APPENDIX - 3


UNITED BANK OF INDIA
HEAD OFFICE : CALCUTTA

APPLICATION FORM FOR TERM LOAN
UNDER EDUCATIONAL LOAN SCHEME ( 2001 )
 

(NOTE : Application form to be read carefully before filling in Application should be submitted in duplicate)

                                                                                                                          Place :.....................
                                                                                                                          Date    :.....................

To
United Bank of India,                                                                                    PHOTOGRAPH

_______________________
    (Name of the Branch)



I hereby apply for an Educational Loan of Rs................................................................ repayable in .......................................................... monthly instalments beginning ...................................... years after the disbursal of the loan to enable me to prosecute higher education in ..........................................
   

2. BIO-DATA OF THE STUDENT:
(a)  Name in full                            :

(b)  Address                                 :

 

(c)  Date of birth and age               :

(d)  Nationality                              :

(e)  Is the student otherwise
      gainfully occupied elsewhere   :            Yes/No

      If yes, please give details         :
      of present occupation

(f)   Marital Status                         :            Married   [  ]     Unmarried   [  ]
      If married, number of
      children, if any

 

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(g)  Parents' Name in full               :
               i)   Father                      :
              ii)   Mother                      :

(h)  Guardian's name in full
      and relationship with               :
      the student

(i)   Address of father/parent/
     Guardian with Telephone          :
     No., if any,

     Permanent                              :

     Present                                   :

     Full Office Address                   :
     with designation &
     Telephone No.

3.  EDUCATIONAL QUALIFICATIONS
Examination Passed
   

Institution/University from which passed

Year of Passing

Percentage of marks ontained

Class Obtained

1   2 3   4 5




Mark Sheets of examinations passed as also testimonials from the College last attended to be attached.
4.  Particulars of Scholarship/Prizes won for academic distinction:

    a)    Examination                           :

    b)   Nature of Scholarship/             :
          Prizes

    c)   Amount                                  :

    d)   Duration of Scholarship              :

 

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                                                                  APPENDIX-3 (CONTD.)
5.  Parents'/Guardian's financial
     status/family particulars:
     a)   Occupation (Give full              :
           particulars)

     b)   Income per month                  :

     c)   If in service, the age               :
           of retirement

     d)   Number of dependants           :

     e)   Details of income of               :
           any other member of
           family, if earning

6.   Particulars of the course for
      which the loan is required             :

      a)   Name of the course                :

      b)   Duration                                 :

      c)   Institution/University                :

      d)   Detailed yearwise breakup of expenses
            including fees & other requirement:

      i)   Fees payable to College/School/Hostel                                      :

      ii)   Examination/Library/Laboratory Fees                                         :

      iii) Purchase of books/equipments/
          instruments/uniforms                                                                 :

      v) Caution Deposit/Building Fund/
          Refundable Deposit supported                                                    :
          by Institution Bills/Receipts

      v) Travel Expenses/Passage Money for
           studies abroad                                                                         :

      vi) Purchase of Computers essential for completion of the course     :

     vii) Any other expenses required to
          complete the course like study                                                   :
          tours, project work, thesis, etc.

          Funds avaiable from own/family                                                   :
          source including margin

          Amount of loan required                                                              :
          (Rate of conversion of Foreign
           currency taken is to be indicated here)
                                                  TOTAL                                              :

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      e)  Other Particulars                                                                       :

7.    Schedule of Disbursement                                                              :
       proposed by the applicant

 


8.    i)  Expected income per month                                                        :    Rs.
           after completion of course

      ii)  Anticipated monthly expenses                                                     :    Rs.
                                          Balance                                                      :    Rs.

          Amount avaiable for                                                                      :    Rs.
          repayment of loan                                                                        

9.    In case of students intending to
       go abroad, details of passport                                                           :

Note:   i)   Permission of the Foreign University
                      accepting the student for environment or
                      letter of addmission to the Foreign
                      University to be enclosed.

          ii)   Permission of the RBI Exchange Control
               Department should be produced at the time
               of submission of the application along
               with the Paasort and Visa of the Student.

10.   Any other useful information                               :

 

11.   Details of documents attached                            :
        a)                                                                     b)
        c)                                                                     d)
        e)                                                                      f)

12.  Details of securities offered                                   :
       (where applicable)

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13.  Particulars about 3rd party as Guarantor:
       (in case of 3rd party providing security)
       (A declaration by the Guarantor to be submitted as
       per specimen enclosed along with this application):

       a) Name                                                 :

       b) Residential Address                             :
           with Telephone No.

 

 

          and office Address                                 :
          with Telephone No.

 

       c) Occupation with designation                  :
           and other details

       d) Estimated worth                                    :


14.  Reference (Name and Address of two Referees
       (not related to you):
      1.

      2.

We hereby give the under taking that the borrower student shall follow all the rules and regulations laid down by the institution where he will be prosecuting studies and shall maintain such dignity and honour, as is expected of a student pursuing higher studies.

We further undertake that if the borrower student studying abroad takes up any part time employment, full particulars of such employment shall be intimated to the bank.

We also hereby undertake that the borrower student should inform the Bank of any financial aid, assistance-ship, scholarship. Sponsorship or any other assistance availed of by him at the time of applying for the loan or thereafter and of any other subsequent change in the financial position during the pendency of the loan.

We further undertake that full details of employment after completion of the course shall be furnished to the Bank by the student borrower.

 

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                                                                  APPENDIX-3 (CONTD.)

We certify that to the best of our knowledge and belief, the information furnished herein is true and correct. We promise to abide by the terms and conditions governing the grant of the Educational Loan by UNITED BANK OF INDIA. We also undertake to furnish the correct address from time to time.

 

SIGNATURE OF STUDENT (APPLICANT)

 

(SIGNATURE OF FATHER/GUARDIAN

SIGNATURE OF MOTHER/GUARDIAN)


  



 

 

 

 

 

 

APPENDIX - 3

 

UNITED BANK OF INDIA
HEAD OFFICE : CALCUTTA

 

NAME OF THE BRANCH:_______________________

 

Particulars about the Guarantor
(To be furnished by the Guarantor)
In respect of Educational Loan Proposal
of  Shri/Smt. ____________________________

(Name of Student applicant)

 

1.  Name                                       :


2.  Address                                    :


3.  Age                                           :


4.  Occupation                                :
       (Please give details)


5.  Approx. Annual Income               :


6.  Estimated net worth                    :
     indicating inter alia
     details of Fixed
     Assets and Liabilities,
     if any.

 

Dated:                                                                                                         Signature:.........................