Application No.

: 3 0 8 5 C D 0 1 8 4 0 8 6

Prospect No.: 3 0 8 5 C D 0 1 8 4 0 8 6

Location Code/Name: S O L A P U R

SCE Name: O N E N E S S S Y S T E M S O N E N E S S S Y

SCE Mobile No.: SCE Employee No. C D 1 2 4 7 4

Your existing relationship with TVS Credit Services Ltd.

Borrower: Yes No

Relationship with other Bank/NBFCs

Loan A/c No./Credit Card No.:

Bank/NBFC:

Purpose of Loan/Finance Requirement/Asset Details

Manufacturer/Make: S A M S U N G

Product Category: M O B I L E P H O N E S

Model Name & No.: S M - A 1 6 6 P L G H I N S

Asset Cost: 1 8 0 0 0 Applied Loan Amount: 1 8 0 0 0

EMI: 2 0 0 0 Tenor: 9 No. of Advance EMI: 0 months

Insurance (Credit Shield): Total Down Payment: 6 9 9

Insurance (Health Insurance): T-Health Subscription Fee Collection: With Loan With DP Not Required

Extended Warranty: Total EMI Amount: 2 0 0 0

Mobile Accidental
Damage / Liquid Total Loan Amount: 1 8 0 0 0
Damage:
Processing Fee : 3 9 9 . 0
(Non-Refundable) Insta Card Programme Enrollment Fee :

Customer IRR 2 6 . 0 2
(% p.a. fixed - calculated on monthly reducing balance method)

Opting for InstaCard Programme: No Yes

 Borrower - Personal Details

Name: S a n t o s h R a m u l u D a s a r i Age: 4 1

Date of Birth 2 1 0 3 1 9 8 3 Gender : Male Female Marital Status: Married Single

Fathers Name R A M U L U

Mothers Name

Correspondence Address: D.No 3 3 / 3 / 4 9 n e w p a c c h a p e t h , S o l a p u

r S o u t h , S o l a p u r , M a h a Locality:

District: City : S o l a p u r

State: M A H A R A S H T R A Pincode: 4 1 3 0 0 6

Correspodence Stability 2 1 0 months Correspondence: Owned Rented Leased

Telephone: Mobile: 9 9 2 3 5 4 8 4 0 2
Educational Qualifications: Graduate UG PG Qualified Professional SSC 12th Other
Aadhaar No.: 7 8 5 4 Address Proof:

LPG No:

Electricity Consumer No.: Voter ID No.:

Driving License No.

ID Proof No.: 7 8 5 4 CKYC Number: 4 1 1 9 3 1 4 9 7 8 5 4

Current Address: 3 3 / 3 / 4 9 n e w p a c c h a p e t h , S o l a p

u r S o u t h , S o l a p u r , M a h a r a s h t r a g a n e s h m

a n d i r j a v a l S o l a p u r M A H A R A S H T R A 4 1 3 0 0

Personal Email:

Borrower - Business Details

Employment Type: Salaried Self-employed

Profession Type:

Company Name: D A S A R I G E N E R A L S T O R E S

Address: N E W P A C H C H A P E T H S O L A P U R S O L A

P U R M A H A R A S H T R A 4 1 3 0 0 6

Designation: O w n e r Employee ID:

Telephone: Mobile: 9 5 4 5 6 0 5 7 5 3

Business Email:

Borrower - Additional Details

Spouse's Name: V A I S H A L I

Pan No.:

Total Family members: 2 Earning members: No of Dependents:

Religion: H I N D U Gross/Net Monthly Income: 2 5 0 0 0 . 0

 Additional Income:

Banking Details - Bank Name: B A N K O F I N D I A

Branch Name: S A D A R B A Z A R

Account Number: 0 7 0 4 1 0 1 1 0 0 1 1 5 9 1
Credit Card: Classic Silver Gold Platinum
Car: Mini Compact MUV/SUV/Premium
Debit Card - Bank Name:

Member Since: 0 Card No.:

Relationship Declaration
Whether you are a "Director" of TVS Credit or a "Relative" (father, mother, Son, daughter, son's wife, daughter's husband, brother, sister) of
a director?
Yes No Relationship:
Whether you are a "Senior Officer(s)" (i.e all members of management one level below the executive directors, including the functional
heads) of TVS Credit"?
Yes No Designation:

Reference
Name:

Relationship:

Telephone: Mobile:

Personal Email:

Credit Shield
Nominee Name:

Relationship:

Nominee Contact Number:

I voluntarily opt for the Credit Shield insurance at my own wish and the loan would be covered by the insurance facility offered by TVSCS
being a group master policy holder.

Declaration/Undertaking
1. I/We hereby apply for the Consumer Durable/Products Loan mentioned in this application.
2. I/We affirm that all the particulars and information and details given/filled in this Application Form are true, correct, complete and up-to-date in
every manner and that I/We have not withheld any information whatsoever from TVS Credit.
3. I/We agree to receive SMS, telephonic calls, emails, or through any other mode of communication, the various schemes, plans, and offers
provided by TVS Credit Ltd., and I/We am/are aware that laws in relation to the unsolicited communication referred in "National Do Not Call
Registry" (the "NDNC Registry") as laid down by TELECOM REGULATORY AUTHORITY OF INDIA will not be applicable for such
communication/calls/SMSs received from TVS Credit, its employees, agents and/orassociates.
4. I/We authorise TVS Credit Services and all its group companies and their agents to exchange, share or part with all the information and details
relating to my/our existing loans and/or repayment history to other TVS group companies, banks, finance institutions, credit bureaus, agencies,
statutory bodies etc as may be required or as they may deem fit and shall not hold the Company or any of its group companies or its/their
agents/representatives liable for use/sharing of this information
5. If I/We purchase mobile phone/tablet/any other electronic gadgets, I/We unconditionally authorize TVS Credit to deploy versions of application
in order to send reminders / blinker for timely repayment of EMIs and notification messages including such alerts in the event of any delay of
payment of EMIs and if the default continues, to lock the mobile until I/We clear such dues.
6. I/We confirm that I/We have been made aware of the terms and conditions of the loan to which I/We agree unconditionally and I/We have not
made any payment in cash, bearers cheques or of any other kind along with or in connection with this Application Form to any person collecting
or assisting with my/our Application Form nor have I/We received any gift/discount or any other commitment not mentioned in the loan
agreement by TVS Credit or any of its authorized agents/representatives.
7. I/ we hereby declare that the one-time password (OTP) generated using the cell phone number 9923548402 belongs to me/my relative and the
company can rely upon the same and process the loan application. I/we hereby adhere to all the terms & conditions and release, and absolve the
company from any liability whatsoever for processing the loan documentation basis this declaration subject to fulfillment of other criteria as per
the policy of TVS Credit.
8. I/We understand and acknowledge that mere submission of this Application Form does not entail approval of the loan from TVS Credit and that
the Company shall have the absolute discretion to reject my/our application without specifying reasons for the same and without notification.
9. I/We agree to pay any amount as may be applicable on the levy of Goods and Service Tax on the loan amount.
10. . I/We concede that the Company shall increase or decrease the credit limit as per its internal policy and criteria at its sole discretion from time to
time and I/We understand that no dispute with respect to the same from my/our end will be entertained.
11. I/We shall pay a processing fee (non-refundable), if any, charged towards the loan application.
12. I/We shall pay the required fee (non-refundable), levied toward Credit Verification and Mandate Registration charges, and charged towards the
loan application.
13. I/We agree that foreclosure charges are on balance tenor at 6 % for term less than 12 months, at 4 % for term between 12 to 24 months, and at and
 that these are levied/calculated on the balance outstanding of the loan.
14. I/We agree that prepayment of the loan amount is not allowed for the first 6 months from the date of disbursement of loan.
15. I/We affirm that I/We have submitted all the self-attested, necessary documents mentioned in the checklist and that the same, along with attached
photograph,are not liable to be returned.
16. I/We agree to notify the Company in any change of address of employment or of residence, or of nature of employment, so mentioned by me/us in
the Application Form.
17. I/We agree to the terms and conditions of the e-Agreement, if any/in case of online filing of this Application Form.
18. I, hereby confirm having received, read and understood the terms and conditions including the scheme details explained to me.
19. I/We agree to download the No Due Certificate (NDC) from SAATHI application / Customer Portal by logging in using the registered mobile
number or contact the Customer Service Support Team.
20. For post-claim settlement and the foreclosure of the loan account, I/We should directly contact TVS Credit Services Limited. One Assist and/or
its Insurer shall not hold any liability concerning the loan closure.
21. I/We agree that in case of a Mobile ADLD claim being declared as Beyond economic repair (BER) / Total Loss, the final monetary
settlement/claim payment shall be done to the financier/TVS Credit ONLY. I/We, understand, that I/We shall have no rights to claim the BER
payable amount from One Assist/Across Assist. Once the payment is settled with the financer/TVS Credit, all One Assist/Across Assist and/ or its
insurer’s obligations under this contract will be deemed fulfilled and the plan coverage shall stand terminated. Post claim settlement and for the
Foreclosure of the loan account, I/We should directly reach out to TVS Credit Service Limited. One Assist/Across Assist and/ or its Insurer do
NOT hold any liability in the loan closure.

Borrower's Signature

Loan Term Sheet

SF Deal ID:

Customer Name: S a n t o s h R a m u l u D a s a r i

Dealer Name: O N E N E S S S Y S T E M S Customer IRR 2 6 . 0 2

Product Financed & Model S A M S U N G S M - A 1 6 6 P L G H I N S

EMI Amount for CD: 2 0 0 0 Total EMI Amount: 2 0 0 0 Tenor: 9

Loan Amount Financed: 1 8 0 0 0 First EMI Due Date: 0 3 0 1 2 0 2 5

Mode of Loan Payment: Read, received and understood

Borrower's Signature

Important Note
1. The decision to give a loan and the interest rate applicable to each loan account is assessed on a case to case basis, based on multiple parameters
such as the type of the asset being financed, borrower profile, and repayment capacity, borrower's other financial commitments, past repayment
track record if any, the security for the loan as represented by the underlying assets, loan to value ratio, mode of payment, tenure of the loan,
geography (location) of the borrower, end use of the asset etc.
2. Kindly note that the Company:
3. - Will decide the quantum of the loan at its sole discretion - Reserve the right to reject any application, without assigning any reasons - May
request for additional documents other than those collected in this connection - Reserves the right to retain photograph and documents submitted
along with the application form and shallnot return the same - The Equated Monthly instalment (EMI) in connection with the loan will be due as
per the schedule of the loan Agreement - Will not be liable for loss or delay in the receipt of documents.
4. Incomplete, defective application will not be processed and the Company shall not be responsible in any manner for the resulting delay or
otherwise
5. All post dated cheques are to be issued favouring TVS Credit Services only.
6. With the acceptance and signing of the loan application form, the customer unconditionally agreed to terms and conditions which may be changed
by the company at any time with due notice, and the customer will be bound by the amended terms and conditions.

Checklist of Documents
Photo Identity Proof: Aadhaar Card Passport PAN Card Voters ID Card Driving License
Address Proof: Aadhaar Card LPG EB Voters ID Card Driving License
Passport Bank Passbook Telephone Bill Municipal Water Bill Property Tax
Schedule of Charges

Schedule of charges Charges (inclusive of GST)

ACH Failure Charges/Mandate Rejection
Rs.500/-
Charges
Bounce Charges Rs.500/-
Cash Collection / Visit Charges Rs.100/- per visit
Credit Verification Charges Rs.150.0/-
Duplicate NDC/NOC charges Rs.250/-
Duplicate Repayment Schedule - hard copy Rs.250/-
3% on principal outstanding for all interest-
Foreclosure Charges bearing schemes,Nil for non-interest-bearing
schemes
Credit Shield Insurance Premium Charge NA
Legal, Repossession & Incidental Charges At Actuals
For Interest bearing schemes - Rs.1000/- +
Broken period interest (from disbursement date
Loan cancellation charges
to cancellation date)
For non-interest-bearing schemes - Rs.1000/-
Mandate Registration Charges Rs.150.0/-
Penal Charges (exclusive of GST) 36% per annum on unpaid installment
Processing Fees Rs.399.0/-
Stamp Duty/Stamping/Franking Charges Rs. 0.0 /-
Statement of Accounts - hard copy Rs.250/-
Swap Charges Rs.500/-
Value Added Services NA
Mobile Accidental Damage / Liquid Damage
Value Added Services
NA
T-Health
 Income-tax Rules, 1962
FORM NO. 60
[See second proviso to rule 114B]
Form for declaration to be filed by an individual or a person (not being a company or
firm) who does not have a permanent account number and who enters into any
transaction specified in rule 114B

First Name Santosh

1 Middle Name Ramulu
Surname Dasari
2 Date of Birth/ Incorporation of declarant 2 1 0 3 1 9 8 3
3 Father's Name (in case of individual)
First Name Ramulu
Middle Name
Surname
Flat/ Room No. Floor No.
4 5
33/3/49 new paccha peth ganesh mandir javal
Name of premises Block Name/No.
6 7

Road/ Street/ Lane Area/ Locality

8 9
Solapur South,Solapur,Maharashtra Ashok Chowk S.O-413006
Town/ City District State
10 11 12
Solapur Solapur MAHARASHTRA
Pin code Telephone Number (with STD code) Mobile Number
13 14 15
413006 9923548402
16 Amount of transaction (Rs.) 18000/-
17 Date of transaction 1 1 1 2 2 0 2 4
18 In case of transaction in joint names, number of persons involved in the transaction
19 Mode of transaction: Cash, Cheque, Card, Draft/Banker's Cheque, Online transfer, Other

20 Aadhaar Number issued by UIDAI (if available)

If applied for PAN and it is not yet generated enter D D M M Y Y Y Y
21
date of application and acknowledgement number
If PAN not applied, fill estimated total income (including income of spouse, minor child etc. as per section 64 of
22
Income-tax Act, 1961) for the financial year in which the above transaction is held
a Agricultural income (Rs.)
b Other than agricultural income (Rs.) 0.0/-
Details of document being produced Document code Document identification Name and address of the
23 in support of identify in Column 1 number authority issuing the document
(Refer Instruction overleaf) 7854
Details of document being produced Document code Document identification Name and address of the
24 in support of address in Columns 4 number authority issuing the document
to 13 (Refer Instruction overleaf) 7854
 Verification

I, Santosh Ramulu Dasari do hereby declare that what is stated

above is true to the best of my knowledge and belief. I further declare that I do not have a Permanent Account Number and my/
our estimated total income (including income of spouse, minor child etc. as per section 64 of Income-tax Act, 1961) computed
in accordance with the provisions of Income-tax Act, 1961 for the financial year in which the above transaction is held will be
less than maximum amount not chargeable to tax.
Verified today, the 11 day of 12 20 24

Place: Solapur (Signature of declarant)

Note:
1. Before signing the declaration, the declarant should satisfy himself that the information furnished in this form is true, correct
and complete in all respects. Any person making a false statement in the declaration shall be liable to prosecution under section
277 of the Income-tax Act, 1961 and on conviction be punishable,
(i) in a case where tax sought to be evaded exceeds twenty-five lakh rupees, with rigorous imprisonment which shall not be
less than six months but which may extend to seven years and with fine;
(ii) in any other case, with rigorous imprisonment which shall not be less than three months but which may extend to two
years and with fine.
2. The person accepting the declaration shall not accept the declaration where the amount of income of the nature referred to in
item 22b exceeds the maximum amount which is not chargeable to tax, unless PAN is applied for and column 21 is duly filled.