PaisePe Financial Services

LOAN APPLICATION FORM

For Personal · Home · Business · Education · Vehicle Loans

Application No: _________________Date: ___ / ___ / ________

SECTION A — LOAN DETAILS

Loan Type

PersonalHomeBusinessEducationVehicleOther

Loan Amount Required (₹)

Loan Tenure Required

Purpose of Loan

Preferred EMI Date

How Did You Hear About Us

SECTION B — PERSONAL DETAILS

Full Name (as per PAN)

Father's / Spouse Name

Mother's Name

Date of Birth

Gender

Marital Status

Nationality

PAN Number

Aadhaar Number

Mobile Number

Alternate Mobile

Email Address

SECTION C — ADDRESS DETAILS

Current Address (House No., Street, Area)

City

State

PIN Code

Years at Current Address

Residence Type

Permanent Address (if different from above)

City (Permanent)

State (Permanent)

SECTION D — EMPLOYMENT & INCOME DETAILS

Employment Type

SalariedSelf-Employed (Business)Self-Employed (Professional)RetiredOther

Employer / Business Name

Designation / Nature of Business

Total Work Experience

Current Job / Business Since

Office / Business Address

Office City & PIN

Net Monthly Income (₹)

Gross Annual Income (₹)

Other Monthly Income (₹)

SECTION E — BANK DETAILS

Bank Name

Branch Name

Account Number

IFSC Code

Account Type

Account Held Since

SECTION F — REFERENCES

REFERENCE 1

Name

Relationship

Mobile Number

Address

REFERENCE 2

Name

Relationship

Mobile Number

Address

DECLARATION & SIGNATURE

I/We hereby declare that the information furnished above is true and correct to the best of my/our knowledge. I/We authorise PaisePe Financial Services and its partners to verify my/our details, obtain credit reports from credit bureaus, and share information with lenders/NBFC partners for the purpose of processing this loan application. I/We understand that any false or misleading information may result in rejection of the application or legal consequences.

Place

Date

APPLICANT SIGNATURE / THUMB IMPRESSION

DOCUMENTS REQUIRED (attach self-attested copies)

PAN Card

Aadhaar Card

Passport / Voter ID / Driving Licence

Last 3 months salary slips (Salaried)

Last 6 months bank statements

Form 16 / ITR last 2 years

Business proof / GST certificate (Self-Employed)

Property documents (Home Loan)

Passport size photograph (2 nos.)

PaisePe · hello@paisepe.com · www.paisepe.comForm Version 1.0 · 2026