CRISIL CREDIT RATING FAAA/STABLE

Transcription

1 PUBLIC DEPOSIT SCHEME LIC Housing Finance Ltd. TRANSPARENCY & TRUST BUILD LASTING RELATIONSHIPS DEPOSIT SCHEMES FOR RESIDENTS / NON RESIDENTS INDIVIDUALS / CO-OPERATIVE SOCIETIES / ASSOCIATION OF PERSONS. CRISIL CREDIT RATING FAAA/STABLE HIGHLIGHTS LICHFL is one of India's large housing finance company providing financial assiance in e acquisition and maintenance of homes since 1989; having nation-wide network across six regional offices, 15 back offices and 115 marketing offices. Consient record of dividend payments since YEAR DEPOSIT % P.A. 5 YEAR DEPOSIT % P.A. NON-CUMULATIVE SCHEMES Minimu m Amount of Deposi t R s.1 0,000/ - Additional deposit i n multipl e o f R s.1, 000/- Intere payment half yearly on 30 September and 31 March. REGISTRARS TO THE PUBLIC DEPOSIT SCHEME INTIME SPECTRUM REGISTRY LIMITED C-13, Pannalal Silk Mills Compound, L.B.S. Marg, Bhandup (W), Mumbai Tel.No.: /4 Fax: Contact Person : Mr. Vijay Ayare. All communications wi regard to Public Deposit should be addressed to e Regirar to Public Deposit Scheme at e above address. FUND MOBILIZERS TO THE PUBLIC DEPOSIT SCHEME Integrated Enterprises (India) Limited 59, Sonawala Building, Mumbai Samachar Marg, Fort, Mumbai Tel.No / Selected Centres / Branches of e Fund Mobilizer Ahmedabad- (079) , Bangalore- (080) , Baroda- (0265) , Bhopal- (0755) , Bubhaneshwar- (0674) , Chennai (T.Nagar)- (044) , Cochin- (0484) , Coimbatore- (0422) , Panjim (Goa)- (0832) , Hyderabad- (040) , Indore- (0731) , Jaipur- (0141) , Kolkata- (033) , Lucknow- (0522) , Madurai- (0452) , Mangalore- (0824) , Mumbai (Fort)- (022) , Mysore- (0821) , Nagpur- (0712) , Nasik- (0253) , New Delhi , Patna- (0612) , Pune- (020) , Rajamundhry- (0883) , Rajkot- (0281) , Surat-(0261) , Trivandrum- (0471) , Vijayawada- (0866) , Vishakapatnam- (0891) INTEREST RATES APPLICABLE WILL BE THE PREVALENT RATE AS ON THE DATE OF SUBMISSION OF THE APPLICATION FORM AT ANY OF THE BRANCH OF THE FUND MOBILIZER. *Acceptance of deposits are subject to e terms and conditions mentioned overleaf. REGISTERED & CORPORATE OFFICE KYC Compliance National Housing Bank had introduced Know Your Cuomer (KYC) Guidelines for Housing Finance Companies. In order to comply wi ese guidelines, we reque you to kindly fill up e KYC Compliance Form for each applicant separately. This form has to be filled in only once or while placing e deposit for e fir time. On submission of is form alongwi e necessary identification documents, Cuomer No. will be allotted by e Company which should be quoted on e application form while placing any furer deposits. KYC Compliance Form is attached wi Public Deposit Application Form. Additional KYC Forms are available wi above offices of Fund Mobilizer and wi Regirar to e Public Deposit Scheme. nd Bombay Life Building, 2 Floor, 45/47, Veer Nariman Road, Mumbai Phones: , Fax: lichfl@bom2.vsnl.net.in Website:

2 TERMS AND CONDITIONS GOVERNING THE PUBLIC DEPOSITS 1. Acceptance of Public Deposits : Public Deposits will be accepted from Resident/Non-Resident Individuals, minors rough guardians, Association of Persons, Hindu Undivided Family, Co-op. Societies, Proprietary Concerns and Partnership Firms. 2. Non-Resident Indians (NRI) : Deposits from Non-Resident Indians and Persons of Indian origin resident outside India would be accepted in accordance wi e regulations governing e acceptance of deposits from NRIs. Deposits would be accepted for a maximum period of 3 years. Payment of intere as also e repayment shall be made only by credit to e NRO Account. Income Tax at Source will be deducted as applicable to Non-Residents. 3. Application Form : The prescribed Application Form duly accompanied by cheque/demand draft in favour of LIC Housing Finance Limited-Public Deposit A/C marked Account Payee Only is payable at selected centres i.e. branches of Fund Mobilizer. Outation depositors can send demand drafts after deducting e demand draft charges. This facility is applicable for places oer an e selected branches of e Fund Mobilizer. Please ensure at your cheque/demand draft togeer wi your completed application form is handed over by you or by your agent, if any, to Fund Mobilizer immediately since LIC Housing Finance Limited will not pay any intere for e priod between e date of e cheque/demand draft and e date on which your cheque/demand draft is received by Fund Mobilizer wi your completed application form. Signature by umb impression mu be atteed by a Magirate or a Notary Public under eir Official Seal. In case an application is made under Power of Attorney or by a Association of Persons or by a Co-Operative Societies or by a Tru, e relevant Power of Attorney or Resolution mu be given. 4. Payment of intere : Intere on deposit (Non Cumulative) will be paid on 30 September and 31 March. In case of intere payment for part period, e same will be made on pro-rata basis. However, if a deposit is made wiin a period of 30 days prior to any of e intere payment date, e intere for e part period will be paid on e next intere payment date. Payment of intere will be made rough intere warrant or rough Electronic Clearing Service (ECS) in respect of e places where such facility has been offered by e Company. 5. Deduction of Tax at Source : In case where e intere amount exceeds Rs.5,000/- (or any such amount notified by e Government from time to time) in a financial year, income-tax will be deducted at source as per section 194A of e Income-tax Act, 1961 at e rates in force. If e depositors, who are not liable to pay income tax and e intere to be paid / credited in e financial year does not exceed e maximum amount exempt from tax, depositor may submit a declaration in Form 15G in triplicate to e Regirar namely Intime Spectrum Regiry Limited, Mumbai in e beginning of every financial year, so as to receive intere wiout deduction of tax at source, failing which tax will be deducted at source in accordance wi Section 194A of e Income-tax Act, Senior Citizens may submit a declaration in Form 15H. TAX DEDUCTED DUE TO NON-COMPLIANCE WITH THIS CONDITION WILL NOT BE REFUNDED. Where Income-tax is deducted at source, a consolidated TDS Certificate may be issued for e financial year. Section 139A (5A) of e Income-tax Act, 1961 requires every person receiving any sum or income from which tax has been deducted to intimate his Permanent Account Number (PAN) to e person responsible for deducting such tax and e person deducting such tax to indicate e PAN on e TDS Certificate. Please mention your PAN in e application form. However, in case you have applied for PAN or PAN is not applicable in your case, please tick e appropriate box in e application form. 6. Joint Deposit Holders : Deposits will be accepted in joint names not exceeding ree in number. In case of deposits in joint names, all communications will be addressed to e fir named depositor and payment of intere and repayment of principal amount shall be made to e fir named depositor. Any discharge given by any of e depositors will be valid and binding on all e joint depositors unless expressly intimated to e Company at e time of making deposit. In e event of dea of e fir / sole depositor e repayment of deposit and payment of intere will be made to e joint depositor fir in order of survivor/s / nominee on submission of dea certificate wiout reference to e heirs and / or legal representatives of e deceased. 7. Nomination : Individual depositors can, singly or jointly, nominate oer person under is facility. The nominee shall be recognized as e Holder of e title to e Public Deposit on dea of all e depositors. Power of Attorney Holder or a guardian applying on behalf of a minor cannot nominate. In case e deposit is placed in e name of e minor e nomination can be made only by a person lawfully entitled to act on behalf of e minor. Depositors are advised to provide e specimen signature of e nominee to expedite e transmission of e deposits to e nominee in e event of demise of e depositors. The payment by e Company to e nominee shall conitute full discharge to e Company of its liability in respect of e deposit. 8. Deposit Receipt / Intere Warrant : The deposit receipt and intere warrant will be sent by po / courier by e Company to e address given in e application form and e Company shall not be held responsible for any loss or delay in transit. If e deposit receipt is not received by e depositor wiin 4 weeks from e application date, e depositor should write to enquire wi e Corporate Office of e Company. In e event of loss/deruction/mutilation of deposit receipt, e Company may at its sole discretion issue a duplicate receipt upon receiving an indemnity from e depositor in e form prescribed by e Company. The deposit receipt is not transferable. The Company will not recognize any lien or assignment of e deposit or intere ereof. 9. Renewal and Repayment of Deposits : In case of renewal of Public Deposit, a fresh application form duly filled should accompany e discharged deposit receipt. In case of repayment, e duly discharged deposit receipt should be surrendered at lea 15 days before e date of maturity. The deposit would be repayable at e city/town where e deposit is placed. No part repayment or renewal will be permitted. 10. Premature Widrawal : a) No premature widrawal will be allowed before e completion of ree mons from e date of receipt as per National Housing Bank (NHB) guidelines. In case of reque for premature widrawal after e expiry of ree mons, e rates given in e table below shall apply: Period completed from date of deposit After 3 mons but before 6 mons After 6 mons but before date of maturity 11. Loan again Deposits : Loans may be granted again Public Deposits upto 75% of e deposit amount, carrying intere at e rate of 2% per annum (at half yearly res) above e intere rate and any oer additional charges as applicable on such deposits, provided such deposits has run for a minimum period of 3 mons. The outanding loan togeer wi intere shall be settled in one lump sum by e depositor or shall be adjued on maturity of e deposit. However, e granting of loan will be at e sole discretion of e Company. 12 For auorized agents : Agents are not auorized to accept cash or issue receipts on behalf of LIC Housing Finance Limited. Please ensure at e Agent's name and code number is clearly mentioned in e Application Form to enable payment of brokerage. Application Forms received wiout name and code number of e agent will not be considered for payment of brokerage. Brokerage will be paid to regiered agents at e rate decided by e management as per RBI/NHB regulations/guidelines. 13. Electronic Clearing Service (ECS) : This facility is provided to depositors in select centers whereby e intere will be credited directly to e depositors' bank account. The depositor would receive credit entry ECS LICHFL in passbook / bank atement. Intimation of intere credited would be sent to e depositors. Your Bank will not levy any charge for is facility as per present RBI Guidelines. However, e intere for e broken period on maturity as well as repayment of deposit amount will be made rough warrants. 14. General: Deposits will be subject to e Rules/Guidelines framed from time to time by NHB or any oer atutory auority and/or Central/State Government in connection wi acceptance of Public Deposits by Housing Finance Companies. Terms and conditions form part of e prescribed form. The Company reserves e right to alter or amend from time to time e terms and conditions wiout assigning any reason if so required by NHB regulations/guidelines. Brokerage will be paid to e ird party (oer an deposit holders) as per NHB regulations / guidelines. The Company has Public Deposit Desk at e Corporate Office to look into any inveor grievance regarding deficiencies, if any, in e services. The Board of Directors certify at all e relevant information regarding e Schemes as well as e financial position of e Company is correctly declared. As required by NHB guidelines, it is to be diinctly underood at e Public Deposit Application Form should not in any way be deemed or conrued to have been cleared or approved by NHB. NHB does not undertake any responsibility eier for e financial soundness of any scheme or for e atements made in e Public Deposit Application Form. In case of any defeciency of e Company in servicing its deposits, e depositor may approach e National Consumers Disputes Redressal Forum, e State Level Consumers Disputes Redressal Forum or e Dirict Level Consumers Disputes Redressal Forum for relief. In case of non-repayment of e deposit or part ereof in accordance wi e terms and conditions of e deposit, e depositor may make an application to an auorized officer of e NHB. Public Deposit Receipts & Warrants will be sent to e fir depositor by po/courier. LIC Housing Finance Limited will not be responsible for non-receipt/loss or any delay in transit. In case of loss / misplacement of Public Deposit Receipts / Warrants, relevant legal procedures will have to be followed. Change of address of e fir depositor should be intimated to Intime Spectrum Regiry Limited. Acceptance of deposits is subject to Mumbai jurisdiction only. All e tru depositors mu mention PAN/GIR No. and oer deposit holders placing deposit in excess of Rs.20,000/- mu mention PAN/GIR No. along wi jurisdiction. LIC HOUSING FINANCE LIMITED Rate of intere payable (% p.a.) No intere Intere shall be 2% less an e rate applicable to e period for which deposit remained wi e Company, if intere rate has not been prescribed for such period, e intere rate applicable will be 6.00% p.a. b) In e event of e deposit holder already having/received intere at a higher rate, e difference in e total intere paid and revised intere payable would be adjued again e intere / principal amount. c) Outanding po-dated intere cheques/warrants in e cuody of e depositor, if any should be surrendered to LIC Housing Finance Limited. The brokerage payable to auorized agents is for e period completed and excess brokerage paid will be recovered from e depositor. Acknowledge Slip [To be filled in by e Applicant] Application No. Date : RECEIVED FROM Address [Name of e fir/sole applicant] Pin Code An application for a fixed deposit togeer wi Cheque/Draft/Public Deposit Receipt No drawn on for Rs Dated being fixed deposit amount for a period of 3/5 years. For LIC HOUSING FINANCE LIMITED AUTHORISED SIGNATORY

3 LIC Housing Finance Ltd. Fund Mobilizer's Agent's Name : (if applicable) Code No : Appl. No.: Date: APPLICATION FORM FOR PUBLIC DEPOSIT Individual Oers PLEASE USE BLOCK LETTERS AND TICK IN APPROPRIATE PLACES (PLEASE REFER TERMS AND CONDITIONS) I/We apply for placement / renewal of deposit for a period of 3/5 years and at e intere rate of % p.a. The necessary details are as under : DEPOSITOR'S NAME (in Block Letters) 1. Mr./Mrs./Ms/ M/s. 2. Mr./Mrs./Ms/ M/s. 3. Mr./Mrs./Ms/ M/s. In case Fir/Sole Applicant is minor : Date of bir Kindly fill in a Know Your Cuomer (KYC) Compliance form for each depositor. If already submitted, please mention e Cuomer No. for 1 depositor 2nd depositor 3rd depositor ADDRESS (Fir / Sole Depositor) Guardian s name ( Please use separate KYC Compliance Form for non individual cases ) Date of Formation City Pin Code id (Tel. No. (wi STD Code) AMOUNT OF DEPOSIT Rs. Mode of payment Cheque DD/PO Renewal Rupees (in words) IF CHEQUE / DD/ PO No. Bank IF RENEWAL : Old Deposit Receipt No Renewal Amount Rs. Dt Maturing On Additional Amount Rs Branch For Rs. Maturity Amount Rs. Crossed A/c Payee Cheques/DD should payable to LIC Housing Finance Limited - Public Deposit A/c. SCHEME Non Cumulative Intere payable Half Yearly on 30 September and 31 March PERIOD (YEARS) 3 5 DETAILS OF BANK ACCOUNT Type of Account Savings Current Account No Bank Branch ECS Yes No 9 Digit Code No. (as appearing on MICR cheque issued by your Bank) OCCUPATION Service Business Retired Housewife Oer INCOME Rs. P.M. (Optional)

4 STATUS Resident Individual Non- Resident Individual Oers (specify) CATEGORY Public Shareholder Director/Relative of a Director Promoter DEPOSIT REPAYABLE TO Fir Depositor Fir Depositor or Survivor/s TAX STATUS Exempt Non- Exempt 15G/15H Enclosed (In Triplicate) Order u/s. 197 Order u/s.10 INTEREST PAYABLE BY ECS Warrants PAN / GIR : Applied for (zerox copy of application to be attached) Not Applicable INTRODUCTION / IDENTIFICATION OF NEW DEPOSITOR introducer mu be a LIC Housing Finance Limited depositor or an Agent of e Fund Mobilizer. Introducer's Name : LICHFL Public Deposit Receipt No. / Agent Code No: Signature : If ere is no introducer submit a photocopy of any one of e following for e fir depositor: PAN Card Election Identity Card Passport/Ration Card Document evidencing creation/regiration of e tru / AOP. NOMINATION Name of Nominee : Date of Bir : Relationship of nominee wi fir depositor : Guardian's Name (if nominee is minor): Address of Nominee : id : PIN Code Signature of Nominee: I/We e applicant(s) hereby apply for e placement / renewal of Public Deposit as per details given above in accordance wi e Terms and Conditions and confirm at ese are binding on me/us. I/we also declare at I/we have not acquired e fund being deposited wi you by borrowing or accepting deposit from any oer person. I/we declare at e fir name depositor is e beneficial owner and is to be treated as e payee for e purpose of deduction of tax under section of 194 A of e Income-tax Act 1961, I/we have gone rough e financial & oer atements /particulars/ representation furnish /made by e Company and after careful consideration, I/we are placing deposit wi e company at my / our own risk and volition. I/We furer declare at, I/We am/are auorised to make ese deposit in e above mentioned scheme and e amount kept in e deposit is rough legitimate source and does not involve directly or indirectly any proceeds of schedule of offence and / or is not designed for e purpose of any contravention or evasion of e provision of Money Laundering Act, 2002 and any Rules, Regulations, Notifications, Guidelines or Directions ereunder, as amended from time to time. I/We shall provide any furer information and fully co-operate in any inveigation as and when required by e Company in accordance wi e applicable law. I/We furer affirm at information / details provided by me / us is / are true and correct in all respects and noing has been concealed. Signature of depositor/s : 1) Fir / Sole / Guardian 2) Second 3) Third FOR OFFICE USE ONLY PUBLIC DEPOSIT RECEIPT NO. DATE OF DEPOSIT RATE OF INTEREST %p.a. AMOUNT OF DEPOSIT (RS.) AUTHORISED BY : MATURITY DATE CHECKED BY :

5 PARTICULARS AS REQUIRED UNDER NON-BANKING FINANCIAL COMPANIES AND MISCELLANEOUS NON-BANKING COMPANIES (ADVERTISEMENT) RULES, a) Name of e Company : LIC Housing Finance Limited b) Date of Incorporation : 19 June, 1989 c) Business carried on by e Company : The Company is primarily carrying on business of advancing finance for purposes of conruction / purchase of residential houses. and its subsidiary wi details of Branches The addresses of e Regiered Office and branches of e Company are as under:-: i) Regiered &Corporate Office : nd Bombay Life Building, 2 Floor, 45/47, Veer NarimanRoad, Mumbai ii) Subsidiary Company : 1) LICHFL CARE HOMES LIMITED Engaged in e business of providing Care Homes to elderly people. iii) The Company has Regional Offices / Back Offices at e following places : Kolkata (033) , ; Lucknow (0522) , ; New Delhi (011) , ; Bangalore (080) , ; Chennai (044) , ; Mumbai (022) , Regional Offices : Back Office : In addition to above e Company has 115 Area Offices all over India. Shri. T. S.Vijayan, Chairman Shri Thomas Maew T., Managing Director Shri G. M. Ramamury, Director Shri Y. B. Desai, Director Kolkata (033) , , Siliguri (0353) , ; Lucknow (0522) , ; Bhopal (0756) , ; New Delhi (011) , ; Chandigarh (0172) , ; Jaipur (0141) , ; Bangalore (080) , ; Hyderabad (040) , ; Chennai (044) , ; Coimbatore (0422) , ; Ernakulam (0484) , ; Madurai (0452) , ; Mumbai (022) , ; Pune (020) , d) Brief Particulars of e Management of e Company : The Company is managed by e Managing Director and Director and Chief Executive subject to e superintendence, control and direction of e Board of Directors. e) Name, address and occupation of Directors: Shri Dhananjay Mungale, Director LIC of India, Central Office, Yogakshema, Jeevan Bima Marg, Mumbai LIC of India, Central Office, Yogakshema, Jeevan Bima Marg, Mumbai The Indurial Development Bank of India, IDBI Towers, WTC Complex, Cuffe Parade, Mumbai /322, Raheja Cre 3,Off New Link Road, Lokhandwala, Andheri (We),Mumbai , Tulsiani Chambers, Nariman Point, Free Press Journal Marg,Mumbai Shri S. Ravi, Director D-296, IInd Floor, Sarvodaya Enclave, New Delhi Service Service Advisor (Legal) Retired Profession Profession Shri K. Narasimha Mury, Director , 104, Pavani Eate, Himayatnagar, Hyderabad Shri B. N. Shukla, Director Shri S. K. Mitter, Director & Chief Executive Siddhar, 2H/71, T. V. Tower Road, Mahatma Gandhi Nagar, P.O. Lohia Nagar, Patna LIC Housing Finance Ltd., Bombay Life Building, 2nd Floor, 45 / 47 Veer Nariman Road, Mumbai Profession Retired Service f) & g) Profit and Dividend Financial Year ended Profit Before Tax Profit after tax Dividend (Rs. in Crores) (Rs. in Crores) 31 March % 31 March % 31 March % h) Summarised financial position of e Company as appearing in e la two Audited Balance Sheets (Rs. in Crore-rounded off) Liabilities As at As at Share Capital Reserves & Surplus Secured Loans Unsecured Loans Current Liability Total Assets As at As at Housing Loans Fixed Assets Invements Deferred Tax Asset Current Assets Total Brief particulars of contingent Liabilities as on : Contingent liabilities in respect of: a. Income Tax (demands disputed and pending before appellate auorities) aggregating to Rs. Nil [Previous year Rs.2,520,386/-] b. Corporate Undertaking of Rs.143,500,000/- (Previous year Rs.143,500,000/-) and cash collateral of Rs.25,800,000/- (Previous year Rs.25,800,000/-) for securitization transactions. c. Uncalled liability in respect of party paid invements in units of Venture Capital Funds Rs. 550,000,000 (Previous year Rs. Nil) i) The amount of Public Deposits which e Company can raise under e Housing Finance Companies (NHB) Directions, 2001 is equivalent to 5 (five) times of e net owned fund i.e., Rs.6, crores. The Company has not accepted Public Deposits so far. j) There are no overdue deposits as e Company has not so far accepted any deposits. k) We declare at; I. The Company has complied wi e provisions of e above directions. II. The compliance wi ese directions does not imply at e repayments of deposits are guaranteed by e Reserve Bank of India / National Housing Bank. III. The deposits accepted by e Company are unsecured and rank pari-passu wi oer unsecured liabilities. The total amount of exposure, oer an invement in share including e non-fund based facilities to companies in same group or oer entities or business ventures in which director and / or e company is holding subantial intere as on March 31, 2006 was Rs crores. The above text has been approved by e Board of Directors at its meeting held on 13 March 2007 and is being issued on e auority and in e name of Board of Directors of e Company. A copy signed by e majority of Directors of e Company has been filed wi e Regirar of Companies, Maharashtra, National Housing Bank, New Delhi and e Department of Non Banking Companies of e Reserve Bank of India, Mumbai. Date : March 13, 2007 Place : Mumbai By Order of e Board, LIC Housing Finance Limited S.K.Mitter Director & Chief Executive

6 KNOW YOUR CUSTOMER (KYC) COMPLIANCE APPLICATION FORM (Individual) PLEASE FILL THE INFORMATION IN BLOCK LETTERS AND TICK IN APPROPRIATE PLACES The information is sought under Preventive of Money Laundering Act, 2002, e rules notified ereunder and NHB s guidelines on Anti Money Laundering. Name of e Applicant (As appearing in supporting identification document) Mr./Mrs./Miss/M/s. Full Name of e Faer / Husband / Guardian Mr./Mrs./Miss/M/s. Status Date of Bir / Formation Nationality Resident Individual Non Resident Individual Co-Operative Societies Persons of Indian Origin (PIO) (Attach copy of PIO Card) Income-tax Permanent Account Number (PAN) (Attach a copy of PAN Card) Proof of Identity to be provided by Applicant. (Please submit ANY ONE of e following certified documents) Passport Photo Pan Card Driving Licence Voter's Identity Card Photo Ration Card Photo Debit/Credit Card issued by Bank Any oer Identification wi Photograph (Subject to satisfaction of LICHFL) Present Address of Applicant for all communications Company Name / Flat No. & Bldg. Name Road No. / Name City Pin Code State Country Tel. (R) STD Code Fax Mobile Tel. (O) Extn. No. id Proof of Address to be provided by Applicant (Please submit ANY ONE of e following certified documents) Late Telephone Bill of Land Line / Mobile Latesh Electricity / Gas Bill Late Bank Account Statement Late Demat Account Statement Regiered Rent Agreement Ration Card Any oer Address Proof (Subject to satisfaction of LIC Housing Finance Limited) Oer Details Education SSC/HSC Graduate Po-Graduate Occupation Service Retired Business Professional Housewife Student Marital Status Single Married Number of Children: Son/s Daughter/s Accomodation Own Rented No. of years at current address Household Income Less an Rs.1 lakhs p.a. Rs.1-3 lakhs p.a. Rs.3-5 lakhs p.a. Above Rs.10 lakhs p.a DECLARATION Rs.5-10 lakhs p.a. I/We hereby declare at above information is true to e be of my /our knowledge and belief. I/We furer declare at e deposit made under e deposit application is rough legitimate source and does not include directly/ indirectly any proceeds of schedule of offence and/or is not designed for e purpose of contravention or evasion under any law. Place : Date : Signature of e Depositor For Office use only : Branch : Checked by : Auorised by : Date of Receipt : Cuomer No.