LOAN APPLICATION FOR INDIVIDUALS (For All Loans including Housing Loans, of any amount from Individual Applicants)

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18/10000forms/S.E. /01-2015 Price Rs.25/- Sr. No. LOAN APPLICATION FOR INDIVIDUALS (For All Loans including Housing Loans, of any amount from Individual Applicants) To, The Managing Director, ABHYUDAYA CO-OP. BANK LTD. K.K.Tower, Off. G. D. Ambekar Marg, Parel Village, Mumbai-400 012. Date: Dear Sir, I/We hereby apply for a loan of `. (Rupees ) from the Bank, repayable in monthly installments including interest. The loan is required for the purpose of. I/We am/are enclosing all necessary documents for your reference and record. Kindly sanction me/us the loan as above. I/We am/are also furnishing the following information to you: 1. Particulars Applicant Co-Applicant Name in Full Is Borrower is known by any other name in past? If yes, Name: Borrower s Father s Name Surname First Name Middle Name Surname First Name Middle Name Photograph/s Photograph Photograph Sex Male Female Male Female Relationship with - N.A - Applicant Date of Birth Membership No. Nationality Aadhaar (UID) No. Passport No. & Issue Office. Passport Expiry Date E-mail Address PAN No. Religion & Caste ST NT OBC GEN GEN ST NT OBC GEN GEN Residence Status Ownership Rental Pagadi Ownership Rental Pagadi Area ( Sq.Ft.) Residential Address Tel. Nos. Resi. Mobile

2 Native Place Address: Name & Address of the Employer/ Business Tel. No. Tel. No. Business Place Ownership Rental Pagadi Ownership Rental Pagadi No. of years in Business/Service Designation in Service Type of Business (Nature of Job) Gross Salary / Income p.m. ( `.) Net Salary/ Income p.m. ( `.) Income Tax Paid ( `.) 2. Details of Applicant s Family members: a) Spouse Name Date of Birth/Age b) Children i) ii) iii) Other Legal Heirs- Father Mother 3. Accounts Details: Applicant Abhyudaya Co-op. Bank Ltd. Br. Co-Applicant Abhyudaya Co-op. Bank Ltd. Br Other Bank Accounts (Bank, Branch & A/c Nos.) Other Bank Accounts (Bank, Branch & A/c Nos.) 4. Details of all Associate Concerns: (`. in Lakh) Name Constitu tion Owners Nature of Business Bankers Facility Enjoyed

3 5. Details of loans & Advances availed from Other Banks/Financial Institutions/ Credit Societies, if any: (`. in Thousand) Name of the Date of Amt. Amt. Sr. Facility & Name of the Loanee Bank & Branch/ Sanction Sanctioned Outstanding No. A/c. No. Fin. Institute OR I/We am/are not enjoying any credit facilities with any other Bank/Branch of your Bank and undertake to inform you promptly as and when credit facility /ies is/are availed by me/us from other Banks/Branches of your Bank. 6. Securities: (A) Prime (Purchase of Flat/House)/Mortgage of Immovable Property: Particulars of Property (Full Details) Area (Sq. ft.) Purchased on Agreement Value Rs. Builder/Vendor s Name Ready/ Under Construction Present Value as per the Valuation Report of Whether 3 rd Party is occupied the said property? If yes, Name of the Occupier (B) Collateral Securities LIC (Surrender Value) NSC/KVP FDR Total M/s Dated: Market Value: `. Lakh Distress Value: `. Lakh If Yes, Details of Lease/L&L: Yes/No Date of Expiry of Lease/L&L: ( `. in Lakh) Face Value Present Value Own/Third Party 7. Details of Projected Cost/Budget: ( `. in Lakh) Particulars of Purchase of Flat / House Machinery/ies Vehicle/s Purchase of Gala/ Shop/ Office etc. House Repairs Total Cost/Amount Supplier/Contractor/Seller Advance paid Amt. Applied Total 8. Total Cost/Budget: Total cost/budget `. Loan applied `. Margin Money Required `. Balance in Account `. Advance Paid `. Deficit, if any `. Arrangements made to raise deficit amount:

4 9. DEBT SERVICE COVERAGE RATIO (DSCR) For Loans above Rs.15.00 Lakh (Except Educational Loans to Students): (`. in Lakh) Years 20 20 20 20 20 20 20 1. Net Profit after Tax 2. Depreciation 3. Interest on Term Loan 4. Cash Accruals (1 + 2 + 3) 5. Term Loan Installment 6. Int. on Term Loan 7. Total Repayment (5 + 6) 8. DSCR (4/7) 9. Average DSCR 10. I/ We am/are offering the Guarantee of: i) Mr/Ms: ii) Mr/Ms: Their consent letters are enclosed. 11. I/We declare/undertake that a) I/We hereby declare that I/We am/are not relatives of any Director of Abhyudaya Co-op Bank Ltd as specified in the guidelines of Reserve Bank of India. We further confirm and declare that no Partner/Director/Trustee in our firm/concern is a relative of any Director of the Abhyudaya Co-op Bank Ltd nor any of our relatives has any beneficial interest or control in the affairs of any firm or concern in which Director of Abhyudaya Co-op Bank Ltd is involved or interested. OR I/We am/are the relatives of Director Shri/Smt. of Abhyudaya Co-op Bank Ltd as (Relationship). b) I/We am/are the resident/s of India and hereby certify that all the information furnished by us is true and correct. No legal action has been/is being taken/initiated against me/us by any lending institution/bank. c) I/We have paid all our Statutory Dues to the respective authorities and no dues/claims are pending /to be paid to/with any of the authorities till date. d) I/We shall furnish all other information that may be required by you in this connection with my/our application. We also authorize you to exchange the information with any agency you may deem fit. e) You, your representative, or any other persons authorized by you, may at any time, inspect/verify our assets, books of accounts, details/information provided by us etc. in factory/business premises/residence or Employer, without prior information. f) I/We agree to display the Bank's Name Board with wordings, "Goods hypothecated to/we are banking with "Abhyudaya Co-op. Bank Ltd. at a prominent place in Office/Gala/Factory/ Business place and on Securities hypothecated to you. g) I/We hereby undertake to operate exclusively with your Bank and will not hypothecate/mortgage securities offered to you, to any other Bank/Financial institution and avail any loan/facilities from other Financial Institution/Bank. h) I/We consent for the Bank submitting information about the details of all our Credit facilities to Reserve Bank of India, Indian Banks' Association, Any Credit Information Agencies, Reserve Bank of India and other Authorities. I/We also consent for the Bank to share the information about all our accounts with any other Banks/Authorities. i) I/We shall abide by the terms and conditions of the sanction unconditionally and pay all the charges and interest amount that may change from time to time. j) I/We understand and know that the Bank s decision is final whether to reject/sanction/sanction in part the amount of banking limits without assigning any reason. The Bank shall reserve all the rights to call back the amount at any time in case it is found that any of the information given by us is false. k) We also confirm that we have not availed any credit facilities from other Banks/Financial Institution/Credit Societies. l) We also confirm that we have received the List of Bank Charges/Fees payable by the Applicants, enclosed with this application. Signature Verified by Name : Staff No. (Mr/Ms : ) (Applicant) (Mr/Ms : ) (Co-Applicant)

5 Check List for Documents Documents to be submitted along with the Loan Application (Wherever copies are submitted, please bring originals for verification) Sr. No. Name of Document Applicant/Co-Applicant 1. *Passport/Driving Licence/ Voter s ID Card/NREGA Job Card/Aadhaar Card (Copy of any one) 2. Salary slips & Copy of Form No.16 3. Income Statements for 2 years (All) 4. 5. Purpose Proof (Quotation/ Declaration/ etc.) Statement/s of all Bank Account/s for last I year. 6. 3 Photographs 7. Copy of PAN Card Whether submitted (Yes/No) If not submitted, reason for Non-submission Surety I 1. *Copy of any one of KYC as above 2. Salary slip/form No.16 3. Income Statements 4. Signature Verification from Bank 5. 1 Photograph Surety II 1. *Copy of any one of KYC as above 2. Salary slip/form No.16 3. Income Statements 4. Signature Verification from Bank 5. 1 Photograph Other Documents to be submitted where properties are offered as security. (Other documents if any, shall be submitted as per Mortgagebility Checking Report after verification of Mortgage-ability of the property) 1. Original Agreement for Sale 2. Original Registration Receipt 3. Copy of Approved Plan & CC 4. NOC from Builder/ Society/ MHADA/CIDCO 5. Copy of Occupation Certificate 6. Copy of Regn. Certificate of Society 7. Original Receipts of Payment 8. Title Clearance Certificate 9. Valuation Certificate 10. Previous original chain documents 11. Original Possession Letter

6 List of Bank Charges/Fees payable by the Applicants Share Amount Minimum shares 100 and Maximum shares 50,000 per Member. Surety loans - 1% of the amount sanctioned. Vehicle Loans (a) Private Vehicles - `.1,000/- shares (max. (b) Other Vehicles - 1.5% of the amount sanctioned. Educational loans - 1% or `. 2,500/- (max.) Secured Loans/Working Capital Limits - 2.5% of the amount sanctioned. Housing Loans (a) Loans up to Rs.20.00 Lakh - 1% or `. 2,500/- (max.) (b) Loans above Rs.20.00 Lakh - `. 5,000/- (max.) Processing & Service Charges A. Processing Fees/Charges: i) Processing Charges for all New /Takeover Proposals/Project Loans of above `. 10.00 Lakh and all In- Principle Acceptance proposals (except Housing Loans). : 0.10% of the amount applied (Maximum `. 25,000/-.) ii) Processing charges for checking of mortgagebility of properties. : `. 1000/- per Property. Note: Processing Charges are non-refundable if the proposal is rejected. B. Service Charges: SERVICE CHARGES FOR CREDIT FACILITIES Cash Credit / Bill Discounting & Working Capital Limits/Packing Credit/ AGClg. (Except SOD against FDRs/FLXLN/ LC & BG) For SOD/SODGLD SODIMP Builders & Developers - Other than Builders & Developers (outstation branches) Bill Discounting under LC TERM LOAN (All Types) (Except loan against Term Deposit/ Gold ornaments, NSC, LIC, Govt. Sec. & RBI bonds) Short Term Corporate Loan (STCL)/TOD 1.3% for first sanctioned limit & subsequently, on enhanced limit subject to max. `. 25.00 Lakh (Per party in case of combined facilities). 0.70% of Loan amount subject to min. `. 100.00 & max. `. 1,000.00 1.3% of sanctioned amount 0.60% of sanctioned amount 0.1% of sanctioned limit subject to minimum of `. 250/- (To be collected at the time of discounting of Bill) 1.3% of sanctioned limit subject to maximum `. 25.00 Lakh (Per party in case of combined facilities) 1.3% of sanctioned limit. SERVICE CHARGES : BANK GUARANTEE (Fresh and renewals) PARTLY SECURED BY OUR BANK'S TERM DEPOSIT ONLY Less than 50% of Bank Guarantee amount 50% or more but less than 100% of Bank Guarantee Fully secured by our Bank's Term Deposit only. Amendment without value enhancement/extension Charges for invoked Bank Guarantee 2.50% per annum + `.125/- (inclusive of claim period) 1.50% per annum + `.125/- (inclusive of claim period) 1% of BG amount subject to minimum `.100/- & maximum `.1,000/- `.300/- per amendment `.1,000/- per Bank Guarantee Note: Charges will be collected for a minimum period of 1 month and its multiple for additional part period.

7 SERVICE CHARGES SOLVENCY/FINANCIAL CAPACITY/CREDIT FACILITY CERTIFICATE (FOR ONE TIME OR LIMIT) Amount of Certificate Service Charges Upto `. 25.00 Lakh `. 200/- per `. 1.00 Lakh or part thereof subject to max. `. 2,500/- Above `. 25.00 Lakh to `. 50.00 Lakh `. 5,000/- Above `. 50.00 Lakh to `. 1.00 Crore `. 10,000/- Above `. 1.00 Crore to `. 10.00 Crore `. 15,000/- Above `. 10.00 Crore to `. 25.00 Crore `. 20,000/- Above `. 25.00 Crore `. 25,000/- If certificate is issued to individuals for their ward s education purpose 25% of the charges as mentioned above In case of extra original copy of same certificate `. 115/- per certificate. Notes: 1. All Processing Charges (including the Mortgagebility checking charges) will be collected at the time of acceptance of new applications and adjusted towards service charges if the facility is sanctioned. 2. All new/takeover proposals/project Loans above Rs. 10.00 Lakh excluding Housing Loans are required to pay processing charges in advance at Branches/Zonal Offices. 3. In case of renewal/enhancement of CC/BD etc. Service Charges will be only on enhanced limit. In case of WCTL/STCL (if sanctioned for a period less than one year) & TOD, Service Charges will be for the proportionate period (month-wise). 4. No prepayment charges will be levied. 5. Rate of Interest is floating unless otherwise specified and will be calculated on the daily debit balance in the said account from time to time with monthly rests to be taken and such interest to be paid on or before 15 th of each month. 6. The rate of interest is subject to change in accordance with the Directives issued by RBI and/or Bank's PLR and its policy, from time to time. 7. The Bank shall be entitled to change the rate of interest by sending intimation or publishing in any Newspaper or on the Notice Board of the Bank or made known through an entry in the statement of account, its intention to change the rate of interest applicable to Credit facilities. The Bank shall also be entitled to increase the amount of installments and/or number of installments as and when there is revision in rate of interest. 8. In default of payment of interest as stated above the same shall be capitalized and added to the principal and shall be treated as an advance and the Bank will be entitled to charge interest at the aforesaid rate on the amount of the debit balance inclusive of interest not paid and hence capitalized as aforesaid, in addition to charging penal interest at the rate decided by the Bank from time to time from the date of default to the date of actual payment. 9. Service charges are applicable as per the Bank s rules in force that exists as on date. 10. No conversion/switchover charges will be charged at present. If Bank decides to charge in future, the rates will be intimated to the Borrowers from time to time.