans and Advances dated July 1, 2015,
para 2.2.1.8 and shall include any amendments made thereto.
9. The Bank and its group companies reserve the right to retain the application form and all other documents including photographs in accordance with the relevant internal policies and the applicable
laws.
10. I/We authorize the Bank to share the application form with its affiliates/group companies for appraising the loan and such group companies/affiliates may contact me/us for offering their loan
facility required by me/us. Approval of the loan application and disbur ements thereunder shall be made by such affiliates/group companies, at its sole discretion.
(Please tick Yes, No as acceptable): Yes No
11. I/ We, unconditionally and irrevocably, authorise (i) the Bank, (ii) its group companies, (iii) its agents, and/or (iv) its representatives, to: collect, access, store, use, share, exchange and process all
information and records (including personal information) received (from me and/or external sources), for (i) and in connection with the loan, (ii) analysis, (iii) credit scoring, (iv) carrying out
marketing and promotional activities; and/or (v) making offers of various financial or other products and/or services through any mode (including without limitation through telephone calls/SMS -
s/e-mails/ WhatsApp) to me/us.
Yes No Others (please specify your choice)
(Please tick Yes, No, or others as acceptable);
12. I/ We further agree and confirm that the any document(s) submitted by me/ us to the Bank in electronic form shall only be submitted through my/ our registered email address and any such document(s)
sent by me/ us through my/ our registered email address can be relied upon by the Bank for considering my/ our application.
13. I/We understand that electronic/telephonic/digital channels are not secured mode of transmission and may be subject to tampering and unauthorized access, fraudulently or mistakenly written, altered
or sent, not be received in whole or in part by the intended recipient, may reach you/us in a jumbled state or in a manner or shape that it may be misunderstood. I/We hereby agree to bear all risks and
responsibility with respect to the Bank acting on the basis of such information/ document(s) furnished over aforesaid medium.
14. Consent to Aadhaar based authentication/ verification: I/ We voluntarily submit my/ our Aadhaar details to the Bank for the purpose of establishing my/ our identity /address proof to open account
/process instructions/ facilitating affixation of Aadhaar based digital signature in my/ our name or as an authorised signatory. The purpose of collecting Aadhar has been explained to me/ us in local
language. Upon authentication, UIDAI may share with the Bank information in nature of my/ our demographic information (including photograph) which the Bank may use for the aforesaid purpose. I/
We consent for sharing my/our Aadhaar detail with UIDAI, NPCI, regulatory or statutory authorities as required under applicable laws. I/We have been informed that my/our biometric information will
not be stored by the Bank.
15. I/We acknowledge that the request for cancellation of the loan must be given before first instalment and that any such request, if made after the disbursement of the first instalment, shall be treated as
a request for loan foreclosure.”
16. The GSTIN number provided by me/ us can be used by the Bank for the purposes of charging GST and reporting of transactions on the GSTN portal and for other related aspects as may be required
under the applicable laws.
17. If after repayment of the loan, the amount lying in the loan account maintained by the Bank is less than or equal to Re.1, the Bank reserves the right to appropriate such amount and utilize the same in
the manner it deems fit.
18. I/ We authorize the Bank/ its group companies/ agents/ representatives to verify my/ our information with credit bureaus, agencies, auditors, RBI, other statutory authority, service providers and such
other third parties as it/ they deem necessary and disclose, exchange, share with the RBI or any other authority including but not limited to credit bureaus, credit information companies, or any other
third party all the information and details relating to the name, my/ our credit information including payment history, financial assistance extended/ to be extended to me/us, my/ our existing loans and/
or repayment history and such other information as may be deemed necessary.
19. That I/We are aware that the loans (if sanctioned) shall also be governed by certain terms and conditions, including terms as available on the website www.icicibank.com and other transaction
documents. I/We have read, understood and agreed to abide and comply with the same, including changes made from time to time.
18 A. For electronically submitted application form – I/We confirm that by submitting this application form and applying for the product through Bank’s website www.icicibank.com (“ICICI Bank Portal”),
and clicking on ‘Accept’/’Agree’/‘Agree and Proceed’ icon/button and/or by submitting one-time password received on my/our registered mobile number and/or by affixing electronic signature (e-sign)
or digital signature certificate, I/We have read, understood and agreed to abide and comply with the same, including changes made from time to time.
Terms specific to Credit Card –
• For cash withdrawals interest will be charged from the day of transaction and no free credit period will be provided.
• The card application shall continue to be valid for any replacement card provided at the time of closure/renewal.
20. I/ We understand that any reference to terms such as preliminary application form, preliminary credit appraisal form, appraisal application form, preliminary credit facility application form, facility
application form and/or any other application form in any of the transa tion documents, as the context may require, shall refer to this application form.
21. In compliance with the rule 9B of the Prevention of Money Laundering (Maintenance of Records) Rules, you are required to intimate us if there is any change in your KYC details along with updated
documents (i.e. address, contact details, profile, etc.) within a period of 30 days from the date the change was made. Once you intimate us, we will make necessary changes in our records. Any update can
be intimated to the Bank by visiting the nearest asset servicing branch
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CONSENT FOR ICICI BANK
A) I/ We, unconditionally and irrevocably, authorise (i) the Bank, (ii) its group companies, (iii) its agents, (iv) its representatives and/or (v) third parties engaged by the Bank, to: collect, access, store, use,
share, exchange and process all information and records (including personal information) received (from me and/or external sources), for (i) designing, improving and providing the product and services,
(ii) analysis & verification, and/or (iii) credit assessment.
Yes No Others (please specify your choice) (Please tick Yes, No, or others as acceptable);
B) We authorize the Bank/ its group companies/ agents/ representatives to verify my/ our information with credit bureaus, agencies, auditors, statutory/regulatory authorities, service providers and such other
third parties as it/ they deem necessary and disclose, exchange, share with the RBI or any other authority including but not limited to credit bureaus, credit information companies, or any other third party
all the information and details relating to the name, my/ our credit information including payment history, financial assistance extended/ to be extended to me/us, my/ our existing loans and/ or repayment
history and such other information as may be deemed necessary.
C) MARKETING CONSENT
The Bank would like to use your personal details in the application form/registration form from time to time to send you marketing information to inform you about product, services or promotional offers
that are offered by the Bank on its own and in collaboration or through tie-ups with partners/third parties. By opting into the following methods of communication, you confirm that Bank may contact you
for these purposes in one or more of the following ways:
By Email By WhatsApp By Social Media By SMS/Text By Telephone/Call Yes to marketing by all of the above No to marketing by all of the above
The Bank would like to share your personal details in the application form/registration form with its group entities/partners of the Bank so that group entities/partners of the Bank may from time to time
sent you marketing information to inform you about the products, services or promotional offers that are offered by the group entities/partners in collaboration with the Bank. By giving your preference
below you either allow or disallow the Bank to share your personal details in the application form/registration page :
Yes, I would like the Bank group companies to contact me Yes, I would like Partners of the Bank to contact me No for both
You can proactively opt-out of this any time or update your preferences by visiting our branches or by calling us, please also see our privacy notice for more information in relation to how we collect and
use your personal information for EU data subjects:https://www.icicibank.com/nri-banking/RHStemp/privacy-notice-eu-users.page / for domestic customers:https://www.icicibank.com/privacy.page
D) I hereby represent, warrant and confirm that the aforesaid purpose is a valid purpose and is not speculative or illegal in any manner. --------------------------------------------------------------------------
I also declare that funds under the facility will not be used towards purchase of gold in any form, including primary gold, gold bullion, gold jewellery, gold coins, units of gold Exchange Traded Funds (ETF)
and units of gold Mutual Funds. --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
I further agree, confirm and undertake that the purpose of use of funds under the Loan shall not be changed in any manner during the tenor of the Loan; or that such change in purpose shall take place
only with the prior written permission of ICICI Bank. I agree that any breach or default in complying with all or any of the aforesaid undertaking(s) will constitute an event of default under the facility
document. -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Affix Recent
passport Size
Authorised Signature/Applicant/Co-Applicant/Guarantor Signature
Colour Photograph of
Applicant
with Signature across
Date : D D / M M / Y Y
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Product Type
Home/Mortgage Loan Car Loans Two Wheeler Loans Commercial Business Loan Personal Loan Business Loan Education Loan
Authorised Official//Person
Time frame for Disposal of Loan Application Form (MSME Borrower) is as below: (from the date of receipt, provided your application is complete in all respects and is accompanied by documents as
per 'check list' provided)
Up to 5 lakh within 2 weeks
Above 5 lakh and up to 25 lakh within 3 weeks
Above 25 lakh within 6 weeks
The processing fee is a one-time non-refundable fee, and is collected b ICICI Bank for the purpose of appraising the Application for the facility and the same is independent of the outcome / result of
such appraisal.
Please note that the processing fee is payable at the time of submitting of this Application Form, duly filled in, by way of a Cheque / Demand Draft payable at favouring
ICICI Bank Limited for loan account of "name of main applicant" and / or such other mode as may be acceptable to ICICI Bank. Please ensure to mention your 'Application Form Number; Name' &
'Mobile number' at back of the cheque.
Received application for an ICICI Bank Credit Card, along with the requisite Know Your Customer (KYC) documents, from :
Mr./Ms.
Application Number
Date D D M M Y Y Sales Executive Name
I have shared the Most Important Terms & Conditions (MITC) along with the Credit Card application form.
Dear Customer,
SE ID:
Please SMS 'CCAPP<space><13-digit application form number><space><SEID>' to 5676766. We would request you to
send the SMS in above format to enable the application processing. This will assist us in reporting the status of your
application post the submission of completed documents. To know the status, please call our Customer Care. If you are
an existing ICICI Bank account holder, you can track your application through iMobile-Services- Cards Services - Status of
New Application. T&C apply.
Your ICICI Bank Credit Card application processing may take a minimum of 10 days. The documents submitted along with the X Signature of Sales Executive
application will be kept with the bank for the record purposes and will not be returned.
Safety tips:-
Always write the date and purpose for which you are submitting the self-certied KYC documents
Always share your functional e-mail ID with us; a lot of sensitive information such as statements, PINs, OTP request etc. shall be communicated through e-mail
Never share your e-mail ID and password with others as it increases the risk of your information being compromised
Be safe; make digital payments
Call us on:
1800 1080
To opt for any banking solutions
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DESCRIPTION OF CHARGES
Loan Processing Charges (Non Refundable) plus applicable taxes (including GST) and other statutory levies, if any.
The processing/login fee is a one-time non-refundable fee and is collected by the Bank for the purpose of appraising the Application for the
Facility and the same is independent of the outcome/result of such appraisal. The processing/login fee is payable at the time of submitting of
the Application, by way of Cheque/Demand Draft favoring the Bank and/or such other mode as may be acceptable to the Bank.
Administrative Charges 0.25 % of Facility Amount or ₹ 5000/- whichever is lower plus applicable taxes.
(The Administrative charges are a one-time non-refundable charges collected by the Lender for the purpose of appraising the valuation
and legal verification of property to ascertain suitability of accepting the property for mortgage and the same is independent of the
outcome /result of such appraisal. Please note that the administrative charges are payable at the time of disbursement of the Facility)
Commitment charges / Non utilisation fee (Applicable for Minimum 30% utilization required on a quarterly average basis. Charge of 0.5% will be levied on the deficit amount*.
Overdraft Facility) * Not applicable for salaried customers
Part Prepayment Fees Nil
Prepayment Charges 1. For the Facility with Fixed Interest Rate at the time of prepayment:
a) 2% on Home loan, Home improvement loan, Land loan and Top up on home loan on amount prepaid and on all amounts tendered by
the Borrower(s) towards prepayment of the Facility during last 1 year from the date of final prepayment.
b) 4% on Non-home loan (i.e. Loan Against Property, Non Residential Premises, Lease Rental Discounting, Non Home Loan Top Up, Retail
Trade Finance, Overdraft) on amount prepaid and on all amounts tendered by the Borrower(s) towards Prepayment of the Facility during
the last one year from the date of final prepayment.
c) Nil Prepayment charges on fixed rate loans if loan is booked under priority sector lending and Borrower(s) type is Small or Micro & Loan
amount is less than or equal to Rs. 50 lacs.
2) For the Facility with Adjustable Interest Rate at the time of prepayment:
a) Nil prepayment charges on home loan, home improvement loan and land loan.
b) Nil prepayment charges on top up on home loan where the Borrower(s) is individual and the end use of the loan facility is other than
business purpose.
c) 2% on top up on home loan on amount prepaid and on all amounts tendered by the Borrower(s) towards prepayment of the Facility
during the last one year from the date of final prepayment where the loan is given to individual Borrower(s) for business purpose and to
Non-Individual Borrower(s) for all purpose. Nil prepayment charges will be applicable to individual Borrower(s) if loan is booked under
priority sector lending and Borrower(s) type is Micro or Small Enterprise.
d) Nil prepayment charges on Non-home loan (Loan against property, Non Residential Premises, Lease Rental Discounting, Non Home
Loan Top Up, Retail Trade Finance , Overdraft) where loan is given to Individual Borrower(s) and the end use of the Facility is other than
business purpose.
e) 4% on Non-home loan (Loan Against Property, Non Residential Premises, Lease Rental Discounting, Non Home Loan Top Up, Retail
Trade Finance, Overdraft) on amount prepaid and on all amounts tendered by the Borrower(s) towards prepayment of the Facility during
the last one year from the date of final prepayment where the loan is given to individual Borrower(s) for business purpose and to
non-individual Borrower(s) for all purpose. Nil prepayment charges will be applicable to individual Borrower(s) if loan is booked under
priority sector lending and Borrower(s) type is Micro or Small Enterprise.
f) Nil prepayment charges on Money Saver Account.
Conversion charges For all floating (adjustable) rate
linked term loan to Fixed or floating (adjustable) Rs. 3,000.
• For Overdraft - 0.5% of the principal outstanding
• Semi Fixed / Fixed Interest Rate to
Adjustable Interest Rate - 2% of the principal outstanding
Cheque/ECS/NACH dishonor Charges, per transaction ` 500/- charges per bounce/return/dishonor of cheques and /or any payment instruction including AD / ECS / NEFT / E-Cheque or such other
amount as may be specified by the Bank from time to time and it shall be levied as per the discretion of the Bank. The applicable taxes and/or
other statutory levies shall be levied over and above charges charged by the Bank.
Property Document retrieval charges ` 500/-plus applicable taxes and other statutory levies, if any.
Cheque/Repayment mode swap charges ` 500/-plus applicable taxes and other statutory levies, if any
Penal Charge for late payment Term Loan –
5% per annum will be charged on the overdue EMI until repayment plus applicable taxes which may be payable pursuant to the
applicable laws and terms and conditions.
Over Draft –
5% per annum on the overdue amount and/or overdrawn amount from due date till the date of actual payment plus applicable
taxes which may be payable pursuant to the applicable laws and terms and conditions.
Penal Charges in the event of default/delay in payment/repayment Penal Charges shall be equal to 5% per annum on the overdue sum from the due date to the actual payment date plus applicable taxes or
of any part of the loan amount on due date other statutory levies, if any.
Charges for Amortisation Schedule ` 200/-plus applicable taxes and other statutory levies, if any for physical print out
Charges for Statement of account ` 200/-plus applicable taxes and other statutory levies, if any for physical print out
Charge for Prepayment or Foreclosure statement ` 200/-plus applicable taxes and other statutory levies, if any for physical print out
Charges for duplicate NOC/No Dues Certificate ` 250/- plus applicable taxes and other statutory levies, if any.
Charge for non submission of post disbursement documents ` 5000/- plus applicable taxes and other statutory levies, if any. Every month the said charge will be levied from the day the
document is due till the same is not submitted.
Charges for non collection of property documents post ` 1,000/- Every month charges will be levied till collection of documents.
60 days from the loan closure date
Penal Charges for breach of construction timeline In case of land loan, the Borrower(s) shall complete the construction of the house within 4 years. If the construction of the house is not completed
within 4 years from the first disbursement date the Borrower shall be liable to pay Penal Charges as under -
1% annually on the principal outstanding or ₹ 50,000/- whichever is lower or such other amount as may be specified by the Bank from time to time
and it shall be levied as per the discretion of the Bank.
Penal Charges will be levied every year after 4 years till the construction is completed.
Renewal Fee Applicable for Overdraft Product: ` 5,000/-
(Applicable for Overdraft Product) Not applicable for Money Saver and Insta OD.
Cash Transaction Charges (for repayment of EMI due in ` 100/-plus applicable taxes and other statutory levies, if any.
cash at branches)
Information utility charges (Only for corporate cases) ` 300/-plus applicable taxes and other statutory levies, if any.
Non-refundable charges under Central Registry of Securitization
`100/- plus applicable taxes and other statutory levies, if any.
Asset Reconstruction and Security Interest of India (CERSAI)
Auction charges for repossessed asset At Actuals
Charges incurred in filing legal suit At Actuals
Charges incurred in SARFAESI proceedings At Actuals
Enforcement charges At Actuals
Non Maintenance of Mode of Payment charges (NMMP) ₹ 800/-plus applicable taxes and other statutory levies, if any.
Paper advertisement charges At Actuals
Professional charges (Advocate Charges/Retainer ship Charges) At Actuals
Repossession charges At Actuals
Security guard charges At Actuals
Note: Goods and Services Tax and other govt. taxes, levies, etc. applicable as per the prevailing rate will be charged over and above these charges.
The above mentioned charges are subject to change. For the latest Home Loan charges, please get in touch with ICICI Bank representative.
For the detailed Terms & Conditions governing facilities for/against properties, please visit to our website www.icicibank.com or get in touch with ICICI Bank representative.
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