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PLEASE FILL IN BLOCK LETTERS

CITIBANK HOME LOAN APPLICATION FORM Please tell us about yourself (Applicant)
Name of the Applicant (Please leave one space between each name) Mr./Mrs./Ms./M/s: Date of Birth/ Incorporation: PAN No.: Education: Current Residential Address: City: Telephone: e-mail ID: Permanent Address
(If different from above)
First Name Middle Name Last Name

Nationality: Sex: Male Female

No. of dependants: Marital Status: Single Married

Graduate

Post-graduate

Professional

Others, please specify

PIN: Mobile No.:

Years at current residence:

City: Telephone: Your current residence: Preferred Mailing Address: Owned Residence Rented Permanent Address Company Provided Office Community In accordance with requirements prescribed vide Circulars dated 05-07-2007 & 03-09- 2007 issued by the RBI, request you to kindly provide the following information as may be applicable to you: Not Applicable for Companies Use additional sheet and provide information for all partners Sikh Muslim Others Christian Zoroastrian Buddhist

PIN: Are you the Property Owner for the property offered as collateral: New property Category

Yes

No

sc
ST Others

Hindu

Please tell us about your occupation and income details (Applicant)


Salaried You work for Government Public Sector Privately held Multi-National Company Others If you are a professional tick the relevant option Architect Name of company/ concern: Designation: Office Address: CA Doctor Engineer MBA Others You are Proprietor Partnership Company HUF Self Employed Nature of Business Trader Service Consultancy Stock Broker Others Manufacturer Contractor Real Estate Transporter Micro I Micro II Small Medium If you are a Micro, Small or Medium Enterprise, Please tick the relevant box as per Investments upto* Mfg 5 Lakh 25 Lakh 5 Crore 10 Crore Basis of Identification CA Certificate MSME/SSI Certificate Service 2 Lakh 10 Lakh 2 Crore 5 Crore

*Mfg Enterprise - Investments in Plant & Machinery Service Enterprise - Investments in Equipment

City: Telephone: Employee No: Extn.: No. of years with current employer Fax: Number of years at previous organisation/s:

PIN:

Retirement Age

Salaried
Gross Annual Salary (Rs.) Other Income (p.a.)

Self employed
Gross receipt from Business/Profession (Rs.) Net profit from Business/Profession (Rs.) Other Income (p.a.)

Please tell us about yourself (Co-applicant)


Name of the co-applicant (Please leave one space between each name) Mr./Mrs./Ms./M/s: Date of Birth/ Incorporation: PAN No.: Education: Current Residential Address: City: Telephone: e-mail ID: Permanent Address
(If different from above)
First Name Middle Name Last Name

Nationality: Sex: Graduate Post-graduate Professional Male Female

No. of dependants: Marital Status: Single Married

Others, please specify

PIN: Mobile No.:

Years at current residence:

City: Telephone: Your current residence: Relationship with main applicant: Owned Rented Company provided

PIN:

Are you the Property Owner for the property offered as collateral:

Yes

No

Community In accordance with requirements prescribed vide Circulars dated 05-07-2007 & 03-09- 2007 issued by the RBI, request you to kindly provide the following information as may be applicable to you: Not Applicable for Companies Use additional sheet and provide information for all partners Sikh Muslim Others Christian Zoroastrian Buddhist

Category

sc
ST Others

Hindu

Please tell us about your occupation and income details (Co-applicant)


Salaried You work for Government Public Sector Privately held Multi-National Company Others If you are a professional tick the relevant option Architect Name of company/ concern: Designation: Office Address: CA Doctor Engineer MBA Others You are Proprietor Partnership Company HUF Self Employed Nature of Business Trader Service Consultancy Stock Broker Others Manufacturer Contractor Real Estate Transporter Micro I Micro II Small Medium If you are a Micro, Small or Medium Enterprise, Please tick the relevant box as per Investments upto* Mfg 5 Lakh 25 Lakh 5 Crore 10 Crore Basis of Identification CA Certificate MSME/SSI Certificate Service 2 Lakh 10 Lakh 2 Crore 5 Crore

*Mfg Enterprise - Investments in Plant & Machinery Service Enterprise - Investments in Equipment

City: Telephone: Employee No: Extn.: No. of years with current employer Fax: Number of years at previous organisation/s:

PIN:

Retirement Age

Salaried
Gross Annual Salary (Rs.) Other Income (p.a.)

Self employed
Gross receipt from Business/Profession (Rs.) Net profit from Business/Profession (Rs.) Other Income (p.a.)

Please tell us about your Requirements


Home Loan
Cash Out Loans

Optional Features

Developer Under Construction Loan takeover from another bank Self Construction Loan

Property yet to be identified Ready Property

Property Power Loan Home Loan Top-up Loan takeover from another bank with enhancement Additional Information for CitiHome Loans

CitiHome One Home Credit Fast Track Home Credit Vanilla

Loan Details

Term Loan

Credit Line

months Interest Rate:


#

months Interest Rate:


#

months Interest Rate:


#

% p.a.

% p.a.

% p.a.

Application Fee*

Booking Fee+

Annual Fee**

Interest Rate on the loan shall be benchmarked with the Reference Rate. Home Loans are referenced to Home Loan Reference Rate (HLRR) whereas Cash out loans (Property Power, Home Loan Top-up, Home Loan Takeover Enhancements) are referenced to Property Power Reference Rate (PPRR). The Reference Rate is calculated interalia on the basis of the Base Rate as notified by the Bank from time to time . * Up to 1% of the total loan amount. The fee is collected towards processing of your application and is collected upfront irrespective of whether the loan is sanctioned. This is non refundable under all the circumstances. Payments to be made by cheque / draft favoring Citibank N.A. Application Fee A/c +Up to 1% of the loan amount sanctioned. This fee is at the time of loan documentation. ** An annual fee is charged in the case of loans with CitiHome One Facility and Property Power Loans with Home Credit Facility on every anniversary of the Loan. For CitiHome One loans, the annual fee is charged at the rate of 1% on the sanctioned credit line and in case of Property Power Loans with Home Credit Facility, the annual fee is charged at the rate of 1% on the loan outstanding as increased by the line amount

Total Requirement and funding sources


Requirements (in Rs.) Total purchase price/construction cost Incidental & other costs Registration costs/Service tax Total Loan applied for Savings / Personal funds Other Total Funding Sources (in Rs.)

I/ We, hereby declare that I/ We will use our savings/ personal funds to meet the balance requirement net of the loan amount sanctioned

Specify the end use for Cash out Loans


Marriage Expenses Repair or Renovation of property Purchase of office/ shop / factory premises Repayment of running business loans Travel Expenses Consumer Durable/ Motor Car Payment to suppliers / creditors Other Personal (Please specify) Medical Expenses Education Expenses of Children / Family Member Purchase of stock / equipment / machinery

End use of the loan cannot be towards any speculative or anti social or illegal or unproductive purpose

Please tell us about property offered as collateral


Property Address:

City: UDS/Land Area Area: Rate per sq. ft.: Land Ownership: Expected date of possession: For developer Under construction cases: Freehold Leasehold Property completion status: Built-up Area Current

PIN: Proposed

Ready for possession

Under construction

Builder Name Project Name 3

Your Credit Card details (Applicant)


Citibank Card Other Bank Other Bank

Your Credit Card details (Co-applicant)


Citibank Card Other Bank Other Bank

Details of Loans and Liabilities*


S. No Institution Name++ Type of Loan Loan Amount/ Credit Line EMI Amount Current Outstanding Balance Tenor

* Kindly attach additional sheets, if required. ++ Incase loan has been taken from employer kindly mention employer name.

Please provide two non-family references#


Name: Telephone:
# Citibank may make such enquiries from these referees if it deems necessary.

Name: Telephone:

Please tell us about your bank account


Applicant Bank: Account No: Branch: Bank: Account No: Branch: Co-applicant

Subscription to CitiAlert / Statement on Email


CitiAlert Keep track of your Home Loan Account through our CitiAlert Facility. This special service provides payment reminders, payment confirmation and similar alerts. Please select the medium by which you wish to receive CitiAlert: None Mobile E-mail Both Receive your requests for loan statements / Interest & Principal certificates through our Statement on Email Facility. Its completely secure and comes in encrypted format. Yes, I wish to avail of this option No, I do not wish to avail of this option

Statement on Email

These facilities are currently free of cost and will be sent only to the main applicant. Please provide a valid E-mail ID / Mobile Number. Incase of any change, kindly intimate us about your new E-mail ID / Mobile Number. Citibank reserves the right to, at its sole discretion, with prior intimation to the customer, charge fees for provision of these services. Kindly refer to the loan agreement for Terms and Conditions.

Our other value added products


l/We hereby voluntarily requisition, accept and expressly authorise Citibank N.A and/or all the companies/entities/subsidiaries/affiliates thereof under Citigroup and their agents to exchange, share, disclose or use in any manner whatsoever, the information voluntarily provided by me/us herein, to offer and/or market and/or sell to me/us any of the products or services or any enhancements/upgradation/revisions thereof offered from time to time by Citibank N.A and/or all/any of the companies/entities/subsidiaries/affiliates thereof under Citigroup.

Applicant Name Telephone No.

Co-applicant

Signature

Sign this declaration


Terms and conditions apply. I/ We understand that this loan is at the sole discretion of the Bank and is subject to the terms and conditions as advised by the Bank from time to time. I/We confirm that all details as given above to the Bank are true and correct and no material information has been suppressed/withheld. l/Weconfirm that the funds shall be used for the stated purpose only and shall not be used for speculative/antisocial purposes. I/We authorize Citibank and/or any such third parties appointed/authorised by Citibank to conduct such checks as it considers necessary in its sole discretion and also to authorize the Bank to release such information or any other information in its records for the purpose of credit appraisal/sharing for any other purpose. I/We confirm that l/we have had no insolvency proceedings against me/us nor have l/we ever been adjudicated insolvent. I/We undertake to inform Citibank regarding any change in my/our occupation/employment and to provide any further information that you may require. I /We have read and understood the terms and conditions as contained in this Application Form and I/We are aware that the Loan ( if sanctioned) shall be governed and be subject to the terms and conditions as contained in the Loan Agreement between the Bank and myself/ ourselves.

Photograph of Applicant Please paste recent passport-sized colour photograph here and sign across the photograph Please do not use pins, tape, staples on the photograph.

Photograph of Co-Applicant
Signature of the Applicant

Please paste recent passport-sized colour photograph here and sign across the photograph Please do not use pins, tape, staples on the photograph.
Date:

Signature of the Co-applicant

Credit Card (Applicant)


Your Name as you would like on your Card (Restrict to 24 characters including spaces)

Choose Your Credit Card


Citibank PremierMiles Yes, I wish to apply First Year Fee Master Visa Citibank Rewards Yes, I wish to apply First Year Fee : Nil Renewal Fee p.a. : Nil*
*If yearly spend more than ` 30,000 else fee ` 1,000

: ` 3000/-

Renewal Fee p.a. : ` 3000/Mailing Address: Current Residential Address Office Address Yes, I wish to avail this option

Sign-up for the Statement on email (SOE)* and Go Green:

No, I do not wish to avail of this option

*In lieu of physical statement/advice for Credit Card and Banking Products. You will receive mandatory alerts pertaining to your product.

Credit Card (Co-Applicant)


Your Name as you would like on your Card (Restrict to 24 characters including spaces)

Choose Your Credit Card


Citibank PremierMiles Yes, I wish to apply First Year Fee Master Visa Citibank Rewards Yes, I wish to apply First Year Fee : Nil Renewal Fee p.a. : Nil*
*If yearly spend more than ` 30,000 else fee ` 1,000

: ` 3000/-

Renewal Fee p.a. : ` 3000/Mailing Address: Current Residential Address Office Address Yes, I wish to avail this option

Sign-up for the Statement on email (SOE)* and Go Green:

No, I do not wish to avail of this option

*In lieu of physical statement/advice for Credit Card and Banking Products. You will receive mandatory alerts pertaining to your product.

Citibank Credit Card Authorisation


I hereby apply for the Issue of a Citibank Card and declare that the information included in this application is true and correct. I am a Resident Indian and I am eligible to apply for an internationally valid card. I accept that Citibank is entitled in its absolute discretion to accept or reject this application. I hereby understand and agree that it is my responsibility to obtain, read and understand the terms and conditions related to the Citibank Card and those applicable to Mobile Banking Services. I authorize Citibank and/or its associates/subsidiaries/affiliates to verify any information or otherwise at my office/residence and/or contact me and/or my family members and/or my Employer/Banker/Credit Bureau/CIBIL/RBI and/or any third party as they deem necessary and/or to do any such acts as they deem necessary. If this application is accepted, I hereby undertake to be bound by the terms and conditions as may be in force from time to time and use of the Citibank Card shall be deemed to be unconditional and irrevocable acceptance of the terms and conditions. I understand that acceptance of the application is subject to Citibank, on enquiry, not receiving any adverse report relating to my creditworthiness from any bank or financial entity, which has provided to me or my family members a credit facility. I agree to be charged my Card fee as applicable per the offer. I understand and undertake that the usage of the Citibank Card shall be strictly in accordance with all applicable laws (including without limitation, any governmental acts, orders, decrees, guidelines, rules and regulations including fiscal exchange control regulations) and in the event of any failure to do so, I will be liable for any action/prosecution or penalty as prescribed. I further understand and agree to the levy of all additional statutory levies, charges, taxes, Service Tax, as applicable, on all fees, interest and other charges as per the Government of India regulations and agree to pay the same.

Declaration
I understand that the credit card application processing with commence only post successful booking of your Mortgage Loan and may take up to 15 days. I have read and understood the Citibank Credit Card authorization. I hereby undertake to be bound by the Cardmember Terms and Conditions available on the Citibank website and the Most Important Terms and Conditions (MITC) shared along with the card application; along with any amendments/revisions thereto as may be in force from time to time and that my usage of the credit card shall also confirm such acceptance. I further understand and agree that Citibank shall process my application only after the booking of Mortgage Loan. In case the same is not approved or is withdrawn by me, my Citibank Credit Card application will not be processed. Signature of Applicant: Signature of Co-Applicant:
(only if applied for a credit card)

For bank use only


Source Code:
DSA Channel: Alternate Channel: ADVT ABML EMRF XSUV CPCD CARF ATOP ETOP CGAT DSAO BRCO LCBR CGPB TELE CBOL LMSF CGSR WALK CPBR MGMS CRTX CPHN RETX INTR DEVD USFO CPCR

Name DSA

Code

SE RM In case of Branch / Suvidha / Unified Sales Force referral please provide Branch Name: Referral RM Employee Code: Alps Reference Number: Referral RM Name :

Application fee details


Cheque/DD No. Instrument date: DD/MM/YYYY Drawn on Amount (in Rs.)

Details of existing loan (For Home Loan Enhancement/Topups/Cross Collateral loans)


Existing Loan No.: Loan Sanctioned: Currently Outstanding/Ideal Balance: Tenor of the Existing Loan: months Booking date: Loan Disbursed: Rate of Interest on Existing Loan: EMI on the Existing Loan: %
Mortgage Application Form/July 2012/Version 4.0

For Takeover/ Takeover Enhancement Cases


Takeover Institution Current Outstanding Sanction Date: DD/MM/YYYY

Declaration by Sales Executive


This is hereby to confirm that I have personally met form and has provided the necessary documents for processing the loan. Executive Name: Signature: Date: and the customer has filled up the application

Dear Customer,
For Loan Sanction

Documentation Requirements

Thank you for choosing Citibank Home Loans and giving us the opportunity to serve you.

Salaried Customers - Latest Salary slip not more than 60 days old - Latest Form 16 or ITR - Proof of total work experience (2 years for Home Loans and 3 years for cash out loans) - Bank Statement for last 3 months

You now have more than one reason to choose Citibank Home Loans as they come with unmatched features* such as:

Proof of Identity, Signature, Address and Date of Birth (for Individuals)

Self Employed Customers - Income Tax Returns and Financial Statements including Balance Sheet, Profit & Loss Account, Schedules. These documents are to be certified by a Chartered Accountant. (Required for 2 years for Home Loans and 3 years for all cash out loans) - Business Continuity proof for 3 years. - For Partnership Firms: Latest partnership deed - For Companies: Latest Memorandum & Articles of Association CA certificate on list of directors / partners with their shareholding / profit sharing ratio. - Bank Statement for last 3 months (Required for 6 months for Income Estimation cases)

Proof of Document Identity Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Valid Passport MAPIN Card Voter ID Card PAN Card Valid Driving License Valid Identity card issued by Govt. Org., PSU, Statutory/ Regulatory Auth., Recognized Professional Bodies such as ICAI, ICWAI, ICSI, Bar Council, Indian Medical Association, established under the central or state statutes, members of trade bodies and trade councils. Birth Certificate School Leaving Certificate Banker Certificate Utility Bills (electricity, telephone bills,) not older by 3 months Ration Card Lease deed, Rental Agreement, Property registration document in the name of customer Bank Account Statement on Banks letter head not more than 3 months old Y Y Y Y Y Signature Address Y Date of Birth Y

Interest calculated on daily outstanding

balance.

No co-borrowers/guarantors required.

Option to avail unique CitiHome One / Home

credit facility that allows you to save while you borrow by parking your surplus funds.

Specially designed Protection Plans from

our insurance partners that help protect your loved ones from the loan liability and protect your dream property.

24x7 Online Access to your loan account with

range of services at your finger tips.

Free CitiAlert Service

Free Statement on Email Service

CitiPhone Banking Platform to answer all your

queries.

Warm Regards
Title documents pertaining to your property

Citibank

All documents submitted must be self attested as True Copy The application will be processed within 15 days on a best effort basis, on receipt of all the required documents mentioned above. The document requirements given above are indicative and Citibank reserves the right to request further documents, if required. This document is not to be construed as a commitment from Citibank, either express or implied. Terms and conditions as mentioned in the Loan Agreement will apply. For Loan Disbursement After the loan has been sanctioned, you will execute the loan agreement, and provide us with Repayment instructions and Original Property Documents to avail disbursal from your loan.

* Terms & Conditions Apply. All loans at the sole discretion of Citibank N.A.

Acknowledgment Slip

Received from ________________________________________________________ application for a Citibank Home Loan.

We have received a cheque / draft no.___________________ for Rs._____________________ drawn on __________________________________________ towards the application fee payable.

In case of any queries relating to your application, please contact _______________________

your Sales Executive / Relationship Manager at ________________________.

For any queries / issues related to services provided by Citibank or it's outsourced service providers write to us at indiaservice@citicorp.com

Schedule of Charges applicable for Citibank Home Loans from June 07, 2012 (For Latest schedule of charges refer our website www.citibank.com/india)
Home Loans Same as Home Loans Cash out Loans (Property Power / Home Loan Takeover Enhancement / Home Loan Top-ups)

Description

Interest Rate

Interest Interest

Rate on your loan will be the rate as applicable at the time of signing the loan agreement. for the month will be charged on the last day of the month basis loan outstanding on daily basis for actual number of days in a month.

Reference rate rate applicable on their loan

Interest Rate on your loan is linked to Home Loan Reference Rate (HLRR). In the event of change in HLRR, the borrower shall be notified the revised interest

within 30 days of the revised interest rate becoming applicable on the loan.

Interest Rate on your loan is linked to Property Power Reference Rate (PPRR). In the event of change in PPRR, the borrower shall be notified the revised interest rate applicable on their loan within 30 days of the revised interest rate becoming applicable on the loan.

Re-pricing Frequency

In the event of change in reference rate, the interest rate on your loan will be reset on a monthly basis. The reset date will be 1st day of every month.

Same as Home Loans

Application Fee*

of your loan application and is collected upfront irrespective of whether your loan has been sanctioned. This is non refundable under all circumstances. Payments to be made by cheque/draft only favoring Citibank N.A. Application Fee Account Same as Home Loans and is non refundable under all circumstances. Same as Home Loans

Up to 1% of the Loan amount applied. The fee is collected towards processing

Same as Home Loans

Booking Fee*

Up to 1% of the Loan amount sanctioned. The fee is collected at the time of loan documentation

Cheque / ECS / SI Bounce charges* Same as Home Loans

Rs. 500 is levied for Cheque / ECS / SI Bounce charges

Re-pricing Fee*

Re-pricing Fee will be charged at the rate of 2% on loan outstanding. At the request of the borrower, Citibank at its sole discretion may permit the borrower for repricing of the loan. Same as Home Loans

Penal Interest

Penal Interest is levied in case of non-payment of the monthly payment. It is charged at the rate of 2% above the prevailing Interest Rate on the loan outstanding for the defaulted period.

Part Prepayment charge*

Nil

Part Prepayment charges for variable rate Home Loans only.

Nil for part prepayments less than 25% of the sanctioned Loan amount in a financial year (i.e April 1st to March 31st). In the event the loan is closed within 12 months of the part prepayment date, the part prepayment will also be subject to foreclosure charges. For part prepayments more than 25% of the sanctioned amount in a financial year, charges will be levied at the rate of 4% for the first 3 years and 2% thereafter. Foreclosure charges are levied at the time of pre-closure of the loan at the rate of 4% for the first 3 years and 2% thereafter Foreclosure charges is payable on Loan outstanding at the time of loan closure. All partial pre-payments made during the last 12 months prior to loan closure as reduced by such amount prepaid in respect of which Prepayment Charge has already been levied and paid by the borrower Undisbursed portion of the loan.

Foreclosure charges*

NIL Foreclosure charges for variable rate Home Loans only. For Fixed Rate loans, foreclosure charges are levied at the time of pre-closure of the loan at the rate of 2% Foreclosure charges, if applicable, are payable on Loan outstanding at the time of loan closure. All partial pre-payments made during the last 12 months prior to loan closure as reduced by such amount prepaid in respect of which Prepayment Charge has already been levied and paid by the borrower Undisbursed portion of the loan.

Additional Charges as applicable for Home Credit Loans Applicable only in case of Property Power Loans availed with Home Credit Facility. The annual Home Credit fee is charged at the rate of 1% of the Loan Outstanding (as increased by the Line) on each anniversary of the loan. The line amount will also be taken in to consideration for calculation of Foreclosure charges

Recurring Annual Service Fees on Home Credit*

NA

Foreclosure charges*

NIL

Threshold amount

Balances in excess of threshold amount subject to a maximum of loan outstanding will be transferred to your loan account for the purpose of calculation of interest. Threshold amount is subject to change from time to time and changes will be intimated from time-to-time. The current applicable threshold amount is Rs. 100,000/-. Additional Charges as applicable for CitiHome One Loans Same as Home Loans Same as Home Loans

Interest Rate

Differential Interest rates are applicable for the Term Loan component and the Credit Line Component of the Loan.

Recurring Annual Service Fees on CitiHome One*

Applicable only on the Credit Line Component. This fee is charged up to 1% of the Sanctioned Credit Line on each anniversary of the loan.

Foreclosure charges*

NIL

For CitiHome One Loans, Pre-closure charges at the rates mentioned above is levied on Loan outstanding (Outstanding amount on Term Loan & Credit Line) at the time of loan closure. All partial pre-payments made during the last 12 months prior to loan closure as reduced by such amount prepaid in respect of which Prepayment Charge has already been levied and paid by the borrower. Undisbursed portion of the Term loan. Unutilized portion of the Credit Line

* - Service Tax, other government taxes and levies as applicable will be levied on all fees and charges.