LoanApplicationForm

Vidya Lakshmi Common Education Loan Application Form
Student ID 4394604
Application ID 2550130
Bank Name Punjab National Bank
Bank Scheme Name PNB SARASWATI
Preferred Bank IFSC Code PUNB0187000
Preferred Bank Branch Name BAREILLY RAJINDER NAGAR,
Date of Application 28-Jun-2024
1. Personal Information
Field Name Student Parent / Husband Co-obligant / Guarantor
Title Mr. Ms.
First Name Ansh Sangeeta
Middle Name Kumar
Last Name Saxena Rani
Father’s /Husband’s First Name Rajendra Rajendra
Father’s /Husband’s Middle Name Kumar Kumar
Father’s /Husband’s Last Name Saxena Saxena
Date of Birth 07/06/2005 01/07/1975
Category Others Others
Sex Male Female
Marital Status Single Married
Educational Qualification Intermediate
Marks obtained in Highest

52.33 0.0 0.0
qualification %
Occupation Student Employee
Income from all sources (Rs) 1.00 1.00
PAN No.# SJBPS2497K
State Uttar Pradesh Uttar Pradesh
Address Line 1 15, 15,
Address Line 2 Munshi Nagar Munshi Nagar
Near Shiv Mandir Lic Colony Near Shiv Mandir Lic Colony
Village / Area/ Locality
Bareilly Bareilly
Block/Taluka /Sub-district/Town Bareilly Bareilly
PIN 243122 243122
Contact No. 9675188666 9193400421
e-mail Id saxenadevyansh@gmail.com saxenadevyansh@gmail.com
Present Banker Details
Branch IFSC SBIN0007027 SBIN0007027
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Banker STATE BANK OF INDIA STATE BANK OF INDIA
Bank Branch CARI BAREILY CARI BAREILY
Account Type Savings Account Savings Account
SB / OD A/c No. 42818421688 10148059565
Direct/Indirect liability details (Rs) NA NA
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 Management Quota
Name of the Institution International Institute Of Hotel Managment Delhi
Name of the Course Hotel Managment
Duration of the Course 00 (Years) 03 (Months)
Date of Commencement 01/06/2023 Date of Completion 01/06/2026
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 250000 250000.00
Exam fees 200000 200000.00
Books Stationery 30000 30000.00
Equipment/Computer 80000 80000.00
Hostel Expenses 70000 70000.00
Sundries/Travel 70000 70000.00
TOTAL 700000 700000.00
Own Source / Scholarship 0
Loan Required 700000 700000.00
5.Details of securities offered 700000
6.Prospects of earning after completion of the course
No. of Installments Amount (Rs) p.m.

Repayment proposed
12 16700.00
7.Uploaded Documents:
Marksheet
Proof Of Admission to the course
Schedule Of Expenses for the course, as given by institution
Proof of Income
Form16 (latest)
Undertaking letter in the absence of PAN & Aadhaar
Applicant Photo
Parent Photo
Co-obligant / Guarantor 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:
--------------------------------------------------------------------------------------------------------------------------------------------------------------------
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.
Manager/Senior Manager / Accepted all the terms and

Chief Manager /Asst Gen Manager conditions of sanction Borrower/s

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Vidya Lakshmi Common Education Loan Application Form

Bank Name Punjab National Bank

Bank Scheme Name PNB SARASWATI

Preferred Bank IFSC Code PUNB0187000

Preferred Bank Branch Name BAREILLY RAJINDER NAGAR,

Date of Application 28-Jun-2024

Field Name Student Parent / Husband Co-obligant / Guarantor

Title Mr. Ms.

First Name Ansh Sangeeta

Middle Name Kumar

Last Name Saxena Rani

Father’s /Husband’s First Name Rajendra Rajendra

Father’s /Husband’s Middle Name Kumar Kumar

Father’s /Husband’s Last Name Saxena Saxena

Date of Birth 07/06/2005 01/07/1975

Category Others Others

Sex Male Female

Marital Status Single Married

Educational Qualification Intermediate

Marks obtained in Highest

Occupation Student Employee

Income from all sources (Rs) 1.00 1.00

PAN No.# SJBPS2497K

State Uttar Pradesh Uttar Pradesh

Address Line 1 15, 15,

Address Line 2 Munshi Nagar Munshi Nagar

Block/Taluka /Sub-district/Town Bareilly Bareilly

PIN 243122 243122

Contact No. 9675188666 9193400421

e-mail Id saxenadevyansh@gmail.com saxenadevyansh@gmail.com

Present Banker Details

Branch IFSC SBIN0007027 SBIN0007027

Bank Branch CARI BAREILY CARI BAREILY

Account Type Savings Account Savings Account

SB / OD A/c No. 42818421688 10148059565

Direct/Indirect liability details (Rs) NA NA

If yes, details of relationship

3. Particulars of course, for which loan is required.

Whether under: Merit / Management Quota Management Quota

Name of the Institution International Institute Of Hotel Managment Delhi

Name of the Course Hotel Managment

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

Date of Commencement 01/06/2023 Date of Completion 01/06/2026

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 250000 250000.00

Exam fees 200000 200000.00

Books Stationery 30000 30000.00

Equipment/Computer 80000 80000.00

Hostel Expenses 70000 70000.00

Sundries/Travel 70000 70000.00

TOTAL 700000 700000.00

Own Source / Scholarship 0

Loan Required 700000 700000.00

5.Details of securities offered 700000

6.Prospects of earning after completion of the course

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

Proof Of Admission to the course