Vidya Lakshmi Common Education Loan Application Form

Student ID 728273

Application ID 345744

Bank Name Punjab National Bank

Bank Scheme Name PNB SARASWATI

Preferred Bank IFSC Code PUNB0152900

Preferred Bank Branch Name NEW DELHI NEHRU PLACE

Date of Application 10-Oct-2018

1. Personal Information

Field Name Student Parent / Husband Co-obligant / Guarantor

Title Mr. Mr.

First Name aakash rajinder

Middle Name kumar

Last Name chauhan chauhan

Father’s /Husband’s First Name rajinder phool

Father’s /Husband’s Middle Name kumar

Father’s /Husband’s Last Name chauhan chand

Date of Birth 05/01/1993 13/12/1960

Category Others Others

Sex Male Male

Marital Status Single Married

Educational Qualification graduate graduate

Marks obtained in Highest

50.0 0.0 0.0
qualification %

Occupation Student Employee

Income from all sources (Rs) 1000000.00

PAN No.# BCAPC5008B

State Delhi Delhi

Address Line 1 131,MAHABHADRA KALI APPT 131,MAHABHADRA KALI APPT

SECTOR-13 DWARKA,NEW SECTOR-13 DWARKA,NEW

Address Line 2
DELHI-78 DELHI-78

Village / Area/ Locality DWARKA DWARKA

Block/Taluka /Sub-district/Town South West Delhi South West Delhi

PIN 110078 110078

Contact No. 9818074385 9643003507

e-mail Id aakash.chauhan9@gmail.com r.kumar@nic.co.in

Present Banker Details

Branch IFSC ORBC0105229 BKID0006018

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 ORIENTAL BANK OF
Banker BANK OF INDIA
COMMERCE

Bank Branch NEW DELHI NEHRU PLACE

Account Type Savings Account Savings Account

SB / OD A/c No. 52292171001211 601810100019110

Direct/Indirect liability details (Rs) 0 50000

2. Whether related to Chairman /Directors / employee of our Bank or any other Banks. No

If yes, details of relationship

3. Particulars of course, for which loan is required.

Whether under: Merit / Management Quota Merit

Name of the Institution integrated institute in learning and managment,greater noida

Name of the Course pgdm

Duration of the Course 02 (Years) 00 (Months)

Date of Commencement 03/07/2018 Date of Completion 30/04/2020

Cost of Finance Details

4. Cost of Course / Source of Finance: (All amounts are in (Rs))

Particulars Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Total

Tuition fees 790000 360000 1150000.00

Exam fees 0 0

Books Stationery 0 0

Equipment/Computer 0 0

Hostel Expenses 0 0

Sundries/Travel 0 0

TOTAL 790000 360000 1150000.00

Own Source / Scholarship 390000 360000 750000.00

Loan Required 400000 0 400000.00

5.Details of securities offered

6.Prospects of earning after completion of the course

No. of Installments Amount (Rs) p.m.

Repayment proposed
60 7000.00

7.Uploaded Documents:

Marksheet

Proof Of Admission to the course

Schedule Of Expenses for the course, as given by institution

Proof of Income

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Form16 (latest)

ITAO / IT Return (latest)

Undertaking letter in the absence of PAN & Aadhaar

Applicant Photo

Parent Photo

I / We declare that all the particulars and information given in the application form are true, correct and complete and binding on me / us. Further,
the above particulars shall form the basis of any loan Bank may decide to sanction to me / us. The loan amount will be used for the purpose for
which it is granted.

Signature of the Signature of the Signature of the

Student Parent/Guardian Co-obligant/Guarantor

Place:

Date:

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For office use

Credit Report No. Date : Customer ID/Application ID:

Details of security including

Rate of Repayment Whether eligible under CSIS
Nature of limit Amount (Rs.) Margin(Rs.) Personal Guarantee/Co-
Interest* conditions Scheme / (Yes/No)
obligation.

Other terms and conditions:

The Bank may revoke in part or in full or withdraw/stop financial assistance at any stage by giving reasonable notice to the borrower. Credit
facilities sanctioned are to be availed within 6 months from the date of this letter, failing which; the limits will automatically stand cancelled.

Manager/Senior Manager / Accepted all the terms and

Chief Manager /Asst Gen Manager conditions of sanction Borrower/s

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