DISBURSEMENT REQUEST FORM

To, Date:
Place:
The Manager
AXIS Bank Ltd.

Dear Sir,

Sub: Request for Disbursement of my Education Loan a/c no _____________________________

I/We have been sanctioned an Education loan by your bank for pursuing the Education course.
I/We request you to kindly disburse the amount as per below details.

Education Loan details

Sanctioned amount : Rs._________________________

Course Name : _________________________________________________
College & University Name : _________________________________________________

I/We request you to kindly disburse the amount of Rs. _______________________

(Rupees___________________________________________________________________________________)

I /We request you to kindly issue the DD or Transfer the funds favoring
__________________________________________ __________________________________________________
(payable in ______________________ currency).

I /We request you to kindly deduct EMI / Pre-EMI ( as applicable ) on the 5th of every month.

Yours faithfully,

(Applicant/Co-applicant)

______________________________