Vidya Lakshmi Common Education Loan Application Form

Student ID 2370162

Application ID 1575741

Bank Name Indian Overseas Bank

Bank Scheme Name IOB VIDYA SURAKSHA

Preferred Bank IFSC Code IOBA0000442

Preferred Bank Branch Name RAJENDRA PLACE ( Pusa Rd ) , N.Delhi

Date of Application 07-Jun-2022

1. Personal Information

Field Name Student Parent / Husband Co-obligant / Guarantor

Title Mr. Mr.

First Name Mandeep Satpal

Middle Name Singh

Last Name Jass Singh

Father’s /Husband’s First Name Satpal Harkewal

Father’s /Husband’s Middle Name

Father’s /Husband’s Last Name Singh Singh

Date of Birth 12/12/2002 02/02/1973

Category OBC Minority

Sex Male Male

Marital Status Single Married

Educational Qualification 12th pass 12th pass

Marks obtained in Highest

92.8 0.0 0.0
qualification %

Occupation Student Business

Income from all sources (Rs) 290000.00

PAN No.# CIVPJ5750K BMJPS3907A

State Delhi Delhi

1929/19 2nd floor govindpuri

Address Line 1 New delhi-110019
extension Kalkaji

Address Line 2

Village / Area/ Locality New delhi New Delhi

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

PIN 110019 110019

Contact No. 7827443713 9818587164

e-mail Id satpalsinghjass@gmail.com satpalsinghjass888@gmail.com

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 Present Banker Details

Branch IFSC PUNB0015600

Banker PUNJAB NATIONAL BANK

Bank Branch DELHI, KALKAJI

Account Type Savings Account

SB / OD A/c No. 0156000100439656

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 Merit

Name of the Institution Manav Rachna International Institute of Research And Studies

Name of the Course Bachelor of Technology in Computer Science And Engineering

Duration of the Course 04 (Years) 00 (Months)

Date of Commencement 15/09/2021 Date of Completion 15/09/2025

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 191500 188500 188500 188500 757000.00

Exam fees 0 0 0 0

Books Stationery 0 0 0 0

Equipment/Computer 0 0 0 0

Hostel Expenses 0 0 0 0

Sundries/Travel 0 0 0 0

TOTAL 191500 188500 188500 188500 757000.00

Own Source / Scholarship 191500 0 0 0 191500.00

Loan Required 0 188500 188500 188500 565500.00

5.Details of securities offered nil

6.Prospects of earning after completion of the course

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

Repayment proposed
48 15000.00

7.Uploaded Documents:

Marksheet

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Proof Of Admission to the course

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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