Application for Educational Loan

A Engineering Medical Hotel Management
Management ………………………. MCA Para Medical
( Branch Name)
Passport Size
Photograph of the
student
Passport size
Photograph of the
Co-applicant/
Guarantor
B. Ed., Nursing Others
(specify)
(Please tick (
) the appropriate box)
I we hereby apply for an educational term loan of Rs. ..................... (in words rupees
............................... ..............................................................................…… only) for pursuing higher
education (as per IBA Scheme) for which I / we furnish below the necessary details.
1. Personal information of the Student Applicant
i. Name in full (BLOCK LETTERS) Mr./Ms.
ii. Date of Birth (dd/mm/yyyy) iii. Age: (Years) (Months)
iv. Gender
 Male  Female
v. Nationality –
1. Indian
[
2. Others (specify)
vi. Occupation, if any (furnish full details)
vii.
Marital status
 Married  Unmarried
 Widow/Widower
If married, No. of children:
viii Community (for statistical purpose only)  SC  ST  OBC  Others Whether Physically
Handicapped - Yes / No
ix. Minority community
(If applicable)
 Sikhs  Muslims  Christians  Zoroastrains  Neo-Buddhists
x. Name of the Father/Husband
xi. Personal identification
1. Passport No:______________date & place of issue
2. Voter ID. No.______________
3. IT PAN Card No.______________
4. Driving licence No.__________
xii. Telephone/Mobile No.
(with STD Code)
xiii. E-Mail id. 1. 2.
xiv. Address for communication (submit proof)
House No/Name_________________________
Street _________________________________
City/Town .........................................................
Dist. ..............................................................
State _________________________________
Pincode
Permanent Address: (submit proof)
House No/Name_________________________
Street _________________________________
City/Town .........................................................
Dist___________________________________
State__________________________________
Pincode
2
2. Educational details (from SSC / SSLC onwards*)
Examination Passed Name of Institution/University
Year of
passing
No. of
attempts
% of
Marks
Class/Division
obtained
i. SSC
ii. H. Sc.,
iii. Degree
iv. PG
v. Others (Specify)
* Please enclose the mark list of the last examination cleared, duly attested.
3. Particulars of scholarships/prizes awarded for academic distinction
Name of the Examination Specify the academic distinction
Name of the
Scholarship/prize
Amount
Duration of scholarship
From To
4. Details of the proposed study
a. Name of the course
Diploma/ Degree / P G
b. Name and full address of the educational
Institution/University
c. Institution affiliated to and recognised by
which University (Mention the name)
- Recognised by concerned national level
Body (Mention name of the body).
d. Duration of the course _____Years From __________ (month) _______ (year)
To __________ (month) _______ (year)
e. Nature of course Full Time / Regular Part Time
(a) Nature of admission  Common Selection Process conducted by
Approved body
 f. Management quota
(b) Whether course offered by the
Institution is approved by University &
National level body concerned. Yes  No 
5. Details of Fees/Other Expenses payable Rs. per annum
(submit the letter/estimate given by the institution)
Particulars I Year II Year III Year IV Year V Year TOTAL
i. Tuition Fees
ii. Cost of Books,
Stationery, etc.
iii. Cost of Equipment
iv. Examination Fees
v. Hostel Expenses
Room Rent
Mess Charges
Sundry Charges
vi. Others (please specify)
TOTAL
3
6. Sources of Funds (Margin)
A. Own sources Rs.
7. Generation of funds for
repayment
i. Non-repayable scholarship (Furnish copy of sanction)
ii. Repayable loan scholarship (Furnish copy of sanction)
Projected monthly income
after completing the
course
Rs.
iii. Funds available from family sources (Attach proof)
iv. Fee concession under ‘First Graduate in the family’
scheme or any other scheme
v. Others – Please specify
B. Bank Loan required (Net of margin)
Less:
Anticipated monthly
expenses
Repayment for loan
scholarship/other expenses
TOTAL
Balance amount available
per month for repayment
of the loan
7. Particulars of the Co - applicant (Parent / Guardian) & Guarantor (Third Party)
Particulars Co-applicant(Parent / Guardian) Guarantor (Third Party)
i. Name (BLOCK LETTERS)
ii. Father/Husband’s name
iii. Relationship to the applicant
iv. >Date of Birth (dd/mm/yyyy)
>Gender
v. Occupation  Employed  Self-employed
 Professional  Business
 Employed  Self-employed 
Professional  Business
vi. Employment details (Please furnish designation, full address of Employer/Office with Telephone / Fax / e-mail)
Particulars Co-applicant Guarantor
1. Name of employer
2. Govt./Public Sector/Private/MNC
3. Designation
4. Gross salary p.m.(latest)$
5. Take home pay (latest)$
6. Date of retirement
$ Please enclose latest salary certificate
vii. If self-employed/ profession/ business, please furnish details (enclose IT/sales tax return, or any other proof)
a. Nature of business
b. Proprietor / Partner / Director
c. Turn over during last year Rs. Rs.
d. Gross income Rs. Rs.
e. Net income Rs. Rs.
f. No. of years in the current
business
4
viii. Permanent Address for communication (please submit proof)
Co-applicant
.................................................................................
...................................................................................
................................................................................
City/Town.................................................................
Dist. ..........................................................................
State ........................................................................
Pincode ...................................................................
Telephone (with STD code).....................................
Mobile No……………………………………………….
E mail .......................................................................
Guarantor
.................................................................................
..................................................................................
.................................................................................
City/Town .................................................................
Dist. ..........................................................................
State ........................................................................
Pincode ...................................................................
Telephone (with STD code).....................................
Mobile No……………………………………………….
E mail .......................................................................
ix. Present Monthly Income (Rs.)
(Income certificate from appropriate authority is
mandatory)
Gross Deductions Net Gross Deductions Net
Self Self
Spouse Spouse
Other sources Other
sources
Total Total
Approx.
monthly exp.
Net surplus
available
x. Number of dependants Number of dependants
xi. Personal identification
1. Passport No:
_________________
Date & place of issue
_________________
2. Voter ID. No.
_________________
3. IT PAN Card No.
_________________
4. Driving licence No.
______________
Personal identification
1. Passport No:
__________________
Date & place of issue
__________________
2. Voter ID. No.
__________________
3. IT PAN Card No.
__________________
4. Driving licence No.
_________________
8. Litigations, if any, against the applicant/co-applicant/guarantor
Student Applicant  Yes  No Co-applicant  Yes  No Guarantor  Yes  No
(If yes, please furnish details like name(s) of the financier(s), bank(s), date of filing suit, amount of suit, court/forum in which suit is
filed, present position, etc)
Student Applicant Co-applicant Guarantor
9. Particulars of securities offered
Nature/Type of security Location Sy. No. / D. No. Value of Security In whose name held
i.
ii.
iii.
iv.
5
10. Details of existing bank a/c of applicant/ co-applicant/ guarantor
Nature of account Name Account
Number
Name of the Bank/
Branch
I Applicant
II Co-applicant
III Guarantor
11. Other Information
a. Name of nearest Branch of Indian Bank and distance from residence in
kms:______________ ____kms
b. Name of nearest Other Bank branch and distance from residence in kms:_____________
_____kms
d. Particulars of loan availed by the applicant/ co-applicant (if any) and his/her family
members:
Nature of Loan Loan Account Number Name of the Branch
1.
2.
3.
e. Particulars of loan availed by the guarantor:
Nature of Loan Loan Account Number Name of the Branch
1.
2.
3.
f. Names and address of nearby known persons for reference
Name: Name:
Address: Address:
Tel. No. Tel. No.
12. Coverage under New IB Jeevan Vidhya Group Insurance
I/ We require / do not require life insurance cover under Group Insurance Scheme.
I/ We request that applicable insurance premium may be sanctioned as part of educational loan /
may be debited to my S.B.A/c No.____________________.
We hereby agree and consent to the bank for the disclosure of all or any such
1. Information and data relating to the applicant/ co-applicant’s obligations in any
credit facility granted / to be granted by the bank while doing pre sanction/ post
sanction follow up
2. To communicate through telephone/ mobile/ E-mail in case of default if any,
committed by the applicant/s in discharge of their obligations.
3. As the Bank may deem appropriate and necessary, to disclose and furnish to
Credit Information Bureau (India) Ltd., and any other agency authorised by
Reserve Bank of India, in this behalf.
6
We will repay the loan in ______________ monthly instalments after the study and holiday
period.
................................................. …........................................
(Signature of the Student Applicant) [Signature of the Parent/Guardian (Co-applicant)]
Place: Place:
Date: Date:
I agree and undertake to stand as guarantor, if the loan is sanctioned.
...................................
(Signature of the Guarantor)
Place: Date:
CONSENT LETTER – ‘NEW IB JEEVAN VIDYA SCHEME’
To
Branch Manager Date:
Indian Bank
_________________
Dear Sir,
I, Mr / Ms _______________________________________ on availment of Educational Loan
from your Branch, hereby give my consent to become a member of the group insurance scheme
New IB Jeevan Vidya,Scheme.
Details:
Name (in block letters)
Date of Birth / Age
Loan Sanctioned (Rs.)
Single Premium (Rs.)
The premium amount may be included as part of educational loan amount and sanctioned or
may be recovered from my S.B.a/c No. ____________________________ (at the option of the
applicant)
................................................................. …......................................................................
(Signature of the Student Applicant) (Signature of the Parent/Guardian (Co-applicant)
Place: Place:
Date: Date:
7
DECLARATION
I hereby apply for an educational loan from Indian Bank to the extent indicated in the
loan application form. I declare that I have not availed any educational loan from any other
bank/financial institution. I declare that the foregoing particulars and information furnished in
this application are true, correct and complete and that they shall form the basis of any loan
Indian Bank may decide to sanction me. I confirm that I have no insolvency proceedings
against me nor I have been adjudicated as insolvent.
I agree that Indian Bank may at its discretion conduct enquiries in respect of this
application. I undertake to provide any further information that the Bank may require at any
time in future. Indian Bank will be at liberty to take such action, as it may deem necessary if
the above statements/information are found to be untrue/ incorrect. I agree that the Bank
shall have the sole discretion to reject the application or reduce the loan amount without
assigning any reason therefor.
I further agree that my loan transactions are governed by the rules of Indian bank that
may be in force from time to time and undertake to abide by the terms and conditions
governing the grant of loan under this application.
I further agree to apprise Indian Bank, details about my academic progress, details of
aid / financial assistance received from all sources if any during the course period,
completion of course and job placement.
I declare that I have availed/ not availed interest subsidy on educational loan for my
Graduation course under _________________scheme.
I will not participate in an unlawful activity which would debar me from pursuing the
studies.
I will not, without bank’s permissions, change the course of study or place and institute
of study.
I will keep the Bank informed of the change of address or mobile number or e-mail id
whenever made.
................................................................. …......................................................................
(Signature of the Student Applicant) (Signature of the Parent/Guardian Co-applicant)
8
APPRAISAL FORM
IBA Scheme/ Non IBA Scheme
1. Date of receipt of loan application : Final Reply:
Details of Fees/Other Expenses payable (as per the letter/estimate given by the institution) Rs. per annum
Particulars I Year II Year III Year IV Year V Year TOTAL
i. Tuition Fees
ii. Cost of Books, Stationery, etc.
iii. Cost of Equipment
iv. Examination Fees
v. Hostel Expenses
Room Rent
Mess Charges
Sundry Charges
vi. Others (please specify)
vii. Insurance Premium
TOTAL (A)
2.Own/other funds (Margin) I Year II Year III Year IV Year V Year TOTAL
i. Non-repayable scholarship
ii. Repayable loan scholarship
iii. Funds from family sources #
TOTAL (B)
I Year II Year III Year IV Year V Year TOTAL
3. Bank Loan (A minus B)
# Funds from family sources is arrived as under
Name of the member of the family Age
Relationship with the
applicant
Net Annual
Income
Source
i.
ii.
iii.
iv.
v.
Total
While computing family income, the income earned by the applicant, his father, mother and their
dependent children, from all sources, inclusive of income received in kind and unearned income, if
any, is taken into consideration and verified. The family income is within the ceiling laid down under
the respective scheme, if any.
_____________________
*Strikeout whichever is not applicable
9
APPRAISAL FORM
4. Security: The loan will be secured by
i. Primary Security
Nature/Type Value/Networth Held by Mode of charge
ii. Collateral Security (including guarantee of parent/guardian/third party)
Nature/Type Value/Networth Held by Mode of charge
5. Documents*
i. * Single/Joint Demand Promissory Note
ii. D 61 (Revised) - Agreement for Educational Loans
iii. F 172 – Declaration by the student applicant and parent/guardian co-applicant/guarantor for
relatives working as Director/Officer/Staff in Indian Bank
iv. D 57- Agreement of Guarantee by Mr./Ms. ..............................................................................
v. On the minor student attaining majority, F 162 (modified) from the student applicant and
parent/ guardian co-applicant/ guarantor
v. Other documents as stipulated below:
a.
b.
c.
6. Rate of Interest
Upto Rs.7.5 lacs > Rs.7.5. lacs
Current BR 10.00% 10.00%
Add Tenor Premium 1.00% 1.00%
Add Spread 3.00% 3.25%
TOTAL 14.00% 14.25%
Current rate of interest 14.00%** 14.25%**
** subject to revision
7. Repayment schedule
i. Repayment should commence after the holiday period or immediately after the student
getting a job, whichever is earlier
ii. Holiday Period …….Years/months (that is course period of ....….Years plus *6/12 months)
iii. Principal repayable as under:
iv. Interest repayable as under:
Projected monthly income of the applicant after completion of the course Rs.
Less a. Anticipated monthly expenditure Rs.
b. Repayment on account of loan scholarship/ Rs.
financial assistance and other expenses _________ Rs.
Balance Rs.
_____________________
*Strikeout whichever is not applicable
10
APPRAISAL FORM
8. Disbursement Schedule
First disbursement after sanction and completion of all formalities Rs..
Insurance Premium Rs.
Second disbursement on/after ................................................... Rs.
Third disbursement on/after ........................................................ Rs.
Fourth disbursement on/after ..................................................... Rs.
Fifth disbursement on/after ........................................................ Rs.
TOTAL Rs.
The details and other information given in the application have been verified by independent
enquiries, and with reference to testimonials/certificates/documents, etc. Wherever necessary
comments have been appended. The request of the applicant/co-applicant for educational loan as per
the application is in conformity with the extant *RBI/IBA/Bank’s scheme in force. The loan is subject to
the terms and conditions stipulated herein and as set out in the various agreements/undertakings
prescribed under column 7 above
*Sanctioned/Recommended a term loan of Rs....................(in words rupees ........................................
...................................................................only) to Mr./Ms. .....................................................................
as per column 3 of the appraisal form with *fixed/floating interest at ..... % per annum (refer column 8)
with ............................... rests.
................................................................. .................................................................................
Officer in charge of Loans Dept *Recommending/Sanctioning Authority
Place: Place:
Date: Date:
For Zonal Office / Head Office Use
_____________________
*Strikeout whichever is not applicable
11
Check List to Educational Loan proposals under IBA Scheme for studies in India/Abroad
Sl
No
Particulars For studies in India
For studies Abroad
Whether furnished
1 2 3 * 4 5
1. Proof for residence
Xerox copies of Ration Card or Voters Identity Card or Passport or Electricity or Telephone bill or any such document acceptable to the bank.
Same as in
Col.3* Yes/No
2. Academic record
Copy of the X th std / XII th std mark list, for under graduates. Degree mark list / provisional certificate for post graduates.
Same as in
Col.3 * Yes/No
3. a. Date of birth/age
b. Community
(for statistical purpose only)
SSLC / TC / Mark list.
Community certificate
Same as in
Col.3 * besides
Passport.
Yes/No
4.
Family income
Salary certificate / Pension certificate/ Auditor’s certificate in case of business category / IT return filed / Income certificate from competent authority notified by State Government under ‘CSIS’ scheme
Same as in
Col.3 *
Yes/No
5. Admission
Admission letter / Bonafide student certificate from the College/University. Certificate / I 20 from the College / University. Yes/No
6. Fee structure /
Approval of institution
Letter / Certificate from the College/ University/
Affiliation/ Accredition details of the institution
Certificate / I 20
from the College
/ University.
Yes/No
7. Passport / VISA
Not applicable
Copies to be
enclosed. Yes/No
8. Co-obligation/
Guarantee
Parent’s / Guardian’s Co-obligation / Guarantors
details to be furnished.
Same as in
Col.3 * Yes/No
9. Collateral, wherever
required
LIC policy / Share certificates / Units of UTI etc..
In case of land/ building, valuation certificate from
Bank’s approved panel valuer and legal opinion
from Bank’s panel advocate will be obtained by the
branch directly.
Same as in
Col.3 *
Yes/No
10. Margin (Above
Rs.4.00 lacs)
For studies in
India : 5%
For studies
abroad : 15%
Details regarding source of funds for meeting the
margin furnished along with documentary evidence.
Same as in
Col.3 *
Yes/No
11. Declaration / affidavit
stating that no
Educational Loan is
availed from any other
bank by the applicant
and his parent
Available in the loan application and to be signed by
the student borrower and parent.
Same as in
Col.3 *
Yes/No
12. Documents to be
enclosed
(a) A & L of the student/ parent/ guardian /
guarantor
(b) Details of securities as in Col.9
Same as in
Col.3 * Yes/No
12
ACKNOWLEDGEMENT
Customer copy:
Application Inward No....................................
INDIAN BANK
______________________ Branch.
Received from Mr/ Ms. __________________________________________
residing at ____________________________________________________
____________________________________________________________
an application dated __________________________ for Rs.___________ under
educational loan scheme.
Brief details of proposal:
Additional information/ documents to be submitted:
Date:_______________ Branch Manager
Place:______________ (with Branch seal)