F 168 BANK OF MAHARASHTRA 'Lokmangal', 1501, Shivajinagar, Pune 411005. APPLICATION FORM FOR EDUCATIONAL LOAN Date____________ To. The Branch Manager BANK OF MAHARASHTRA _______________________Branch Dear Sir, I/My son/daughter/ward Shri./Kum. _______________________________________________ is undergoing _______________ his/her studies for _____________________________ degree/ desire to prosecute diploma at ___________________________________________________ Institute/University at ___________________________________ I request for that purpose a loan of Rs. __________ (Rupees ______________________________________________________________________) I agree to abide by your rules and regulations regarding such loans as existing or as may be changed from time to time. I am giving hereunder information in respect of myself, my family members, the Proposed sureties and declare that the particulars given hereunder are true and correct to the best of my belief. In case the same are subsequently found to be incorrect or in case the ward ./ student does not continue / prosecute his studies successfully or commits breach of any of Bank's rules or any installment remains in arrears, the bank shall be at liberty to recall the loan immediately and / or stop further disbursements of loan amounts as its discretion. Yours faithfully, 1 PARTICULARS OF THE APPLICANT Name _______________________________________ Age ____________________ Address ______________________________________________________________ Financial standing of the applicant Where applicant is in service Where applicant has his business / profession etc. 1) Serving as / Designation : _____ 1) Nature of business _____________________ Name of the office : __________ and address of shop / ___________________ Address of office : ___________ office etc. ____________________________ 2) Basic salary per month : Rs. ____ 2) His own capital investment Total emoluments : Rs. _______ in the business Rs. _________________ Basic salary and other allowances 3) Annual sales as per after deducting Provident balance sheet Rs. _________________ Fund and Income Tax Rs. _______ 4) If assesable to 3) Income of wife (if employed) : Income tax paid, Rs. __________________ Per month net Rs. _____________ 5) Annual sales tax, if paid Rs. __________________ 4) Income of other earning 6) Total profit of the family members net Rs. ________ business Rs. __________________ Total monthly income Rs. _______ 7) Business loan and Total annual Income liabilities etc. Rs. ___________________ of the family Rs. _______ (Please append a copy of the latest Balance Sheet) 5) Interest, dividend / etc. 8) Income by way of interest, annual income (net) Rs. ________ dividend etc. Rs. ___________________ 6) Income from landed property, 9) Income from landed House rent. etc. after deducting property / house rent Taxes and charges etc. Rs. ______ taxes, charges Rs. ___________________ 7) Total annual income Rs. ________ 10) Income of other earning family members Rs. __________________ 8) Life policy, if any. Rs. ________ 11) Total annual income Rs. _________________ Particulars of other earning family members 1) Name _________________ monthly Relation _______ Age earnings 2) Name _____________________ monthly Relation ________ Age earnings 3) Name _____________________ monthly Relation _________ Age earnings Particulars of Income from immovable property 1) If house property address : _______________________________ Municipal / Survey No. _________ Market value Rs. _________ 2) If agricultural land : Survey No. ___________________ Market value Rs. _________ Income from landed property Rent excluding taxes Rs. _________ 2 Agricultural Income less other expenses Rs. _________ Total Income Rs. _________ Details of house-hold expenditure (on monthly basis) Particulars about dependents Name Relation Age 1) House hold expenditure excluding house rent Rs. _______ 1) ______________________________ 2) House rent. Rs. _______ 3) Insurance premium Installment Rs. _______ 2) ______________________________ 4) Loan Installment. Rs. _______ 4) ______________________________ 5) Other. Rs. _______ Rs. _______ 5) _____________________________ Information about old loans Repayment plan for the loan applied Original loan amount Rs. Date of Loan taken. Rs. Installment amount. Rs. Period of repayment Rs. Total repayment to date Rs. Security for loan Balance of loan to be repaid Rs. for Installment Rs. _________ periodicity ( Monthly / Quarterly etc. ) years Source of repayment _______________ Security for loan _______________ Total : 1) 2) 3) 4) 5) 6) 7) 3) ______________________________ Whether the borrower, if employed, is willing to register a mandate with the present employer to deduct installment from his salary and remit directly to the Bank ? Whether the borrower is agreeable to assign life policy for the amount of loan ____________________________ Particulars regarding surety Name _______________________________ If employed : Emoluments less Providend Fun and income tax deduction Rs. Income from interest. dividend etc. Rs. ______ Income by way of house rent less taxes Rs. ______ Agricultural Income less C/RL expenses Rs. ______ Total Income Rs. ______ Address ____________________________ If doing business : Nature of business _________________ Own capital investment in the business Rs. _________ Annual sales as per B/S. Rs. _________ Net profit for the year. Rs. _________ House rent (less taxes) Rs. _________ Agricultural income (less C/RL expenses) Rs. _________ Income tax if paid, and the assessment year for which assessment is complete Rs. _________ Total Income Rs. _________ 3 Particulars of the student Name ________________________________________ Age ________________ Detailed Information about education and qualifications etc. Particulars from S,S,C, to degree Examination Year University / College Class / Marks Distinction 1) 2) 3) 4) 5) Expenses of the proposed educational course Name of the course____________________________________________________________ Fees Period Rs._____________ _____________ Expenditure on books Rs._____________ Instruments etc. Rs._____________ Boarding expenses Rs._____________ Other expenses Rs._____________ Total expenses. Rs._____________ Signature of the Applicants 4