Vidya Lakshmi Common Education Loan Application Form

Student ID 1084848

Application ID 502344

Bank Name State Bank of India

Bank Scheme Name SBI STUDENT LOAN SCHEME

Preferred Bank IFSC Code SBIN0013360

Preferred Bank Branch Name BHATHENA

Date of Application 15-Jun-2019

1. Personal Information

Field Name Student Parent / Husband Co-obligant / Guarantor

Title Mr. Mr.

First Name Pintoo Rameshbhai

Middle Name

Last Name Linka Linka

Father’s /Husband’s First Name Rameshbhai Hadbandhu

Father’s /Husband’s Middle Name

Father’s /Husband’s Last Name Linka Linka

Date of Birth 26/03/1997 05/05/1972

Category Others Others

Sex Male Male

Marital Status Single Married

Educational Qualification BE Mechanical Engineering

Marks obtained in Highest

75.0 0.0 0.0
qualification %

Occupation Student Employee

Income from all sources (Rs) 450000.00 450000.00

PAN No.#

State Gujarat Gujarat

Address Line 1 Plot no - 83 Navanagar Plot no - 83 Navanagar

Address Line 2 udhna yard limbayat udhna yard limbayat

Village / Area/ Locality Limbayat Limbayat

Block/Taluka /Sub-district/Town Surat Surat

PIN 394210 394210

Contact No. 7984783645 8511753365

e-mail Id pinturlenka670@gmail.com prashantdixit105@gmail.com

Present Banker Details

Branch IFSC SBIN0013360

Banker STATE BANK OF INDIA

Bank Branch BHATHENA

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Account Type Savings Account

SB / OD A/c No. 31258799439

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

Name of the Course

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

Date of Commencement 17/06/2019 Date of Completion 17/06/2021

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 65000 65000 130000.00

Exam fees 23900 12250 36150.00

Books Stationery 0 0

Equipment/Computer 0 0

Hostel Expenses 65000 65000 130000.00

Sundries/Travel 0 0

TOTAL 153900 142250 296150.00

Own Source / Scholarship 0 0

Loan Required 153900 142250 296150.00

5.Details of securities offered

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

Copy of land records

Applicant Photo

Parent 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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