vijaya-bank_application-form

2-495

VIJAYA BANK (A Government of India Undertaking)

Head Office, Bangalore APPLICATION – CUM – PROCESS NOTE FOR LOANS TO STUDENTS To The Branch Manager Vijaya Bank, _____ Dear Sir, I request you to grant me loan / advances for undergoing the course detailed below: Details Sl No 1 Name of the Applicant 2 Address of the Applicant 3 Whether SC/ST/OBC, etc 4 5 6

Information

Yes / No (If yes, enclose certificate)

Date of Birth ____ years ___ months

Age

(Enclose Birth Certificate as proof of age)

Father/Guardian Name & Address Occupation Monthly Income

Rs. _____ (If guided by DRI, enclose income certificate)

7

8

9

Educational Qualification Degree Year Marks obtained (%)

Details of scholarship, if any

Details of the proposed course Name of the Duration of Name & Address of the Course Course College

Prospects

Details of estimated expenditure per annum Year

10

Division

Tuition Fee (Rs.)

Cost of text books / instruments (Rs.)

Hostel Fee (Rs.)

Examination Fee (Rs.)

Others

Total

(Rs.)

(Rs.)

Financial requirements a) In India Nature of facility Amount (Rs.)

Purpose

Repayment conditions

b) In Abroad Nature of facility

Purpose

Repayment conditions

Amount (Rs.)

VIJAYA BANK

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12

13

Details of securities offered SI. No. Details of Security

Market Value (Rs.)

In case of studies abroad, whether the admission is secured in the foreign university and whether the 'In Principle' sanction to release the foreign exchange is obtained from the authorised dealer / RBI? S.B. A/c. No.: Date of opening

14. Declaration a) The particulars furnished above are true and correct. b) The advance will be used for the purpose for which it is granted. c) Any change in my address for communication / contact will be intimated to you. d) My/Our banking business will be confined to your bank only and I/we will not borrow from any other bank / source during the currency of the advance with you, without your consent in writing.

APPLICANT Place: Date: 15

Particulars of the Guarantor Details Name Address Occupation / Profession Monthly Income Net Worth Liability Direct Indirect Declaration I / We am / are willing to stand as

I

II

Rs. Rs. Rs. Rs. guarantor/s.

GUARANTOR/S

Place: Date For the Branch Use: Report of the Branch Manager and Particulars of advance sanctioned / recommended Nature of Advance Amount Rs. Rate of interest Details of Security / guarantor(s)

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VIJAYA BANK

Repayment Conditions The applicant is not closely related to me / us. The applicant has a good academic record. The training / course has good employment potential.

Asst. Branch Manager Branch Manager Date -----------------------------------------------------------------------------------------Space for use by Sanctioning Authority Particulars of sanction / rejection:

SANCTIONING AUTHORITY

-----------------------------------------------------------------------------------------RECEIPT

Received the application from Sri / Smt / Kum _____ today for consideration.

SIGNATURE OF APPLICATION RECEIVING AUTHORITY Place: Date:

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