Third GenderMale Female Others

Hindu Muslim Christian Sikh

Jain Parsi Others

Hindu Muslim Christian Sikh

Jain Parsi Others

Page 1 of 6

Maiden Name

StateCountryState

Years in Same city Years in Same city

Years at Present Address

StateCountryState

Years at Present Address

Years at Present Address Years at Present Address

APPLICATION FORMAUTO LOAN

T I T L E F I R S T N A M E

M S

Passport No/Voter ID No/Pan No/Driving License

Driving License / Passport Expiry Date

Indian Others Indian Others

Third GenderMale Female Others

Others Others

T I T L E F I R S T N A M E

M S

T I T L E F I R S T N A M E T I T L E F I R S T N A M E

T I T L E F I R S T N A M E T I T L E F I R S T N A M E

L A S TM I D D L E N A M E L A S TM I D D L E N A M E

L A S TM I D D L E N A M E L A S TM I D D L E N A M E

Father’s Name

CKYC Number (if any)

GSTIN DETAILS

Person with Disability Yes No Yes No

Address registered for GSTIN Same as residence /communication address

Same as Permanent address Others (Use GST Annexure)

Residence / Communication address

Exemption Valid Till (if Yes)

Special Economic Zone Code (if Y)

GSTIN Registration Date

Same as residence /communication address

Same as Permanent address Others (Use GST Annexure)

Exemption Valid Till (if Yes)

Special Economic Zone Code (if Y)

Aadhaar Number*

Page 2 of 6

Signature of Applicant : Signature of Co-Applicant :

Name of Organization Name of Organization

Bank Name

EMI (Rs)

Loan Tenure (Months)

Designation Designation

Designation

Nature of Profession, if Self Employed Professional

Nature of Business (if self employed)

Proprietorship Govt/PSU

Partnership Partnership

Proprietorship Govt/PSU

Employment Nature / Occupation Type

Service: Private Sector Public Sector Government Sector

Other ____

Others: Professional Self Employed

Retired Housewife Student

Occupation

Service: Private Sector Public Sector Other ____Government Sector

Others: Professional Self Employed

Retired Housewife Student

Service Provider Other ________________ Service Provider Other ________________

Public Company LLP If other:(please Specify)

Whether registered under GST (If yes, following details are mandatory) GST Exemption Exemption Reason(If Yes) Y N Y N3.

4. *GSTIN DETAILS

5.

*GST Registration * (Please fill GST Annexure for multiple GST Registration) Single Multiple

Y N

GSTIN ( Default)

Address registered for GSTIN Same as residence /communication address Same as Permanent address Others (Use GST Annexure)

Exemption Valid Till (if Yes)

GSTIN Registration Date

Special Economic Zone Code (if Y)*Special Economic Zone

Email ID:

Farm Credit & Allied activities Farm Credit

PRIORITY SECTOR CATEGORY / MSME DETAILS

Upto Rs. 10 lakh (Micro) Above Rs. 10 lakh upto Rs. 2 crore ( Small)

Above 2 crore upto 5 crore (Medium)

Upto Rs. 25 lakh ( Micro) Above Rs. 25 lakh upto Rs. 5 crore ( Small)

Above 5 crore upto 10 crore ( Medium)

Upto 2.5 Acres Between 2.5 to 5 Acres

Above 5 Acres (1Acre - 0.40 Hectare)

Page 3 of 6

Declaration: I/We hereby declare / confirm that the vehicle purchased / to be purchased by me /us shall be used for: Purchase of Business Farm Credit and Allied Activities and/or assist the transport of agricultural input and farm productsI/We are aware that is on the faith of this representation, declaration and confirmation that you have agreed to consider my loan application for financial assistance under category of Priority sector Advances.I/We shall indemnify the bank to make the loss good in event of any loss damage that may arise on account of false/incorrect declaration by me/us.

PIN Landmark

APPLICANT REFERENCE DETAILS (TO BE FILLED BY THE APPLICANT) One reference has to be non-relative / non colleague

Additional details required for NRI Applicant

Country Name: ____________________________________________ Country code:_______________________________________

If applicant resident for tax purposes in Jurisdiction outside India: Yes No

Jurisdiction of residence: __________________________________________________________________________________________________________

Tax Identification Number or equivalent (If issued by jurisdiction):_________________________________________________________________________

Country of Birth: ____________________________ City/Place of Birth:____________________________________________________________________

If address in jurisdiction where application is resident is same as Current/ Permanent/ Overseas or Correspondence/ Local address details: Yes No

Address in Jurisdiction: ______________________________________City / Town / Village:_____________________________________________________

State:________________________________________ Country: ZIP/Post Code:________________________________________

ISO 3166 Country Code

Landmark

Tel.

Tel.

Fax:

Fax:

Agriculture Export (Please Select)

(Please Select)

Existing Vehicle Details

6.

7.

8.

9.

10.

11.

(b)

Aadhaar Number*

Aadhaar Number*

*Note - Where the client is non-individual, Aadhaar numbers issued to person holding an attorney to transact on its behalf is required to be submitted.

CUSTOMER DECLARATION I hereby apply for the issue of Axis Bank credit card to me and declare that Iam a resident Indian / NRI / Foreign National working in India and that Iam eligible to apply for an internationally valid card. I / We unconditionally agree and accept that, the data provided by me/us to the bank during the application process for acquiring such relationship(s) is true to the best of my /our knowledge and belief, and if at any stage of processing the relationship, if it comes to the knowledge of the bank or the bank is of the opinion that I / W e have provided any incorrect information, and/or fabricated documents, and/or fake documents, and/or document/s appearing to have been manipulated, they will be treated by the bank as having been manipulated by me/us. I hereby understand and agree that it is my responsibility to obtain, read and understand the terms and conditions as may be in force from time to time and use of the Axis Bank Credit Card shall be deemed to be unconditional and irrevocable acceptance of the Terms and Conditions.I further authorize Axis Bank and or its associates subsidiaries affiliates to verify, share and compare any information/data or otherwise at my office/residence and/or contact me and / or my family member and / or my employer/banker/credit bureau/RBI and or any third party such as other Bank / Financial Institution / Credit Information Company during the process of processing my/our application or otherwise as they deem necessary. I understand that Axis Bank Ltd. Reserves the right to provide me with the credit card type/variant based on information available with Axis Bank Ltd. and my eligibility as per internal policy of the bank. I understand and undertake that the usage of the Axis Bank Credit Card shall be strictly in accordance with all applicable laws (including without limitation to any government acs, orders, decrees, guidelines, rules and regulations including foreign 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, GST as applicable on all fees, interest and other charges as per the Government of India regulations and agree to pay the same. I / We have been explained the contents of the same and also understand that it is available online at the bank's website www.axisbank.comI / We also unconditionally agree and accept, that the Bank shall have every right to compare the data available with the Bank or provided with, by any other Bank/Financial Institution/Credit Information Company and in case the data provided to the bank is not matching then the Bank shall every right and liberty for not processing my/our application/rejecting the application so provided to the Bank and enforce any remedy that may be so available with the bank at the Law and Equity. I /We further unconditionally agree and undertake that, the Bank shall be at its liberty, to share any information with any other Banks/Financial Institution either as a part of a consortium of a part of sole Banking Relationship or to any Credit Information Company as the Ban may so decide. I /We waive the confidentiality obligations with respect to the information provided to the bank. I/We further agree that, we shall not hold the bank liable for any cost or reputation for sharing the information as is considered necessary by the Bank in its sole and exclusive opinion, and without any reference to me/us whatsoever, with such Bank/Financial Institution/Credit Information Company and to hold harmless the employees, officers, Directors, agents, etc that may be so appointed by the Bank.I understand, that I may opt out by registering in the 'Provider Customer Preference Register' as per details provided in the 'TRAI' website.I authorize Axis Bank to increase my credit limit once within 6 months of Card Issuance date basis Axis Bank internal policies and other terms and conditions applicable.I/We declare that the particulars and information given in the application form are true,correct and up to date in all respects and I/we have not withheld any information.I/We confirm that I/We had no insolvency proceeding initiated against me/us nor have I/we ever been adjudicated insolvent.I/We have read the application form and am/are aware of all terms and conditions of availing finance from Axis Bank.I/We authorize Axis Bank to make reference and enquiries relative to information in this application which the Bank considers necessary.I/We authorize the Bank to exchange, part /share with all information relating to my/our loan details and repayment history to other Banks/financial inst.etc. as may be required and shall not hold the Bank liable for use this information.I/Weundertake to inform the Bank regarding change in my residence/employment and to provide any further information that the Bank may require. I/We agree that my /our loan shall be governed by the rules of the Bank which may be in force from time to time. I/We understand that the Bank has the right to reject my/our application without providing any reason thereof. I/We agree that in the event of non payment of the Equated Monthly Installment/s(EMI/s) as per he car loan agreement and even after issuance of reminders/notices, if the loan is not regularized, the bank has unequivocal right to seize the vehicle and such seizing of the vehicle will not be perceived as a criminal offence by bank and or its agents. The borrower(s)/guarantor(s)agree(s) to have given his/their express consent to the Bank to disclose all information and data furnished by them to Credit Information Bureau India Limited (CIBIL) or any other credit bureau permitted to operate in India. The Borrower(s)/guarantor(s)agree(s) that they shall execute such additional documents as may be necessary for the purpose. I/We agree(s) that in case of non-payment of dues by the customer in case of any facility availed from the Bank and consequently the account is to be classified as NPA, all other loan accounts of the Borrower, with the Bank also shall be classified as NPA as per the guidelines issued by RBI and ir shall entitle the Bank to recall all such loans/facilities availed by the same customer from the Bank, irrespective of the regular repayment in such accounts. I hereby declare that the details furnished above are true and correct to the best of my/our knowledge and belief and I undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, I/We am/are aware that I/we may be held liable for it.I hereby declare that the details furnished above are true and correct to the best of my/our knowledge and belief and I undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, I/We am/are aware that I/we may be held liable for it.

I wish to apply for a My Zone credit card

I'm aware that the processing of the credit card application would be subject to the successful disbursal of the Auto Loan application form. I agree that the credit card application is an integral part of this application and cannot be segregated. I hereby give my consent for using the information as provided in this car loan application. I am aware that the credit limit on my credit card will be decided by Axis Bank at its sole discretion after verifications and necessary due diligence and I hereby acknowledge that no commitment has been made to me in this regard. (In case if the processing fee is collected upfront, Processing Fee Cheque to be drawn in favour of Axis Bank Ltd. A/c Service Charges)

Yes NoThe Card for Entertainment Fans

Usage Preference Domestic Only

International Enabled (International enabled Credit Card can be used in India as well as overseas)

Nominee Details Yes No, If yes, Nominee Name

Relationship with the applicant

Name as desired on the Credit Card

Joining Fees : Nil

Annual Fees: Nil

Max. 19 Characters including spaces

Yes No

I am a director of Axis Bank or we are a firm in which any director of Axis Bank is interested as a partner/manager/employee/ guarantor or we are a company in which any of the directors of Axis Bank is interested as a managing agent, manager, employee or as a guarantor or holds substantial interest.

I am a director of any other bank or we are a firm in which any director of other bank is interested as partner/ guarantor or we are a company in which any of the directors of other bank holds substantial interest or is interested as a director or as a guarantor.

I/we am/are a relative of director of Axis Bank/other bank/senior officer of Axis Bank or we are a firm (Partnership / Hindu Undivided Family) in which any relative of director of Axis Bank / other Bank is interested as a partner/ guarantor or we are a company in which any relative of the director of Axis Bank / Other Bank hold substantial interest or is interested as a director or guarantor.

If yes, mention the details below.

Relationship of the applicant Yes No

If yes, mention the name of other bank

Customer declaration in respect of relationship with Director/ Senior Officer of the Bank/any other bank

In the event that the Applicant / Co-applicant are related to any of Director of Axis Bank/ Director of other bank/ Senior officer(s) of Axis Bank:

I/We declare(s) that the I/we am/are related to the director(s) and / or Senior Officer(s) of Axis Bank or of any other bank as specified hereto*:

If the above declaration is found to be false then the Bank will be entitled to revoke and/or recall the credit facility.

Page 4 of 6

*including directors of Scheduled Co-operative Banks, directors of subsidiaries/trustees of mutual funds/venture capital fun

Statement Details Preferred Delivery Mode Mail Email Both Please ensure youhave a valid Email ID Preferred Mailing Address Residential Address Official Address

Auto-Debit Option If you wish to avail of the Direct Debit Facility from your Axis Bank savings / Current Account, pleaseselect one of the following options for the amount to be debited for every billing cycle

Total amount due Minimum amount due-5% of Total amount due

Please mention the 15 digit Axis Bank Account no for Direct Debit

Please sign as per Bank's record * To be signed by all the accountholders

Applicant* Joint A/c Holder*

Credit Card Section : ( All fields are mandatory)

I/We hereby confirm that I/we am/are in favour of receiving communication/ information / loan document/ other collaterals from bank pertaining to the loan account via email/ net banking from time to time.

Constitution: Resident Indian NRI Foreign National

Employee ID:

FOR BANK USE ONLY

* Axis Bank Limited may request for additional documents other than requested above in connection with the Car Loan application

Car Loan Documents Submitted

Pls. tick () boxes where appropriate and write N.A if not applicable

GENERAL Proforma Invoice

INDIVIDUAL BORROWER

Salaried Self - Employed

Office / Business Proof NA

Application Form

Application form with photograph duly signed by all applicant

Identity & Address Proof

Income Proof

Bank Statement

Age Proof

Sign Verification Proof

Employment / Business

Continuity Proof

NON INDIVIDUAL BORROWER

Partnership Firm / Trust / Society

Application form with photograph duly signed by all applicant :

Identity Proof

Address Proof

Income Proof

Bank Statement

Employment / Business

Continuity Proof

Additional Documents

Latest Salary Slip & Latest Form 16

Latest 3 Months Bank Statement

Audited Balance Sheet P&L Account & ITR for latest 2 years Others (Pls. specify) ____________________

Telephone Bill Electricity Bill Utility Bill Shop & Establishment Act Certificate SSI or MSME Certificate Sales Tax or VAT Certificate

Current A/c Statement Registered Lease with utility bill

PAN Cards Authority letter by all partners & Board

Resolution for Trust / Society

Shop & Establishment Act Certificate SSI or MSME Registration Certificate Sales Tax or VAT Certificate

Current A/c Statement Others (Pls. specify) ________________________

Latest 3 Months Bank Statement

Others (Pls. specify) ________________________

Copy of Partnership Deed Trust Deed Society Deed

Passport PAN Card Banker's Verification

Others (Pls. specify) ______________________Passport Driving License PAN Card Birth Certificate

Shop & Establishment Act Certificate SSI or MSME Registration Certificate Sales Tax or VAT Certificate Current A/c Statement

Private Limited / Limited Companies

Copy of Latest MOA/AOA

Others (Pls. specify) ________________________

List of Directors & Shareholding Pattern PAN Card

Certificate of Commencement of Business for Ltd. Co.

Certificate of Incorporation

Latest ITR

SSI or MSME Registration Certificate Sales Tax or VAT Certificate Telephone Bill Electricity Bill Shop & Establishment Act Certificate

Passport Voter's ID

Yes No

Yes No

Driving License PAN Card (only as ID Proof) Aadhar Card Others (Pls. specify) ______________

Documents required

Documents required

Current A/c Statement Regd. Lease with utility bill

Copy of appointment Letter Date of joining mentioned on salary slip or Form 16 ITR or Form 16 of completed 1 year WorkExperience Certificate Releiving Letter

Any Other document (please specify) Address Proof ______________________ ID Proof ______________________________

Documents Received : Self-Certified True Copies NotaryIdentity Verification Done :

IN PERSON VERIFICATION CARRIED OUT BYEmp. Name :_______________________________________Emp. Code :_______________________________________Emp. Designation :_______________________________________Emp. Organisation & Code :_______________________________________ Emp. Branch :_______________________________________Place :_______________________________________Date: D D M M Y Y Y Y

(Employee Signature)

Page 5 of 6

Others (Pls. specify) ______________________

Others (Pls. specify) _________________________________________

Others (Pls. specify) _________________________________________

Board Resolution

Others ____________

9. My personal / KYC details may be shared with Central KYC Registry

10. I hereby consent to receiving information from Central KYC Registry through SMS/Email on the above registered number/email address

11. I/We further authorise the Bank to share my Aadhaar related details/information with regulatory / statutory bodies as and when required.

12. I/We authorize Axis Bank to verify and authenticate my/our Aadhaar number during processing my/our application for legitimate Business purposes.

13. I hereby declare that the details furnished above are true and correct to the best of my/our knowledge and belief and I undertake to inform you of any changes therein, immediately.

In case any of the above information is found to be false or untrue or misleading or misrepresenting, I/We am/are aware that I/we may be held liable for it

2. The bank may at its sole discretion sanction or decline the application. The bank shall convey, the reasons, which in its opinion after due consideration, have led to rejection of the application.

3. The bank will decide and assign the loan limit and no commitment has been given to me/ us for the same.

4. The DSA/ DST has not collected any commission/ brokerage or ant other fee by way of cash or cheque other than the cheque no. _____________ towards _______________in favour of Axis Bank Ltd.

5. Prepayment options are available. The details of the prepayment charges are given below.

6. Prepayment clause _________________________________________________________

________________________________________________________________________________

7. Processing fees of Rs. _______________ will not be refunded in case of rejection/ withdrawal of the case.

8. Axis Bank Ltd. reserves the right to retain the photographs and documents submitted with this applications and will not return the same to the applicant.

Please sign across

the photograph

Please sign across

the photograph

Axis Bank will convey its decision (within 2 weeks for credit limit up to Rs. 5 lakh and within 3 weeks for credit limit above Rs. 5 lakh and up to Rs. 25 lakh for Micro & Small enterprises borrowers) and (within 30 working days for other borrowers) from the date of receipt of the application provided the application is complete in all respects and is submitted along with all the documents as per 'check list' provided in the application for loan and/or any additional documents as may be required by the bank for proper appraisal of the application. The computation of timelines shall starts from the day on which all documents required for a proper appraisal of the application are provided by the Customer to bank.

1.

Loan Variant / Type :

Loan Amount (Rs.): Tenor (Month):

Processing Fee (Rs.): Repayment Mode : SI NACH Mandate PDC

Documentation Charges - Rs. 500/-

Location (Name of the ASC) :

5% of the Principal Outstanding plus GST

Part Payment charges:5% of the Part Payment amount plus GST

*Goods and Services tax (GST) will be charged extra as per the applicable rates, on all the charges and fees (wherever GST is applicable)

*Part payment will be allowed twice in a loan calendar year and once in a loan calendar month.

*The minimum amount accepted for part payment will be equal to one EMI and maximum amount will be 25% of the balance principal in one year.

Page 6 of 6

Dealer Cross Sell Direct Digital Insta Sanctions

AL _LNAUL_BRE AL_PREAPPROVED_BRE UC_LNUCL_BRE AU_CORP_BRE

Others ____________

Repayment Mode details :

For SI Cases: 03 undated EMI cheques & 01 undated cheque for entire loan amount to be provided

Channel Code :

Total on - road price

is EMIs in Advance, number of Advance of EMIs

Bank Bazaar Other ___________

Phone BankingSource Code ATM SMS Website Outbound Email Mobile App

Ex-show-room price

Registration cost

Motor Insurance

Octroi / other taxes, if any

Discount

RA

/AL -

Applic

atio

n F

orm

/ A

pril'1

8 / V

ers

ion 5

.0

Promotion Code

Net Banking CIBIL Others ________________

Axis Bank will convey its decision (within 2 weeks for credit limit up to Rs. 5 lakh and within 3 weeks for credit limit above Rs. 5 lakh and up to Rs. 25 lakh for Micro & Small enterprises borrowers) and (within 30 working days for other borrowers) from the date of receipt of the application provided the application is complete in all respects and is submitted along with all the documents as per 'check list' provided in the application for loan and/or any additional documents as may be required by the bank for proper appraisal of the application. The computation of timelines shall starts from the day on which all documents required for a proper appraisal of the application are provided by the Customer to bank.

TW_LAA

Balance Transfer

Credit Life Insurance (Rs)

R O

DME Code

DSA Code:

Team Leader Name

Referrer Name:

18604195555/18605005555 (Local charges applicable) OR write to us at loans@axisbank.com OR visit www.axisbank.com/loanappstatus

Dealer Sales Executive / Account Officer Name & Code:

For NACH Cases: 01 EMI Cheque for 1st EMI banking, 03 undated EMI cheques , 01 undated cheque for entire loan amount & 01 cancelled cheque along with 2 NACH

Mandate to be provided.

Note:

1 undated cheque with full loan amount “Not exceeding Amount <<Sanction Loan Amount>> to be written on cheque.

3 Undated Security cheques equivalent to EMI amount. Amount to be filled in words & figures.

Cheques to be drawn in favor of Axis Bank Ltd Loan A/C <<Customer Name>>

On backside of all cheques customer’s Loan account number to be mentioned

All cheques to be A/c Payee only.

2500

Registration Certificate Collection charges - Rs 200/-