BAJAJ FINANCE LIMITED ("BFL") - Consumer Finance

Application Form Application Form No. - A81000435

CKYC No/KIN : Deal ID : A81000435

Customer ID : Date : 17/06/2023

Personal Details

Name of the Applicant : SHUVABRATA DAM Father's/ Spouse's name : PRADIP KANTI DHAM

Mother's Name : PINKU DAM Date of Birth : 02/01/1998

Gender : Male Marital Status : Married

Nationality : Indian Monthly Income : Rs 15000-25000

PAN or Form 60 (in case PAN is : CTCPD4137J : Aadhaar

Identification Document (POI)
not allotted)

POI Document Number : 7832 POI Document Expiry Date :

: Purchase of Consumer Durable

Purpose of Loan Product

Contact Details

Residence Type : Self Owned Type of Proof Of Address(POA) : Aadhaar

POA Document number : 7832 POA Document Expiry Date :

: 2/2063 GAYESHPUR,
Is OMC/NFCC Customer : FALSE Current Address NADIA GAYESHPUR
GAYESHPUR

Area/Locality : 2/2063 GAYESHPUR, NADIA Landmark : NEAR SUKANTA SADAN

City : NADIA Pin Code : 741234

State : WEST BENGAL Mobile No. : 6291623221

Alternate Number : 8100351746 Email ID : sherlock211.holmes@gmail.com

 Preferred Mailing Address : Residence

Employment/ Business Details

Employment Type : Salaried Qualification : Graduate

Name of the Company/Business : OTHERS Nature of business : Private Ltd

: GAYESHPUR
Designation : Others Office/Business Address GAYESHPUR WEST
BENGAL

Area/Locality : NADIA City : NADIA

Pin Code : 741234 NADIA State : WEST BENGAL

Office Phone : 6291623221 Official Email ID :

Product Details

Applied Loan amount : 35000

Main Product Details :

Sr. No. Product Name Premium/ Product Price

1 SAC 123V Vectra Elegant 4503440 - VOLTAS-AC Rs56990 39900

General Terms and Conditions

I hereby agree and confirm:

1. That, (i) I am at least 18 years of age, (ii) can understand, read and write in the English language, (iii) have read and understood the Application Form,
and Master Terms and Condition in relation to the Loan available on Master Terms & Conditions and (iv) agree to be bound by the same
2. That I am applying for Finance Facility from Bajaj Finance Ltd ("BFL") as stated in this Application Form.
3. To submit and execute any/all documents, in such form and manner as may be required by BFL in relation to this Application Form and/or related
products
4. I shall make payment of the applicable fee and/or charges, as specified herein by BFL with respect to this loan application and as more specifically
detailed under Annexure I, below or which also can be accessed at https://www.bajajfinserv.in/all-fees-and-charges
5. Authentication/Acceptance: The mode of authentication/acceptance may be done by me through any one of the following modes, namely:
1. By Physical execution: The documentation will be signed by me in person and the same shall be relied and acted as my explicit written
instruction/consent by BFL; OR
2. By Electronic authentication: By checking the “I Agree” button at the end of the Application Form and by submitting the one-time password
(“OTP”) sent by BFL, or authentication/execution by any other electronic mode, I confirm my acceptance on the Application Form, Most
Important Terms and Conditions(“MITC”) and Master Terms and Conditions (“Master Terms”) in relation to the Loan through electronic
means and the same shall be relied and acted upon by BFL.
6. CKYC Consent
1. I hereby authorize BFL to verify/ check/ obtain/ download/ upload/ update/ retrieve/ receive my KYC details from/with the Central KYC
Registry(CERSAI): (i) by verifying such details through the CKYC number (i.e. KYC Identifier Number- KIN) provided by me or (ii) by
obtaining such CKYC number/KIN, through details shared by me for this Application Form.
2. I hereby consent for receiving information from Central KYC Registry through SMS/Email on the above registered number/email address
provided by me.
7. Aadhaar based authentication (Aadhaar eKYC) or verification (Aadhaar OKYC) facility provided by Unique Identification Authority of India
“UIDAI”
1. CONSENT : At my own discretion, I voluntarily opt to perform and avail Aadhaar based authentication (eKYC) or verification (OKYC) from
UIDAI and hereby submit to the BFL, the physical copy of Aadhaar card / physical e-Aadhaar / masked Aadhaar / Aadhaar Secure QR code /
offline electronic Aadhaar xml as issued by UIDAI (Aadhaar), Aadhaar number, Virtual ID, e-Aadhaar, Aadhaar Letter, XML file, date of
birth, Aadhaar holder name, photo, demographic information, face authentication details and/or biometric information (collectively,
 1.

“Information”) for the purpose of establishing my identity / address proof or in the capacity of guardian of my minor child’s identity / address. I
am informed by the BFL that in connection with Aadhaar e-KYC or Aadhaar OKYC services, BFL shall share Aadhaar number and/or
biometrics with CIDR/UIDAI , and in response, the CIDR/UIDAI shall share with BFL, the authentication data or verification data such as
Aadhaar Holder Name, Date of Birth, Address, Photo, and Registered Mobile Number
2. PURPOSE : I for myself/as guardian of minor child, authorise and give my consent to the BFL, for following informed purposes:
1. Above mentioned information shall be used for KYC and periodic KYC updation process as per the PML Act, 2002 and rules
thereunder and RBI guidelines, or for establishing my identity, carrying out my identification, e-KYC, or OKYC, or Yes/No
Authentication, demographic or other authentication/verification/ identification as may be permitted as per applicable law, for all
accounts, facilities, services and relationships of/through the BFL, existing and future.
2. Collecting, sharing, storing, preserving Information, maintaining records and using the Information and authentication/verification/
identification records: (a) for the informed purposes above, (b) as well as for regulatory and legal reporting and filings and/or (c)
where required under applicable law;
3. producing records and logs of the consent, Information or of authentication, identification, verification etc. for evidentiary purposes
including before a court of law, any authority or in arbitration.
3. I further understand that Aadhaar number and core biometrics will not be stored/ shared except as per laws/regulations and for CIDR/UIDAI
submission.
4. In case of OKYC, I shall share the Share Code or confirm on the auto populated shared code, as the case may be for successful XML file
download and upload as contemplated under applicable law to complete my offline KYC process.
5. I am informed by the BFL, that the submission of Aadhaar is not mandatory, and there are alternative options for KYC and establishing identity
including by way of physical KYC with officially valid documents other than Aadhaar. All options were given to me.
8. CONSENT DATA AND INFORMATION SHARING FROM FOR DIGILOCKER PROVIDED BY MeIT (Ministry of Electronics and
Information Technology)
I authorise and give my consent to the BFL to obtain, share and store Certified Copy of Officially Valid Documents (OVD) or equivalent e-documents of
OVD including documents issued through secured cloud based Digilocker platform of MeIT for the purpose of availing Financial Products from BFL.
9. eMandate Registration with eSignature
In the event I opt for mandate registration with eSignature through biometric authentication, I agree/authorize BFL as under:
1. that BFL and its Assigns to (a) use my Aadhaar/Virtual ID(as applicable) for the purpose of digitally signing eMandate and (b) authenticate my
Aadhaar/Virtual ID through OTP or Biometric for authenticating my identity through Aadhaar Authentication system of UIDAI for obtaining
my eKYC through Aadhaar based eKYC services of UIDAI, for the purposes of digitally signing eMandate.
2. that BFL will be sharing certain details such as Mandate Start Date, Mandate End Date, Monthly Amount to be debited, my personal details
etc., to my bank either on its own or through service provider for registration of mandate and I authorize BFL to share said details
3. to debit my account basis the payment instructions as confirmed by me herein and agree that such debit shall not be disputed by me for any
reason, whatsoever.
4. that during the tenure of my relationship with BFL, the mandate shall NOT be cancelled by me, excepting when the relationship is terminated
by me.
5. that my bank may charge mandate processing charge and hence my Bank account could be debited with the mandate processing charges, basis
the authorization given by me to the bank and I will not hold BFL and its Assigns liable or responsible for any fees and charges levied/collected
from my Bank on account of registration of mandate or dishonour of mandate(s).
10. I also authorize BFL
1. To use, verify, exchange, share or part with all information and details as provided by me to BFL’s group companies/business
partners/permitted assigns, affiliate/subsidiaries/agents/ service provider/representatives/empanelled merchants (collectively referred to as
“Assigns”) and any third party including but not limited to, banks, financial institutions, credit bureaus, telecommunication companies,
statutory bodies, empanelled merchants, Central KYC Registry, Protean eGov Technologies Reserve Bank of India, GST Portal,
CIBIL/CRISIL/any credit rating agency/credit information company(CIC), Information Utility, NSDL e-Governance Infrastructure Limited
(NSDL)/UTI Infrastructure Technology and Services Limited (UTIITSL), UIDAI for purposes such as, including but not limited to customer
verification and due diligence, personalization of products or services, credit rating, data enrichment, analysis, marketing or promotion of BFL
services or related products or that of its Assigns or for enforcement of my obligations and I shall not hold BFL/its Assigns liable for the
use/storage/sharing of the data and informations as stated above. I am aware and I agree that my Aadhaar details such Aadhaar Number,
registered mobile Number, and registered email ID will be masked by BFL before sharing to its permitted Assigns and/or any third party as per
laws/regulations.
2. To seek/obtain any other information, generate periodic reports relating to me either by itself and/or from any third party.
3. To procure/avail my CIBIL report and provide it to me by deducting applicable charges for the same.
11. I hereby expressly authorise BFL, its group companies, affiliates and/or business associates and their respective representatives to send me
communications regarding loans, insurance and their respective products and/or services (collectively “Other Products”) through telephone
calls/SMSs/emails/post/bots/bitly etc. including but not limited to promotional communications. I agree and understand that such Other Products if
availed, are governed by their own set of terms and conditions, which shall be in addition to and not in derogation to the terms and conditions prescribed
by BFL herein. I understand that I can at any time opt not to receive any telecommunication;
12. I hereby declare that all the information voluntarily furnished by me is true, correct and complete. I will not hold BFL or any of its officials responsible
in case of any incorrect information provided by me.
13. That no insolvency proceedings or suits for recovery of outstanding dues, monies or property (ies) and/or any criminal proceedings have been initiated
and/or are pending against me.
14. I have not received any request for or made any payment in cash, bearers cheques or of any other kind in connection with this Application
Form from/to any person.
15. That BFL has the absolute discretion, to accept or reject this loan application, as it may be deemed fit by BFL at any time, either before or after
verification.
16. I hereby expressly consent for taking my photo/video along with the invoice and product evidencing the conduct of loan transaction by me and that such
photo/video is unconditionally agreed to be stored and preserved for a period of at least five (5) years or otherwise from the date of closure of my
account and/or as the law/regulations may so mandate, whichever is higher.
17. That this Application Form, its contents and information/details provided by me, from time to time, as part of this application, may be submitted to:
1. BFL, its subsidiaries and affiliates of BFL, any service provider/third party/ legal entity with whom BFL may have business relationship and/or
in reference to rendering services in connection with the product(s) availed by me and/or for promoting/marketing various products and
services.
2. To any Regulator, Court, Law enforcement agency, Quasi-Judicial authority etc. on a need basis.
18. That all the particulars, information and details provided in this Application Form and the documents submitted by me are true, correct, complete and
up-to-date in all respects and that I have not withheld any material information. I shall keep BFL updated of any change in the information provided by
me, specifically KYC details, Bank details, etc. and in case any of the above information is found to be false or untrue or misleading or misrepresenting,
I am aware that I shall be held liable for the same and I will not hold BFL liable for any consequences that may arise owing to any delay/lapse on the my
part
19. Interest Rate Methodology- Interest rate applicable for consumer durable Loans varies from 0% to 36% basis the BFL’s internal credit and risk policy
and as per an algorithmic multivariate score card which includes following variables (inclusive and not exhaustive): (i) Interest rate risk (fixed vs
floating loan), Credit and default risk in the related business segment (iii) Historical performance of similar homogeneous clients (iv) Profile of the
borrower (v) Industry segment, (vi) Repayment track record of the borrower, (vii), Nature and value of collateral security, (viii) Secured Vs unsecured
loan, (ix) Subvention available, (x) Ticket size of loan, (xi) Bureau Score, (xii), Tenure of Loan, (xiii) Location delinquency and collection performance
and (xiv) Customer Indebtedness (other existing loans) The aforesaid variables may be revised from time to time.
20. BFL Customer Care Contact details:
1. For any queries, visit our website https://www.bajajfinserv.in/reach-us.Select the < Email Us > tab and follow the directions to get your query
resolved.
 Officially Valid Documents (OVDs) or Deemed to be OVDs

OVDs or Deemed to be OVDs (to be taken in case address mentioned on OVDs is not the current address). In cases where Deemed to be OVD is submitted
towards current address, applicant shall submit an OVD updated with current address within a period of three months of submission of Deemed to be
OVD)

List of Officially Valid Documents (OVDs) :

1. Passport
2. Driving License
3. Aadhaar (First Eight Digits of Aadhaar number to be redacted/masked)
4. Voter's Identity Card issued by the Election Commission of India
5. Job Card issued by NREGA duly signed by an officer of the State Government
6. Letter issued by the National Population Register containing details of name and address

List of Deemed to be OVDs (DOVDs) :

1. Utility bill which is not more than two months old of any service provider (electricity, telephone, post-paid mobile phone, piped gas, water bill)
2. Property or Municipal tax receipt
3. Pension or family pension payment orders (PPOs) issued to retired employees by Government Departments or Public Sector Undertakings, if they
contain the address
4. Letter of allotment of accommodation from employer issued by State Government or Central Government Departments, statutory or regulatory bodies,
public sector undertakings, scheduled commercial banks, financial institutions and listed companies and leave and licence agreements with such
employers allotting official accommodation

Annexure I : Fees & Charges Levied by BFL

Processing Fees Mandate Rejection Charges

Upto Rs. 1017 Rs. 450/-

per month from the first instalment due date for mandates rejected by customers
(Inclusive of applicable taxes) collected upfront bank until the new mandate is registered
Convenience Fees Cash Repayment Charges

Cash Repayment Charges of

Rs. 117/- Rs. 499/-

(Inclusive of applicable taxes) will be collected along with 01st instalment. (Inclusive of applicable taxes) are applicable for Repayment of EMI dues in
Cash at BFL Branches
Loan Enhancement Fees
Credit Suraksha Fees

Rs. 117/-
Rs. 117/-
(Inclusive of applicable taxes) levied on certain set of Customers who are
(Inclusive of applicable taxes) for temporary increase in EMI card limit for the facilitated with loan for purchasing mobile devices and where Bajaj Finserv
loan transaction. Same will be charged only for increase in limit in excess of Rs. Credit Suraksha application is installed on such mobile devices which will
999/- to be collected along with 01st instalment. enable BFL to put restrictions on usage of device in the event of default by
Customer

CIBIL Transunion Report Fees (If Availed)

EMI Network Card Fee (If Availed)

Rs. 46/- Rs. 530/-

(Inclusive of applicable taxes) will be collected along with 01st instalment. (Inclusive of applicable taxes)

Pre-payment Charges Add-on EMI Network Card Fee (If Availed)

Full Pre-payment: NIL

Rs. 199/-
Part Pre-payment: NIL
(Inclusive of applicable taxes)
Penal Interest
EMI Network card Annual fee
Delay in payment of Monthly instalment shall attract penal interest at the Rs. 117/-
rate of
(Inclusive of applicable taxes) for each card availed Annual fee will only be
3.5% charged to the respective Card holders who have not availed any loan using such
Card in the preceding year. The duration of the preceding year is calculated 12
per month on the Monthly Instalment outstanding, from the respective due months from last year’s validity month, which is printed on the face of your
date until the date of receipt. respective Card. For example, If the Card is issued in the month of February
2019 (referred to as ‘Member Since’, on the Card) the date for payment of the
Mandate Registration Charges (If Applicable) annual fee will be March, 2020.

Health EMI Network Card Fee

Rs. 118/-
Rs. 999/-
(Inclusive of applicable taxes) Please visit
https://www.bajajfinserv.in/all-fees-and-charges for list of bank on which (Inclusive of applicable taxes)
mandate registration charges will be applicable. In case of UPI Mandate
registration, Rs 1/- (Inclusive of applicable taxes) will be collected from the NACH/ Cheque Bounce Charges
Customer
Note : Not Applicable on successful E-mandate registration.

Rs. 500/-
per bounce in case of default by reason of the repayment instrument(s) being
dishonoured

“Additional cess/ taxes, if any, will be applicable on all charges as per the respective State Laws as may be applicable from time to time.”
The aforementioned charges/fees may be modified by Bajaj Finance Limited from time to time upon prior intimation via Acceptable Modes of Communication
from Bajaj Finance Limited in this regard.

I hereby expressly authorise BFL, its group companies, affiliates and/or business associates and their respective representatives to send me promotional
communications regarding loans, insurance and their respective products and/or services through telephone calls/SMSs/emails/post/bots/bitly, etc. I understand
that I can at any time opt not to receive any telecommunication

By clicking on "I Agree" below, I hereby apply for Loan from Bajaj Finance Limited and confirm that all the particulars, information and details
mentioned in this Application Form are true and correct.

SHUVABRATA DAM ________________

(Name of Applicant) Signature/Thumb Impression

Digitally Signed by : SHUVABRATA DAM

Location : WEST BENGAL

Date : 6/17/2023

Deal ID : B195772780

IP Address of customer : 157.40.104.153

Customer Mobile Number : 6291623221

Email ID if available (Optional) : sherlock211.holmes@gmail.com

OTP Validated On : 6/17/2023

BFL/CF/SF/AppF/English/2023/Feb/V1