Vidya Lakshmi Common Education Loan Application Form

Student ID 3815152

Application ID 2328728

Bank Name CENTRAL BANK OF INDIA

Bank Scheme Name Cent Vidyarthi

Preferred Bank IFSC Code CBIN0280110

Preferred Bank Branch Name RABIND RABINDRA SARANI

Date of Application 28-Nov-2023

1. Personal Information

Field Name Student Parent / Husband Co-obligant / Guarantor

Title Mr. Mr.

First Name yagesh santosh

Middle Name kumar

Last Name sharma sharma

Father’s /Husband’s First Name santosh santosh

Father’s /Husband’s Middle Name kumar kumar

Father’s /Husband’s Last Name sharma sharma

Date of Birth 12/04/2004 05/07/1976

Category Others Others

Sex Male Male

Marital Status Single Married

Educational Qualification persuing B.tech

Marks obtained in Highest

86.0 0.0 0.0
qualification %

Occupation Student Business

Income from all sources (Rs) 200000.00

PAN No.# RCYPS8368N AZLPS3623D

State West Bengal West Bengal

Address Line 1 sapuipara bally howrah sapuipara bally howrah

Address Line 2 belur station road belur station road

Village / Area/ Locality bally bally

Block/Taluka /Sub-district/Town Howrah Howrah

PIN 711227 711227

Contact No. 8100006103 9831053488

e-mail Id sanjanasharma98313@gmail.com yageshsharma70448@gmail.com

Present Banker Details

Branch IFSC ICIC0006279 SBIN0000050

Banker ICICI BANK LIMITED STATE BANK OF INDIA

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Bank Branch KOLKATA - BURRA BAZAR? BURRA BAZAR

Account Type Savings Account Savings Account

SB / OD A/c No. 627901021598 20012638859

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 UNIVERSITY OF ENGINEERING AND MANAGEMENT

BACHELOR OF COMPUTER APPLICATIONS(COMPUTER

Name of the Course
APPLICATION)

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

Date of Commencement 14/09/2022 Date of Completion 14/09/2026

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 171200 150000 150000 150000 621200.00

Exam fees 3000 3000 3000 3000 12000.00

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 174200 153000 153000 153000 633200.00

Own Source / Scholarship 60000 60000 60000 60000 240000.00

Loan Required 114200 93000 93000 93000 393200.00

5.Details of securities offered

6.Prospects of earning after completion of the course

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

Repayment proposed
72 5000.00

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

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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