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SBI SCHOLAR LOAN SCHEME

APPLICATION CUM APPRAISAL FORM


The Chief Manager
State Bank of India
IIM Joka Branch Joka !o"kata #$%%&%'(
&(Partic)"ar* of St)dent +Co)r*e of St)d,
A. Full Name
B. Date of Birth and Marital Status
C.Educational Qualifcations
D.Name of proposed course of Study
E. Name of Institute
F. Duration of the course
.Date of commencement of the course
!.E"pected monthly income of the student
after completion of the course
I.#assport No $ith dt and place of issue %If
Any& and Pan Card No(-Mandator,. - NRI
*t)dent* are not e"igi/"e for Ed)cation
"oan.
'.#ermanent residential address $ith Name of
District(City()illa*e(+ocality and #IN code
and telephone no. and ST0 Code of the
Cit, (
-Per1anent Addre** Proof i*
Mandator,.
,. E-mail id and mo.ile num.er and CASTE
+. Mother/s full name
2( Partic)"ar* of co#a33"icant -Father +1other+*3o)*e.
A. Full Name
B.Date of .irth and a*e on the day of
application
C.#resent residential address $ith #IN code
and telephone no.
D. '.#ermanent residential address $ith
Name of District(City()illa*e(+ocality and #IN
code and telephone no. and ST0 Code of
the Cit, (
-Per1anent Addre** Proof i*
Mandator,.
E. E-mail id and mo.ile num.er and Pan
Card No(-Mandator,.
F. 0ccupation of the co-applicant
. If in Ser1ice 2 Name of the employer
!. Full o3ce address $ith telephone no.
I.Desi*nation of the employee $ith employee
no. if any.
'. No of years $ith the present employer
,.03cial E-mail ID and direct phone no of
the !ead of the o3ce
#a*e & of '
#hoto*raph of
Student $ith
si*nature
#hoto*raph of Co-
applicant $ith
si*nature
+. Mother/s full name
A33"icant4* Signat)re Co A33"icant4*
Signat)re
5(Partic)"ar* of the Loan a33"ied for6
-A"" 7g)re* in Indian R)3ee*.
A. Co*t of co13"etion of the co)r*e6 -In INR.
4.5uition Fee %Ma" 467897999&
8.Essential Boo:s %Ma" ;S.<97999&
=.Stationery %NI+&
>. +A#50# %Ma". ;s.<97999&
<.E"amination Fee %NI+&
6.;ent %NI+&
?.Boardin* %NI+&
@.Clothes %NI+&
A.Sundries %Ma". ?7999 per month durin* the
course&
49.Insurance #remium for the duration of the
loan
R* 28%%%
44.Student E"chan*e #ro*ram %Ma".- 8.< +acs&
A( Tota" E93en*e* -In R*(.
B . 0$n Contri.ution
C(LOAN AMOUNT RE:UESTE0 AN0 APPLIE0
FOR -A#B.
-Ma9i1)1 Loan a1o)nt i* R* 2% Lac*(.
D. Complete Address $ith #IN Code and #hone
No. and Branch Code of any SBI Branch near the
#ermanent Address of applicant(co applicant.
'. 5he education loan reBuested and sanctioned .y the Ban: $ill .e repaid .y us7 in CCCCCC
eBuated monthly installments7 .e*innin* from 0cto.er 8946 .
8(E9i*ting Loan 0etai"* of St)dent and co a33"icantD %From SBI or other Ban:s& - A""
infor1ation 1andator,.
5ype of +oan%
For Car +oans
*i1e )ehicle
No and For
!ousin* +oan
i1e Full
Address of
the property&
+oan
Account
Num.er (
Ban: Name
and Branch
Name $ith
address
Sanction
date (
Sanction
Amount(
Current
0utstandin*
EMI Start
Date and EMI
Amount
A(c
Num.er
from $here
EMI is
.ein* #aid
and Name
of the Ban:
Student
Co
Applicant
;( E<ISTIN= ACCOUNT 0ETAILS OF STU0ENT AN0 CO APPLICANT6
Name of the account
holder
5ype of Account Name of the Ban:
and Branch Name
$ith Address
Account Num.er
$( ASSET 0ETAILS -STU0ENT AN0 CO APPLICANT.6
#a*e 2 of '
%All Fi*ures
in ;s.&
Sa1in*s in
Ban:
)alue of
+and And
Buildin*
)alue of
old and
'e$ellery
In1estment in
NSC
(Share(De.enture(+I
C(#F
0ther
Assets
S5EDEN5
C0
A##+ICAN5
A33"icant4* Signat)re Co A33"icant4*
Signat)re
I/We certify that the information provided by me/us in the loan application form is true and correct in all respects and State Bank
of India is entitled to verify this directly or through any third party agent. I/We confirm that the attached copies of Mark-sheets
/Photo I Proofs/ !ddress Proof/!dmission Proofs/ "ee etails/financials/Income Proofs/Bank Statements/#itle/$egal
documents etc. are submitted by me/us against my/our loan application and certify that these are true copies. I/We further
ackno%ledge the Bank&s right to seek any information from any other source in this regard. I/We understand that all of the
abovementioned information shall form the basis of any facility that the Bank may decide to grant to me/us at its sole discretion.
I/We further agree that any facility that may be provided to me/us shall be governed by the rules of the Bank that may be in force
from time to time. I/We %ill be bound by the terms and conditions of the facility/ies that may be granted to me/us. I/We authorise
the Bank to debit my 'ducation loan account %ith the Bank for any fees( charges( interest etc. as may be applicable.
I/We undertake and declare that I/%e %ill comply %ith the "oreign ')change Management !ct( *+++ ,-"'M!./ and the
applicable rules( regulations( notifications( directions or orders made there under and any amendments thereof. I/We undertake to
intimate the Bank before proceeding overseas on permanent employment and/or emigrating and/or changing my/our nationality.
I/We also undertake to inform Bank in case of change in my /our Permanent !ddress. I /W' also undertake to inform Bank
immediately in case of any change in employment /'mployer.
I/We ackno%ledge that the Bank remains entitled to assign any activities to any third party agency at its sole discretion. I/We
further ackno%ledge the right of the Bank to provide details of my/our account to third party agencies for the purpose of availing
support services of any nature by the Bank( %ithout any specific consent or authorisation from me/us.
I/We ackno%ledge that the e)istence of this account and details thereof ,including details of transactions and any defaults
committed by me/( %ill be recorded %ith credit reference agencies and such information ,including processed information/ may
be shared %ith banks/financial institutions and other credit grantors for the purposes of assessing further applications for credit by
me/us and/or members of my/our household( and for occasional debt tracing and fraud prevention. I/We accordingly authorise the
Bank to share information relating to my/our 'ducation loan account.
I/We understand that as a precondition( relating to grant of loans/advances/other non-fund-based credit facilities to me/us( State
Bank of India re0uires consent for the disclosure by the Bank( of information and data relating to me/us( of the credit facility
availed of/to be availed of by me/us( obligations assumed/to be assumed by me/us( in relation thereto and default( if any(
committed by me/us in discharge thereof.
*. !ccordingly( I/%e hereby agree and give consent for the disclosure by the Bank of all or any such1 ,a/ information and
data relating to me/us ,b/ the information or data relating to any credit facility availed of/to be availed of by me/us and
,c/ default( if any( committed by me/us in discharge of my/our such obligation( as the Bank may deem appropriate and
necessary( to 2redit Information Bureau ,India/ $imited ,2IBI$/ and any other agency authorised in this behalf by
3eserve bank of India / 4overnment of India.
5. I/We undertake that ,a/ 2IBI$ and any other agency so authorised may use( process the said information and data
disclosed by the Bank1 and ,b/ 2IBI$ and any other agency so authorised may furnish for consideration( the processed
information and data or products thereof prepared by them( to banks/financial institutions and other credit grantors( as
may be specified by the 3eserve Bank in this behalf.
I/We agree to receive SMS/ e-mail alerts related to my/our application status and account activity as %ell as product use messages
that the Bank %ill send( from time to time( on my/our mobile phone number as mentioned in this application form. I/We
undertake to intimate the Bank in the event of any change in my/our telephone/mobile phone number and 3esidential and/or
'mployment address.
I/We further ackno%ledge that I / We have read( understood and agree %ith the Most Important #erms and 2onditions governing
the 'ducation loan product chosen by me/us.
@. I(Fe also declare that I(Fe ha1e not a1ailed any education loan or I ha1e a1ailed an
Education loan for ;s. CCCCCCCCCC from CCCCCCCCCCCCCCCCCCCCC for my studies in CCCCCCCCC in the
#a*e 5 of '
yearCCCCCCC the repayment for $hich has started ( $ill .e startin* from CCCCCCCCCCCC. 5he EMI
in case of education loan already a1ailed is ($ill .e CCCCCCCCCCCCCCC.
P"ea*e *anction an ed)cation "oan of R*(>>>>>>>>> - R)3ee*
>>>>>>>>>>>>>>>>>>>>>>>.
in o)r fa?o)r )nder SBI Scho"ar Loan Sche1e(
Signat)re of the St)dent6 >>>>>>>>>>>>>>>>>>>>>>> Signat)re of the Co#
a33"icant>>>>>>>>>>>>>>>>>>>>>>>
Na1e and Reg No( >>>>>>>>>>>>>>>>>>>>>>>> Na1e
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
P"ace >>>>>>>>>>>>>>>>>>>>>>>>> P"ace
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
0ate >>>>>>>>>>>>>>>>>>>>>>>>>
0ate>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
SCHOLAR LOAN IS SANCTIONE0 ONL@ FOR RESI0ENT STU0ENTS AN0 NOT FOR
NRI +PIO STU0ENTS
#a*e ' of '