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DECLARATI

ONFORCANCELLATI
ONOFSCC
APPLI
CATI
ON

I
,Sr
i/
Smt_
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_S/
Dof_
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__appl
i
ed

f
or l
oan under West Bengal St
udent Cr
edi
t Car
d (
WBSCC) Scheme f
rom

_
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_bank _
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_ br
anch. My WBSSC I
D i
s

_
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__.

Iher
ebydecl
aret
hatIam nol
i
ngerwi
l
li
ngnow t
otakeSCCl
oanf
orwhi
chI

appl
i
erear
li
er.Iher
ebyaut
hor
izet
heBank/Di
str
ictt
ocancel
myl
oanappl
i
cat
ion.

Pl
ace:
- Si
gnat
ure
Dat
e:-

Nameoft
heSt
udent

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