Vidya Lakshmi Common Education Loan Application Form

Student ID 1049447

Application ID 493845

Bank Name State Bank of India

Bank Scheme Name SBI Skill Loan Scheme

Preferred Bank IFSC Code SBIN0005461

Preferred Bank Branch Name CHHAPRUNAGAR (NAGPUR)

Date of Application 06-Jun-2019

1. Personal Information

Field Name Student Parent / Husband Co-obligant / Guarantor

Title Mr. Mr.

First Name Nikhil PRADEEP

Middle Name Arvind KUMAR

Last Name Tripathi TRIPATHI

Father’s /Husband’s First Name ARVIND SHARDHA

Father’s /Husband’s Middle Name KUMAR KUMAR

Father’s /Husband’s Last Name TRIPATHI TRIPATHI

Date of Birth 28/05/1999 29/08/1963

Category Others Others

Sex Male Male

Marital Status Single Married

Educational Qualification PERSUING BCA GRADUATION

Marks obtained in Highest

48.0 60.0 0.0
qualification %

Occupation Student Employee

Income from all sources (Rs) 150000.00 450000.00

PAN No.# BGXPT0355F ADWPT0355F

State Maharashtra Maharashtra

C/ S KUMBHARE PLOT NO.3 C/ S KUMBHARE PLOT NO.3

Address Line 1
JUNI MANGALWARI JUNI MANGALWARI

TELEPHONE EXCAHNGE TELEPHONE EXCAHNGE

Address Line 2
SQUARE SQUARE

Village / Area/ Locality NAGPUR NAGPUR

Block/Taluka /Sub-district/Town Nagpur Nagpur

PIN 440008 440008

Contact No. 8446400882 9595986398

PRADEEPTRIPATHI25W@GMAIL.
e-mail Id nikhil.mac.11@gmail.com
COM

Present Banker Details

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Branch IFSC SBIN0005461 SBIN0005461

Banker STATE BANK OF INDIA STATE BANK OF INDIA

Bank Branch CHHAPRU NAGAR CHHAPRU NAGAR

Account Type Savings Account Savings Account

SB / OD A/c No. 36400803075 10428171841

Direct/Indirect liability details (Rs)

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 Management Quota

Name of the Institution institute of information technology

Name of the Course cisc

Duration of the Course 00 (Years) 06 (Months)

Date of Commencement 10/06/2019 Date of Completion 10/11/2019

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 130000 130000.00

Exam fees 0

Books Stationery 0

Equipment/Computer 0

Hostel Expenses 0

Sundries/Travel 0

TOTAL 130000 130000.00

Own Source / Scholarship 0

Loan Required 130000 130000.00

5.Details of securities offered

6.Prospects of earning after completion of the course

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

Repayment proposed
2 10000.00

7.Uploaded Documents:

Marksheet

Proof Of Admission to the course

Schedule Of Expenses for the course, as given by institution

Applicant Photo

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Parent Photo

Co-obligant / Guarantor 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:

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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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