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 largest housing finance company providing financial assistance in the acquisition and maintenance of homes since 1989; having nation-wide network across six regional offices, 15 back offices and 115 marketing offices. Consistent record of dividend payments since 1990. NON-CUMULATIVE SCHEMES Ì 3 YEAR DEPOSIT - Interest @ 9.00% P.A. r Minimum Amount of Deposit – Rs.10,000/- Ì 5 YEAR DEPOSIT - Interest @ 9.25% P.A. r Additional deposit in multiple of Rs.1,000/- Interest payment half yearly on 30th September and 31st March. REGISTRARS TO THE PUBLIC DEPOSIT SCHEME INTIME SPECTRUM REGISTRY LIMITED C-13, Pannalal Silk Mills Compound, L.B.S. Marg, Bhandup (W), Mumbai 400 078 • Tel.No.: 25946960/4 • Fax: 25946969. Contact Person : Mr. Vijay Ayare. All communications with regard to Public Deposit should be addressed to the Registrar to Public Deposit Scheme at the above address. FUND MOBILIZERS TO THE PUBLIC DEPOSIT SCHEME Integrated Enterprises (India) Limited 59, Sonawala Building, Mumbai Samachar Marg, Fort, Mumbai 400 023. Tel.No. 2266 2825 / 2266 2728 u Selected Centres / Branches of the Fund Mobilizer u KYC Compliance Ahmedabad- (079) 26443289, Bangalore- (080) 23446386, Baroda- (0265)2343677, Bhopal- National Housing Bank had introduced Know Your Customer (0755) 4266005, Bubhaneshwar- (0674)2430780, Chennai (T.Nagar)- (044) 28140484, (KYC) Guidelines for Housing Finance Companies. In order to comply with these guidelines, we request you to kindly fill up the Cochin- (0484) 2358922, Coimbatore- (0422) 2471944, Panjim (Goa)- (0832) 2426904, KYC Compliance Form for each applicant separately. This form Hyderabad- (040) 23242375, Indore- (0731) 4247155, Jaipur- (0141) 2378001, Kolkata- (033) has to be filled in only once or while placing the deposit for the 24746400, Lucknow- (0522) 2235736, Madurai- (0452) 2630305, Mangalore- (0824) 2440163, first time. On submission of this form alongwith the necessary identification documents, Customer No. will be allotted by the Mumbai (Fort)- (022) 22662825, Mysore- (0821) 2424188, Nagpur- (0712) 2736372, Nasik- Company which should be quoted on the application form while (0253) 2575524, New Delhi- 09871997001, Patna- (0612) 2205943, Pune- (020) 24473944, placing any further deposits. KYC Compliance Form is attached Rajamundhry- (0883) 2422120, Rajkot- (0281) 2294451, Surat-(0261) 2410815, Trivandrum- with Public Deposit Application Form. Additional KYC Forms (0471) 2461593 , Vijayawada- (0866) 2472414, Vishakapatnam- (0891) 2513606. are available with above offices of Fund Mobilizer and with Registrar to the Public Deposit Scheme. “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 the terms and conditions mentioned overleaf. REGISTERED & CORPORATE OFFICE nd Bombay Life Building, 2 Floor, 45/47, Veer Nariman Road, Mumbai-400001 • Phones: 22040006, 22049799 • Fax: 2204 9839 Email: email@example.com • Website: www.lichousing.com TERMS AND CONDITIONS GOVERNING THE PUBLIC DEPOSITS 9. Renewal and Repayment of Deposits : In case of renewal of Public Deposit, a fresh application 1. Acceptance of Public Deposits : Public Deposits will be accepted from Resident/Non-Resident form duly filled should accompany the discharged deposit receipt. In case of repayment, the duly Individuals, minors through guardians, Association of Persons, Hindu Undivided Family, Co-op. discharged deposit receipt should be surrendered at least 15 days before the date of maturity. The deposit would be repayable at the city/town where the deposit is placed. Societies, Proprietary Concerns and Partnership Firms. 2. Non-Resident Indians (NRI) : Deposits from Non-Resident Indians and Persons of Indian origin No part repayment or renewal will be permitted. resident outside India would be accepted in accordance with the regulations governing the 10. Premature Withdrawal : acceptance of deposits from NRIs. Deposits would be accepted for a maximum period of 3 years. a) No premature withdrawal will be allowed before the completion of three months from the date of Payment of interest as also the repayment shall be made only by credit to the NRO Account. Income receipt as per National Housing Bank (NHB) guidelines. In case of request for premature Tax at Source will be deducted as applicable to Non-Residents. withdrawal after the expiry of three months, the rates given in the table below shall apply: 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 Period completed from date of deposit Rate of interest payable (% p.a.) payable at selected centres i.e. branches of Fund Mobilizer. Outstation depositors can send demand drafts after deducting the demand draft charges. This facility is applicable for places other than the After 3 months but before 6 months No interest selected branches of the Fund Mobilizer. Please ensure that your cheque/demand draft together After 6 months but before date of maturity Interest shall be 2% less than the rate with your completed application form is handed over by you or by your agent, if any, to Fund Mobilizer applicable to the period for which deposit immediately since LIC Housing Finance Limited will not pay any interest for the priod between the remained with the Company, if interest rate date of the cheque/demand draft and the date on which your cheque/demand draft is received by has not been prescribed for such period, the interest rate applicable will be 6.00% p.a. Fund Mobilizer with your completed application form. Signature by thumb impression must be attested by a Magistrate or a Notary Public under their b) In the event of the deposit holder already having/received interest at a higher rate, the difference Official Seal. In case an application is made under Power of Attorney or by a Association of Persons in the total interest paid and revised interest payable would be adjusted against the interest / or by a Co-Operative Societies or by a Trust, the relevant Power of Attorney or Resolution must be principal amount. given. c) Outstanding post-dated interest cheques/warrants in the custody of the depositor, if any should 4. Payment of interest : Interest on deposit (Non Cumulative) will be paid on 30th September and 31st be surrendered to LIC Housing Finance Limited. The brokerage payable to authorized agents is March. In case of interest payment for part period, the same will be made on pro-rata basis. However, for the period completed and excess brokerage paid will be recovered from the depositor. if a deposit is made within a period of 30 days prior to any of the interest payment date, the interest for 11. Loan against Deposits : Loans may be granted against Public Deposits upto 75% of the deposit the part period will be paid on the next interest payment date. Payment of interest will be made amount, carrying interest at the rate of 2% per annum (at half yearly rests) above the interest rate through interest warrant or through Electronic Clearing Service (ECS) in respect of the places where and any other additional charges as applicable on such deposits, provided such deposits has run such facility has been offered by the Company. for a minimum period of 3 months. The outstanding loan together with interest shall be settled in 5. Deduction of Tax at Source : In case where the interest amount exceeds Rs.5,000/- (or any such one lump sum by the depositor or shall be adjusted on maturity of the deposit. However, the amount notified by the Government from time to time) in a financial year, income-tax will be deducted granting of loan will be at the sole discretion of the Company. at source as per section 194A of the Income-tax Act, 1961 at the rates in force. If the depositors, who 12 For authorized agents : Agents are not authorized to accept cash or issue receipts on behalf of are not liable to pay income tax and the interest to be paid / credited in the financial year does not LIC Housing Finance Limited. Please ensure that the Agent's name and code number is clearly exceed the maximum amount exempt from tax, depositor may submit a declaration in Form 15G in mentioned in the Application Form to enable payment of brokerage. Application Forms received triplicate to the Registrar namely Intime Spectrum Registry Limited, Mumbai in the beginning of without name and code number of the agent will not be considered for payment of brokerage. every financial year, so as to receive interest without deduction of tax at source, failing which tax will Brokerage will be paid to registered agents at the rate decided by the management as per RBI/NHB regulations/guidelines. be deducted at source in accordance with Section 194A of the Income-tax Act, 1961. Senior Citizens may submit a declaration in Form 15H. TAX DEDUCTED DUE TO NON-COMPLIANCE 13. Electronic Clearing Service (ECS) : This facility is provided to depositors in select centers WITH THIS CONDITION WILL NOT BE REFUNDED. whereby the interest will be credited directly to the depositors' bank account. The depositor would receive credit entry “ECS LICHFL” in passbook / bank statement. Intimation of interest credited Where Income-tax is deducted at source, a consolidated TDS Certificate may be issued for the would be sent to the depositors. Your Bank will not levy any charge for this facility as per present financial year. RBI Guidelines. However, the interest for the broken period on maturity as well as repayment of Section 139A (5A) of the Income-tax Act, 1961 requires every person receiving any sum or income deposit amount will be made through warrants. from which tax has been deducted to intimate his Permanent Account Number (PAN) to the person 14. General: responsible for deducting such tax and the person deducting such tax to indicate the PAN on the TDS Certificate. Please mention your PAN in the application form. However, in case you have applied for Deposits will be subject to the Rules/Guidelines framed from time to time by NHB or any other statutory authority and/or Central/State Government in connection with acceptance of Public PAN or PAN is not applicable in your case, please tick the appropriate box in the application form. Deposits by Housing Finance Companies. 6. Joint Deposit Holders : Deposits will be accepted in joint names not exceeding three in number. In Terms and conditions form part of the prescribed form. case of deposits in joint names, all communications will be addressed to the first named depositor and payment of interest and repayment of principal amount shall be made to the first named The Company reserves the right to alter or amend from time to time the terms and conditions without assigning any reason if so required by NHB regulations/guidelines. depositor. Any discharge given by any of the depositors will be valid and binding on all the joint depositors unless expressly intimated to the Company at the time of making deposit. Brokerage will be paid to the third party (other than deposit holders) as per NHB regulations / guidelines. In the event of death of the first / sole depositor the repayment of deposit and payment of interest will be made to the joint depositor first in order of survivor/s / nominee on submission of death certificate The Company has Public Deposit Desk at the Corporate Office to look into any investor grievance regarding deficiencies, if any, in the services. without reference to the heirs and / or legal representatives of the deceased. 7. Nomination : Individual depositors can, singly or jointly, nominate other person under this facility. The Board of Directors certify that all the relevant information regarding the Schemes as well as the financial position of the Company is correctly declared. The nominee shall be recognized as the Holder of the title to the Public Deposit on death of all the depositors. Power of Attorney Holder or a guardian applying on behalf of a minor cannot nominate. As required by NHB guidelines, it is to be distinctly understood that the Public Deposit In case the deposit is placed in the name of the minor the nomination can be made only by a person Application Form should not in any way be deemed or construed to have been cleared or approved by NHB. NHB does not undertake any responsibility either for the financial soundness of any lawfully entitled to act on behalf of the minor. Depositors are advised to provide the specimen scheme or for the statements made in the Public Deposit Application Form. signature of the nominee to expedite the transmission of the deposits to the nominee in the event of In case of any defeciency of the Company in servicing its deposits, the depositor may approach the demise of the depositors. National Consumers Disputes Redressal Forum, the State Level Consumers Disputes Redressal The payment by the Company to the nominee shall constitute full discharge to the Company of its Forum or the District Level Consumers Disputes Redressal Forum for relief. liability in respect of the deposit. In case of non-repayment of the deposit or part thereof in accordance with the terms and 8. Deposit Receipt / Interest Warrant : The deposit receipt and interest warrant will be sent by post / conditions of the deposit, the depositor may make an application to an authorized officer of the NHB. courier by the Company to the address given in the application form and the Company shall not be Public Deposit Receipts & Warrants will be sent to the first depositor by post/courier. LIC Housing held responsible for any loss or delay in transit. Finance Limited will not be responsible for non-receipt/loss or any delay in transit. If the deposit receipt is not received by the depositor within 4 weeks from the application date, the In case of loss / misplacement of Public Deposit Receipts / Warrants, relevant legal depositor should write to enquire with the Corporate Office of the Company. In the event of procedures will have to be followed. loss/destruction/mutilation of deposit receipt, the Company may at its sole discretion issue a Change of address of the first depositor should be intimated to Intime Spectrum Registry Limited. duplicate receipt upon receiving an indemnity from the depositor in the form prescribed by the Company. Acceptance of deposits is subject to Mumbai jurisdiction only. The deposit receipt is not transferable. The Company will not recognize any lien or assignment of the All the trust depositors must mention PAN/GIR No. and other deposit holders placing deposit in deposit or interest thereof. excess of Rs.20,000/- must mention PAN/GIR No. along with jurisdiction. LIC HOUSING FINANCE LIMITED Acknowledge Slip [To be filled in by the Applicant] Application No. Date : RECEIVED FROM An application for a fixed deposit together with Cheque/Draft/Public Deposit Receipt No Dated [Name of the first/sole applicant] d d - m m - y y y y Address drawn on for Rs Pin Code being fixed deposit amount for a period of 3/5 years. For LIC HOUSING FINANCE LIMITED AUTHORISED SIGNATORY Fund Mobilizer's Agent's Name : (if applicable) Code No : Appl. No.: LIC Housing Finance Ltd. Date: APPLICATION FORM FOR PUBLIC DEPOSIT Individual Others PLEASE USE BLOCK LETTERS AND TICK I N A P P R O P R I AT E P L A C E S ( P L E A S E R E F E R T E R M S A N D C O N D I T I O N S ) I/We apply for placement / renewal of deposit for a period of years and at the interest rate of % p.a. The necessary details are as under : 3/5 DEPOSITOR'S NAME (in Block Letters) Date of Formation 1. Mr./Mrs./Ms/ M/s. d d - m m - y y y y 2. Mr./Mrs./Ms/ M/s. 3. Mr./Mrs./Ms/ M/s. In case First/Sole Applicant is minor : Date of birth Guardian’s name d d - m m - y y y y Kindly fill in a Know Your Customer (KYC) Compliance form for each depositor. If already submitted, please mention the Customer No. for 1st depositor 2nd depositor 3rd depositor ( Please use separate KYC Compliance Form for non individual cases ) ADDRESS (First / Sole Depositor) City Pin Code email id (Tel. No. (with STD Code) AMOUNT OF DEPOSIT Rs. Mode of payment Cheque DD/PO Renewal Rupees (in words) ____________________________________________________________________________________________________________________ IF CHEQUE / DD/ PO No. Dt For Rs. d d - m m - y y y y Bank Branch IF RENEWAL : Old Deposit Maturity Amount Rs. Maturing On Receipt No d d - m m - y y y y Renewal Amount Rs. Additional Amount Rs Crossed A/c Payee Cheques/DD should payable to “LIC Housing Finance Limited - Public Deposit A/c”. SCHEME PERIOD (YEARS) Non Cumulative Interest payable Half Yearly on 3 5 30th September and 31st March 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 Other INCOME Rs. P.M. (Optional) STATUS Resident Individual Non- Resident Individual Others (specify) CATEGORY Public Shareholder Director/Relative of a Director Promoter DEPOSIT REPAYABLE TO First Depositor First Depositor or Survivor/s TAX STATUS INTEREST PAYABLE BY PAN / GIR : Exempt Non- Exempt Applied for (zerox copy of application to be attached) 15G/15H Enclosed (In Triplicate) ECS Warrants Not Applicable Order u/s. 197 Order u/s.10 I N T R O D U C T I O N / I D E N T I F I C AT I O N O F N E W D E P O S I T O R i n t r o d u c e r m u s t b e a LIC Housing Finance Limited depositor or an Agent of the Fund Mobilizer. Introducer's Name : LICHFL Public Deposit Receipt No. / Agent Code No: Signature : If there is no introducer submit a photocopy of any one of the following for the first depositor: PAN Card Election Identity Card Passport/Ration Card Document evidencing creation/registration of the trust / AOP. NOMINATION Name of Nominee : Date of Birth : d d - m m - y y y y Relationship of nominee with first depositor : Guardian's Name (if nominee is minor): Address of Nominee : Email id : PIN Code Signature of Nominee: I/We the applicant(s) hereby apply for the placement / renewal of Public Deposit as per details given above in accordance with the Terms and Conditions and confirm that these are binding on me/us. I/we also declare that I/we have not acquired the fund being deposited with you by borrowing or accepting deposit from any other person. I/we declare that the first name depositor is the beneficial owner and is to be treated as the payee for the purpose of deduction of tax under section of 194 A of the Income-tax Act 1961, I/we have gone through the financial & other statements /particulars/ representation furnish /made by the Company and after careful consideration, I/we are placing deposit with the company at my / our own risk and volition. I/We further declare that, I/We am/are authorised to make these deposit in the above mentioned scheme and the amount kept in the deposit is through legitimate source and does not involve directly or indirectly any proceeds of schedule of offence and / or is not designed for the purpose of any contravention or evasion of the provision of Money Laundering Act, 2002 and any Rules, Regulations, Notifications, Guidelines or Directions thereunder, as amended from time to time. I/We shall provide any further information and fully co-operate in any investigation as and when required by the Company in accordance with the applicable law. I/We further affirm that information / details provided by me / us is / are true and correct in all respects and nothing has been concealed. Signature of depositor/s : 1) First / Sole / Guardian 2) Second 3) Third FOR OFFICE USE ONLY PUBLIC DEPOSIT RECEIPT NO. DATE OF DEPOSIT RATE OF INTEREST %p.a. d d - m m - y y y y AMOUNT OF DEPOSIT (RS.) MATURITY DATE d d - m m - y y y y AUTHORISED BY : CHECKED BY : PARTICULARS AS REQUIRED UNDER NON-BANKING FINANCIAL COMPANIES AND MISCELLANEOUS NON-BANKING COMPANIES (ADVERTISEMENT) RULES, 1977. a) Name of the Company : LIC Housing Finance Limited b) Date of Incorporation : 19th June, 1989 c) Business carried on by the Company : The Company is primarily carrying on business of advancing finance for purposes of construction / purchase of residential houses. and its subsidiary with details of Branches The addresses of the Registered Office and branches of the Company are as under:-: i) Registered & Corporate Office : Bombay Life Building, 2nd Floor, 45/47, Veer Nariman Road, Mumbai 400001. ii) Subsidiary Company : 1) LICHFL CARE HOMES LIMITED Engaged in the business of providing Care Homes to elderly people. iii) The Company has Regional Offices / Back Offices at the following places : Regional Offices : Back Office : Kolkata (033) 22128628, 22129419, Siliguri (0353) 2640174, 2640173; Lucknow (0522) -2626536, 2201116; Bhopal (0756) Kolkata (033) 22128043, 22129984; Lucknow (0522) 2301657, 2574124, 4245979; New Delhi (011) 23217067, 23232624; Chandigarh (0172) 5086760, 5009655; Jaipur (0141) 2361153, 2396949; New Delhi (011) 23349360, 23367822; Bangalore (080) 22241235, 22277790; Chennai (044) 24311144, 24313906; 2360495; Bangalore (080) 22221422, 22219482; Hyderabad (040) 23440500, 23440507; Chennai (044) 24311140, Mumbai (022) 22641515, 22693975. 24313911; Coimbatore (0422) 22214805, 22218693; Ernakulam (0484) 2370606, 2366330; Madurai (0452) 2601479, 2603162; Mumbai (022) 22705543, 22693165; Pune (020) 25679159, 25650508. In addition to above the Company has 115 Area Offices all over India. d) Brief Particulars of the Management of the Company : The Company is managed by the Managing Director and Director and Chief Executive subject to the superintendence, control and direction of the Board of Directors. e) Name, address and occupation of Directors: 1. Shri. T. S.Vijayan, Chairman LIC of India, Central Office, “Yogakshema”, Service Jeevan Bima Marg, Mumbai - 400 021. 2. Shri Thomas Mathew T., Managing Director LIC of India, Central Office, “Yogakshema”, Service Jeevan Bima Marg, Mumbai - 400 021. 3. Shri G. M. Ramamurthy, Director The Industrial Development Bank of India, IDBI Towers, Advisor (Legal) WTC Complex, Cuffe Parade, Mumbai 400005. 4. Shri Y. B. Desai, Director 321/322, Raheja Crest 3,Off New Link Road, Retired Lokhandwala, Andheri (West),Mumbai 400053. 5. Shri Dhananjay Mungale, Director 309, Tulsiani Chambers, Nariman Point, Free Press Journal Profession Marg,Mumbai – 400 021. 6. Shri S. Ravi, Director D-296, IInd Floor, Sarvodaya Enclave, New Delhi – 110017. Profession 7. Shri K. Narasimha Murthy, Director 3-6-365, 104, Pavani Estate, Himayatnagar, Hyderabad – Profession 500 029. 8. Shri B. N. Shukla, Director ‘Siddharth’, 2H/71, T. V. Tower Road, Mahatma Gandhi Retired Nagar, P.O. Lohia Nagar, Patna – 800 020. 9. Shri S. K. Mitter, Director & Chief Executive LIC Housing Finance Ltd., Bombay Life Building, 2nd Floor, Service 45 / 47 Veer Nariman Road, Mumbai – 400 001. f) & g) Profit and Dividend Financial Year ended Profit Before Tax Profit after tax Dividend (Rs. in Crores) (Rs. in Crores) 31st March 2006 261.74 208.57 60% 31st March 2005 204.30 143.72 50% 31st March 2004 188.24 167.47 50% h) Summarised financial position of the Company as appearing in the last two Audited Balance Sheets (Rs. in Crore-rounded off) Liabilities As at 31.3.2006 As at 31.3.2005 Assets As at 31.3.2006 As at 31.3.2005 Share Capital 85.00 85.00 Housing Loans 14687.70 12244.66 Reserves & Surplus 1260.52 1110.04 Fixed Assets 24.47 25.28 Secured Loans 12361.35 10304.94 Investments 314.14 76.13 Unsecured Loans 1419.05 742.90 Deferred Tax Asset 83.52 72.19 Current Liability 592.23 504.32 Current Assets 608.32 328.94 Total 15718.15 12747.20 Total 15718.15 12747.20 Brief particulars of contingent Liabilities as on 31.03.2006: Contingent liabilities in respect of: a. Income Tax (demands disputed and pending before appellate authorities) 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 investments in units of Venture Capital Funds Rs. 550,000,000 (Previous year Rs. Nil) i) The amount of Public Deposits which the Company can raise under the Housing Finance Companies (NHB) Directions, 2001 is equivalent to 5 (five) times of the net owned fund i.e., Rs.6,309.95 crores. The Company has not accepted Public Deposits so far. j) There are no overdue deposits as the Company has not so far accepted any deposits. k) We declare that; I. The Company has complied with the provisions of the above directions. II. The compliance with these directions does not imply that the repayments of deposits are guaranteed by the Reserve Bank of India / National Housing Bank. III. The deposits accepted by the Company are unsecured and rank pari-passu with other unsecured liabilities. The total amount of exposure, other than investment in share including the non-fund based facilities to companies in same group or other entities or business ventures in which director and / or the company is holding substantial interest as on March 31, 2006 was Rs.110.28 crores. The above text has been approved by the Board of Directors at its meeting held on 13th March 2007 and is being issued on the authority and in the name of Board of Directors of the Company. A copy signed by the majority of Directors of the Company has been filed with the Registrar of Companies, Maharashtra, National Housing Bank, New Delhi and the Department of Non Banking Companies of the Reserve Bank of India, Mumbai. By Order of the Board, LIC Housing Finance Limited Date : March 13, 2007 S.K.Mitter Place : Mumbai Director & Chief Executive 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, the rules notified thereunder and NHB’s guidelines on Anti Money Laundering. Name of the Applicant (As appearing in supporting identification document) Mr./Mrs./Miss/M/s. Full Name of the Father / Husband / Guardian Mr./Mrs./Miss/M/s. Status Resident Individual Non Resident Individual Co-Operative Societies Persons of Indian Origin (PIO) (Attach copy of PIO Card) Date of Birth / Formation d d - m m - y y y y Nationality 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 the following certified documents) Passport Photo Pan Card Driving Licence Voter's Identity Card Photo Ration Card Photo Debit/Credit Card issued by Bank Any other Identification with 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. Email id Proof of Address to be provided by Applicant (Please submit ANY ONE of the following certified documents) Latest Telephone Bill of Land Line / Mobile Latesh Electricity / Gas Bill Latest Bank Account Statement Latest Demat Account Statement Registered Rent Agreement Ration Card Any other Address Proof (Subject to satisfaction of LIC Housing Finance Limited) Other Details Education SSC/HSC Graduate Post-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 than Rs.1 lakhs p.a. Rs.1-3 lakhs p.a. Rs.3-5 lakhs p.a. Rs.5-10 lakhs p.a. Above Rs.10 lakhs p.a DECLARATION I/We hereby declare that above information is true to the best of my /our knowledge and belief. I/We further declare that the deposit made under the deposit application is through legitimate source and does not include directly/ indirectly any proceeds of schedule of offence and/or is not designed for the purpose of contravention or evasion under any law. Place : Date : Signature of the Depositor For Office use only : Branch : Date of Receipt : Checked by : Authorised by : Customer No.