Vidya Lakshmi Common Education Loan Application Form

Student ID 1756128

Application ID 1087575

Bank Name State Bank of India

Bank Scheme Name SBI Global Ed-Vantage Scheme

Preferred Bank IFSC Code SBIN0000221

Preferred Bank Branch Name NEW GUWAHATI

Date of Application 05-Jul-2021

1. Personal Information

Field Name Student Parent / Husband Co-obligant / Guarantor

Title Mr. Ms. Mrs.

First Name Mrinmoy Junu Junu

Middle Name

Last Name Talukdar Talukdar Talukdar

Father’s /Husband’s First Name Abhiram Abhiram Abhiram

Father’s /Husband’s Middle Name

Father’s /Husband’s Last Name Talukdar Talukdar Talukdar

Date of Birth 04/03/1996 01/03/1970 01/03/1970

Category OBC OBC OBC

Sex Male Female Female

Marital Status Single Married Married

Educational Qualification H.S , B.com

Marks obtained in Highest

48.0 0.0 0.0
qualification %

Occupation Professional others Business Business

Income from all sources (Rs) 590000.00

PAN No.# BLYPT5683G ATAPT7939A

State Assam Assam Assam

Akashinagar,Bamunimaidam,Guwa Akashinagar,Bamunimaidam,Guwa Akashinagar,Bamunimaidam,Guwa

Address Line 1
hati hati hati

Address Line 2

Village / Area/ Locality Akashinagar Akashinagar Akashinagar

Block/Taluka /Sub-district/Town Kamrup Metro Kamrup Metro Kamrup Metro

PIN 781021 781021 781021

Contact No. 6900797706 9127306589 9127306589

e-mail Id mtalukdar512@gmail.com trendingtrades2@gmail.com mtalukdar512@gmail.com

Present Banker Details

Branch IFSC UTBI0NOO315 UTBI0NOO315

Banker UNITED BANK OF INDIA UNITED BANK OF INDIA

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Bank Branch NOONMATI NOONMATI

Account Type Savings Account Savings Account Savings Account

SB / OD A/c No. 0005010172301 0005010172301

Direct/Indirect liability details (Rs) 3500000

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 Paris college of music , International Music Educator of Paris

Name of the Course Diploma in Music

Duration of the Course 03 (Years) 00 (Months)

Date of Commencement 01/01/2021 Date of Completion 01/12/2024

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 347377 321514 304568 973459.00

Exam fees 5000 5000 5000 15000.00

Books Stationery 5000 5000 5000 15000.00

Equipment/Computer 80000 0 0 80000.00

Hostel Expenses 50000 50000 50000 150000.00

Sundries/Travel 70000 0 0 70000.00

TOTAL 557377 381514 364568 1303459.00

Own Source / Scholarship 0 0 0

Loan Required 557377 381514 364568 1303459.00

5.Details of securities offered Immovable property

6.Prospects of earning after completion of the course

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

Repayment proposed
0.00

7.Uploaded Documents:

Marksheet

Proof Of Admission to the course

Applicant Photo

Parent Photo

Co-obligant / Guarantor Photo

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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.

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Manager/Senior Manager / Accepted all the terms and
Chief Manager /Asst Gen Manager conditions of sanction Borrower/s

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