Vidya Lakshmi Common Education Loan Application Form

Student ID 2249462

Application ID 1156973

Bank Name Punjab National Bank

Bank Scheme Name PNB SARASWATI

Preferred Bank IFSC Code PUNB0154400

Preferred Bank Branch Name DAWATH, DISTT ROHTAS, BIHAR

Date of Application 06-Sep-2021

1. Personal Information

Field Name Student Parent / Husband Co-obligant / Guarantor

Title Mr. Mr.

First Name kamran AKIL

Middle Name

Last Name khan AHMAD

Father’s /Husband’s First Name AKIL AKIL

Father’s /Husband’s Middle Name

Father’s /Husband’s Last Name AHMAD AHMAD

Date of Birth 14/02/1994 01/01/1961

Category Minority Minority

Sex Male Male

Marital Status Single Married

Educational Qualification BCOM

Marks obtained in Highest

60.0 0.0 0.0
qualification %

Occupation Student Retired

Income from all sources (Rs) 4.50

PAN No.#

State Bihar Bihar

Address Line 1 C/O- AKIL AHMAD, VILL+POST- BABHNOUL

VILL+POST- BABHNOUL,
Address Line 2
ROSTAS

Village / Area/ Locality BABHNOUL BABHNOUL

Block/Taluka /Sub-district/Town Rohtas Rohtas

PIN 802211 802211

Contact No. 8860241783 9939954756

kamran.khan.pgdm23@iilmgsm.ac.
e-mail Id akil99399@gmail.com
in

Present Banker Details

Branch IFSC PUNB0154400 PUNB0154400

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Banker PUNJAB NATIONAL BANK PUNJAB NATIONAL BANK

DAWATH, DISTT ROHTAS, DAWATH, DISTT ROHTAS,

Bank Branch
BIHAR BIHAR

Account Type Savings Account Savings Account

SB / OD A/c No. 1544001700115797 1544000100063262

Direct/Indirect liability details (Rs) 0 0

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 IILM Graduate School of Management Greater Noida 201306

Name of the Course PGDM

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

Date of Commencement 05/08/2021 Date of Completion 04/08/2023

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 462000 288000 750000.00

Exam fees 0 0

Books Stationery 0 0

Equipment/Computer 40000 0 40000.00

Hostel Expenses 0 0

Sundries/Travel 0 0

TOTAL 502000 288000 790000.00

Own Source / Scholarship 390000 0 390000.00

Loan Required 112000 288000 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
40 10000.00

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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Applicant Photo

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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