APPLICATION AND CONSENT TO BECOME A MEMBER UNDER GROUP LIFE

INSURANCE POLICY FOR PERSONAL LOAN CUSTOMERS.

Contract No: 3802911700 Date: 04/05/2018
To,
Home Credit India Finance Private Limited.
3rd Floor, Tower C, DLF Infinity Towers, DLF Cyber City Phase II,
Gurugram, Haryana
I would like to apply for, and accordingly give consent to, voluntarily and unconditionally, membership of group life insurance
policy underwritten by HDFC Standard Life Insurance Company Limited (“Insurer”) and proposed by Home Credit India
Finance Private Limited (“Master Policyholder”) for the benefit of its customers/ borrowers who have specifically opted for
insurance.
I confirm that I have read and understood the terms and conditions of Group Policy as available on
https://homecredit.co.in/corporate-governance and I have applied for the life insurance with following details only after receiving
all information about the Group Policy, including but not limited to, risk cover, insurance premium and claim settlement process
of Insurer:
HDFC LIFE GROUP CREDIT
Death Benefit as mentioned in Group
Group Policy Risk Coverage
PROTECTION PLUS Policy. No benefit shall be payable on
maturity.
Sum Assured 1.25 Times of the Loan Effective Date 04/05/2018
Insurance Term 3 Year Nominee’s Name AARTI
Insurance Premium Rs. 6.99 per thousand* Nominee’s Relation
with Borrower SPOUSE

* Rounding of premium amount upto two decimals. Goods & Service Tax and other taxes extra as applicable.
I agree that the premium under this Group Policy will be included in the monthly fee charged by Master Policyholder basis my
application for the Loan. I hereby authorize Master Policyholder to provide my personal, demographic, business, credit, financial
and other information/ data that is reasonably necessary for the Insurer to provide me with insurance coverage.
I do hereby declare that I have received a loan from Master Policyholder. In order to secure the said loan I have enrolled myself
under the Group Insurance Scheme through the Master Policy Holder offered by Insurer. In consideration of receiving the said
loan I hereby authorize Insurer to make payment to the extent of Outstanding Loan Balance amount to Master Policyholder by
deducting from the claim proceeds payable on happening of the contingent event covered by this Group Policy referenced above
and the remaining to the Nominee. For this purpose, I confirm that ‘Outstanding Loan Amount’ shall include the balance amount
of principal, interest, fee and penalties as mentioned in the statement of loan account submitted by Master Policyholder. I further
declare and confirm that I, or my nominee, and/ or legal heir shall not dispute the right of Master Policyholder to receive the
Outstanding Loan Amount out of the proceeds of insurance claim any point of time.

I declare that I am in a sound state of health. I hereby declare that, as of the date of this declaration, I do not have any history of,
have never suffered from or currently suffering from medical conditions such as, but not limited to, high blood pressure, chest
pain, heart attack or any other heart condition; stroke, transient ischemic attack or any other cerebrovascular disease; diabetes or
any other endocrinal disease; kidney disease; HIV / AIDS or AIDS related complex; any cancer or tumor; asthma or any other
respiratory disease; any mental or nervous disease; hepatitis or any other liver disease; blood disorders; digestive and bowel
disorders; paraplegia, physical disability or any other disorder of the bones, spine or muscle; any other disease, disorder or
disability, not mentioned above and excluding minor impairment such as common cough or cold. I have never undergone or
expect to undergo any surgical procedure for any illness, ailment, disease or disability. In the last 5 years, I have not received any
form of medication for more than 7 consecutive days or been absent from work for more than 7 days. For Female Lives: I further
declare that presently I am not pregnent or I do not have a history in the past of an abortion, miscarriage or caesarian section due
to complications during pregnancy or due to any other cause, I have not given birth to a child with any congenital disorder such as
Down Syndrome, congenital heart disease, etc and I have not ever had any disease of breast, uterus, cervix, ovaries or any other
part of the reproductive system. I further declare that, as of the date of this declaration, I do not engage or intend to engage in any
business, sport or occupation of a hazardous nature. I declare that, I do not have any history of conviction under any criminal
proceedings in India or abroad. I understand, agree and confirm that these statements and this declaration are basis of the
contract between the insurer and the policyholder. If any untrue statement are contained herein or there has been any non
disclosure of any material fact, the policy to be issued by the insurer in the name of the policyholder may be treated as void as far
as I am concerned. I confirm that I have read and understood, the rules and any additional rules of the plan, the standard Policy
provisions and any additional provisions that govern the policy to be issued by insurer in the name of the policyholder and on my
life, and I agree and confirm that the same shall be binding on me. I authorise the policyholder to disclose to the insurer such
particulars as they may require including the details given above and any changes to the same pay the premium payable on my
behalf /collected from me to the Insurer. I understand that any statutory levy or charges including any indirect tax may be charged
to me either now or in future by the insurer and I agree to pay the same. I understand that HDFC SLIC has the right to reject a
proposal without giving reasons thereto and client to give an undertaking thereof that he shall not raise any claims thereof. I
understand the significance of the contract and the contract will be governed by the provisions of the Insurance Act 1938 as
amended from time to time and that the same will not commence until written acceptance of this application by Insurer issue on its
normal terms and conditions is received.

I agree that all the claims under the Group Policy shall be addressed/ resolved by Insurer only. I agree that Master Policyholder
shall be under no obligation to settle any insurance claim. The certificate of insurance shall be provided by the Insurer separately
on approval. I the undersigned hereby declare that the above statements and particulars are true, accurate and complete and I
declare and agree that this declaration shall be held to be promissory and shall be the basis of my membership under Group
Policy. I also confirm the receipt of copy of these terms and conditions from Master Policyholder.

Applicant Sign: Applicant Name: JAI KISHAN

 TERMS & CONDITIONS FOR VALUE ADDED SERVICES (SAFE PAY) – FOR PERSONAL LOANS
This document lays out the terms and conditions which shall be applicable to the package of value added services (named as SAFE
PAY) mentioned herein below that you (‘the Borrower’) have applied for in the Loan Application Form and financed by Home Credit
India Finance Private Limited (‘HCIN’). By applying, using, availing, or opting for this package, you agree to be bound by these terms
and conditions (SAFE PAY Terms) as mentioned herein as well as the registered General Terms and Conditions for obtaining
Personal Loans & POS Loans from Home Credit India Finance Private Limited (‘GTC’). For terms used herein, please refer GTC
unless otherwise re-defined herein.

1. GENERAL CONDITIONS APPLICABLE TO ALL SERVICES UNDER SAFE PAY

1.1. HCIN is a facilitator that allows you/ the Borrower to avail and use various options/ services as described herein.. For obtaining
this package, you have to apply for the same in Loan Application along with your POS Loan/ Personal Loan requirement. The
options under SAFE PAY shall be applicable only with respect to the Loan applied in same application form used for applying
SAFE PAY for use in the manner mentioned below until the termination of the loan period mentioned in Loan Summary and not
for any existing or future loan availed either from HCIN or any other financial institution/ bank.

1.2. HCIN shall provide these value added services as a complete package. However, you are free to opt for the insurance under
group master policy in SAFE PAY. The fee for SAFE PAY shall be payable monthly along with EMI of your loan (hereinafter
referred as Safe Pay Fee and shall be included in Monthly Instalment). The fee for SAFE PAY shall be payable irrespective of the
fact that you have not utilised any or all services/ options under this package. Services/ options under SAFE PAY are neither
transferrable nor negotiable. Any addition of new options/ services in this package by HCIN shall not be available to you.
1.3. For exercising any of the option/ service except insurance, you have to raise a request with HCIN either by calling at 1800 - 121 -
6660 or mailing at care@homecredit.co.in. The request must be raised from your mobile number or e-mail address registered
with HCIN. No other mode of request shall be accepted. The request for exercising this option/ service must be raised at least 15
(fifteen) days before the Due Date of the month for which such option/ service is exercised. If the request is made within 15 days
of the Due Date or anytime thereafter, such request may be activated for the immediate following month to the extent possible
and subject to other conditions of SAFE PAY.

1.4. One or more services/ options in SAFE PAY may be provided by other service providers independent of HCIN. Further, HCIN
may be required to share your personal details with such service providers in order to provide you necessary services. By
applying to SAFE PAY, you agree to abide by the terms & conditions of such service providers as amended from time to time and
grant your consent to HCIN to share your personal details with such service providers. Should you have any issue or concern
arising from the services/ options provided by such service providers, you agree to raise such disputes/ concerns directly to such
service provider and will not make HCIN responsible for any deficiency or breach whatsoever.

1.5. Cancellation: In case you cancel the entire Loan (i.e. including SAFE PAY), or SAFE PAY only, during the free look period as per
Clause 4.13 of GTC, you will not be charged any amounts towards SAFE PAY. The adjustment of fee for SAFE PAY shall be
communicated to you through Contact Options mentioned in your loan application. After free look period, cancellation of SAFE
PAY alone shall not be allowed. However, HCIN may terminate your SAFE PAY package if the Loan is terminated due to
occurrence of any Event of Default mentioned in GTC irrespective of the fact that entire package has not been availed/ utilised by
you until the date of such termination. Such termination of SAFE PAY does not relieve you of obligations to pay charges or costs
accrued towards such package.
2. SPECIFIC CONDITIONS FOR ‘PAYMENT HOLIDAY’ OPTION

2.1. After completing consecutive two months from Effective Date of your Loan, you may choose to postpone the payment of one
Monthly Instalment of the Loan. Such option can be exercised twice in a year provided you have paid all the previous Monthly
Instalments duly on time (i.e. before Due Date) and there has been no amount of any nature outstanding for payment by you as
on the day of activation of the option basis your request as per Clause 1.3 above. This condition needs to be complied with for
availing this option second time as well during Loan Period. This option cannot be exercised for two consecutive months and
there has to be payment of six Monthly Instalments before availing the service for the second time.
2.2. Once this option is exercised, your Loan Period will be extended by one month and you need to make the payment of Monthly
Instalment deferred by you at any time during the balance period of Loan including extended period.

3. SPECIFIC CONDITIONS FOR ‘FREE EARLY REPAYMENT’ OPTION

3.1. You may avail this option any time during Loan Period. Once this option is requested, HCIN representative shall communicate
you the net amount payable for early repayment of the loan. You shall not be charged any penalty on account of prepayment of
the Loan.

4. SPECIFIC CONDITIONS FOR ‘LIFE INSURANCE’ UNDER GROUP INSURANCE

4.1. At the time of applying for the loan, you may specifically opt for life insurance under Group Life Insurance Scheme for selected
customers for a period equivalent to your Loan Tenure mentioned in the Loan Summary. You have to sign an application form
and consent to become a member of group life insurance policy. You are advised to read and understand the terms and
conditions of the policy available on the website of HCIN (https://homecredit.co.in/corporate-governance) as well as the insurance
application/ consent form. The life insurance under Group Life Insurance Scheme shall only be available to the Borrowers who
have specifically opted for insurance.

Acknowledgment from Applicant:

I hereby confirm that I have read and understood clearly and completely the provisions of the aforementioned terms and conditions
and I undertake to abide by the same. I confirm that I have received the copy of these terms and conditions.

Date: Contract Number: 3802911700

Applicant Sign: Applicant Name: JAI KISHAN