| Applicant's Details |
|
| Full Name
| Date of Birth |
Martial Status |
|
|
|
Unmarried Married |
| Current Address |
City |
Pin |
State |
|
|
|
|
| Permanent Address |
City |
Pin |
State |
|
|
|
|
| Phone (with STD Code) |
Mobile No |
Email |
| - |
|
|
| Nearest RACs |
|
| Parent/Guardian Details |
| Name of Parent/Guardian |
Relationship with Applicant |
|
|
|
| Date of Birth
|
|
Occupation
Employed (salaried)
Self employed
In case of Employed:
Name of the employer
Designation
Experience
Total Salary
|
In case of Self-employed:
Nature of business/prof.
No. of years
Total Income (ITR/audited A/C)
|
| Annual Income of Parent/Guardian |
|
| Rs
|
|
| Parent/Guardian's Address |
City |
Pin |
State |
|
|
|
|
| Co-Applicant |
| Name of Co-Applicant |
Relationship with Applicant |
|
|
|
| Date of Birth
|
|
Occupation
Employed (salaried)
Self employed
In case of Employed:
Name of the employer
Designation
Experience
Total Salary
|
In case of Self-employed:
Nature of business/prof.
No. of years
Total Income (ITR/audited A/C)
|
| Annual Income of Co-Applicant |
|
| Rs
|
|
| Co-Applicant's Address |
City |
Pin |
State |
|
|
|
|
| Previous Qualifying Examination Details |
| Examination Passed |
Name of the Institution |
|
|
| Year of Passing |
|
|
|
% of Marks |
| Details of Course applied for: |
| Course Applied:
|
|
| Course details |
Name of the Institution |
|
|
| Whether admission to College Secured? |
Address of Institution |
| Yes No |
|
| Mode of Securing Admission |
|
|
|
| Course/Institution Approved? |
Course Approved by |
| Yes No |
|
| Nature of Course |
|
Full Time
Evening
(Part Time & Correspondance Courses will not be considered) |
|
| Place of study and details of the expenses |
| Study in India / Abroad |
Duration of the course |
| India Abroad |
Months |
| Total Course Expenses (Fee + Hostel Charges etc.) |
Rs
|
| Loan Amount Required |
Rs
|
| Own Contribution |
Rs
|
| Collateral Security |
| For amount exceeding Rs. 4 lakh, furnish details of third party guarantee: |
Name of the Guarantor
|
|
Annual Income
|
|
| For loan amount exceeding Rs. 7.50lakh furnish details of security offered : |
Nature of Security
|
|
Location
|
|
Present Value
|
|
Original Value
|
|
Loan Outstanding Against Security
|
|
| 1. Additional details of security |
Nature of Security
|
|
Location
|
|
Present Value
|
|
Original Value
|
|
Loan Outstanding Against Security
|
|
| 2. Additional details of security |
Nature of Security
|
|
Location
|
|
Present Value
|
|
Original Value
|
|
Loan Outstanding Against Security
|
|
|
I hereby declare that the information given by me is true and correct
to the best of my knowledge. I also agree and undertake that: 1) I will
not violate any rules and regulation framed by college / university/
instituion. 2) I will keep bank informed regarding any change in address
/ progress in education. 3) I will procure and furnish the securities in
favour of bank as and when stipulated and in the form and manner to the
satisfaction of the bank.
|
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