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APPLICATION FORM FOR EDUCATION LOAN

Loan Amount (in Rs.)

For Ofcial Use Only

Paste
Recent Passport size
Photograph of
Co-Applicant
(Cross Signed)

Paste
Recent Passport size
Photograph of
Student
(Cross Signed)

Prospect ID:

Product Group:

Branch Location:

Application Number:

Sourcing Channel:

Student Details

A
1)

Name:

2)

Fathers / Spouses
Name:

3)

Date of Birth:

6)

PAN No.:

9)

Current Residential Address:

First Name

Surname

Middle Name

First Name

Surname

Middle Name

4) Gender:

Male

5) Marital Status:

Female

Married

Unmarried

8) Passport No.:

7) Aadhaar No.:

Landmark:
State:

City:
10) E-mail ID:

PIN Code:

11) Landline No. (Permanent Residence):


13) Educational Details:

12) Mobile No.:


(STD)

(NUMBER)

Year Completed Marks (%)

Exam / Course

Country:

14)

School / College / University

Name of Entrance Test

10

a)

12th

b)

th

Last Degree

Score

c)

(if any):

Specify:

Course Details

B
1)

Admission Status:

2)

University/College:

4)

University/College City:

5)

Course Duration:

7)

Type of Course:

Awaited

Conrmed

3)

6)

years
Management

Certicate Courses

India

Country:

State:

Medicine

Name of the Course:

Full Time

Engineering

Other

(specify) :

Distance Learning

Part Time

(Specialisation):

Other

(Pilot, Clinical Research, etc)

UK

USA

(Specify):

Loan Details

A) Purpose

Amount (Rs.)

1) Tuition Fees

B) Funds Available
1) Own Sources

Amount (Rs.)

(Details)

2) Living Expenses Including Hostel & Food Expenses


3) Traveling Expenses

2) Scholarship

4) Others (Specify):

3) Others (Specify):
Total of A

Total of B

Loan Required (A - B) = Rs.

Details of Security Offered

1) Security Offered:

Yes

2) Type of Security Offered I:


FD

No
Residential

Property Funded by HDFC

2) Type of Security Offered II (if any):


Commercial

Others (Specify):

Plot

Plot

3) Property Address:

4) Current Value (Rs.):


5) Security Owned By:

4)Current Value (Rs.):


5) Security Owned By:

Reference of Student
1)

Name:

2)

Address:

3)

Personal E-mail ID:

Residential

Commercial

Property Funded by HDFC

Others (Specify):

3) Property Address:

FD

(Note: Reference should be known to the student for more than one year.)

City:
4) Landline No.:

State:

PIN:
5) Mobile No.:

Co-Applicant Details
1)

Relationship With Student:

2)

Name:

3)

Fathers /
Spouses Name:

4)

Date of Birth:

Father

Mother

Brother

First Name

Surname

Surname

Middle Name

5) Gender:

PAN No.:

Relative (Specify):

Self

Middle Name

First Name

7)

Spouse

Sister

Male

Female

Single

6) Marital Status:

Married

Other

9) Passport No.:

8) Aadhaar No.:

10) Current Residential Address:

Landmark:

City:

State:

Country:

PIN Code:

11) Permanent Residential Address:


Landmark:
City:

State:

13) Landline No. (Permanent):


(STD)

(NUMBER)

14) Mobile No.:

15) Personal E-mail ID :

16) Qualications:

Diploma

Under-Graduate

19) Current Residence:

18)

Bank Details

Years in Current Residential Address:

Family

Self Owned

Doctorate/Post Graduate

Graduate

17) Number Of Dependents:

Country:

PIN Code:

12) Landline No. (Current):

Years

Rented

Provided by Employer

(Where salary is deposited or your main account)

Name of Account Holder

Branch

Name of Bank

A/C Operated Since

Account Number

1)
2)
3)

Employment / Business Details of Co-Applicant

Employed

Self Employed

1)

Occupation:

2)

Name of the Employer / Business:

3)

Address of the Employer / Business:


City:

State:

4)

Landline No. of Employer / Business:

5)

Designation / Profession:

Country:

PIN Code:
Ext. No.:
(STD)

Others (Specify):

Retired

(NUMBER)

6) Ofcial E-Mail ID:


Years

8) No. of Years in Current Employment/Business:

7)

Age of Retirement:

9)

Gross Monthly Salary / Income Rs.:

11)

Other Monthly Income Rs.:

10) Net Monthly Salary / Income (After all deductions) Rs.:


(Specify):

Financial Information (In Rupees)


Student

Co-App.

A) Assets

Co-Applicant

Student

B) Liabilities

Outstanding Amount Monthly Installment

Outstanding Amount

Monthly Installment

1) Home Loans

1) Bank Balances

A/C #
2) Personal Loans

2) Fixed Deposits

A/C #
3) Car/Two Wheeler Loans

3) Investments
(Stocks/Bonds/Mutual Funds)

A/C #

4) Immovable Property

4) Credit Card:

(Current Value) (House/Land/Farm)

Card #
5) Loan From Employer/
Other Loans

5) Other

Reference of Co-Applicant
1)

(Note: Reference should be known to the co-applicant for more than one year.)

Name:

2)

Address:

3)

Personal E-mail ID:

City:
4) Landline No.:

PIN:

State:
5) Mobile No.:

Declaration

Signature of Student

Signature of Co-Applicant

Mar. 2016

1) We declare that all the particulars, supporting documents and information provided in this Education Loan Application Form are true, correct, completed and up to date in all respect as per our best knowledge and we have not withheld or misrepresented any
information mentioned herein. We hereby undertake to indemnify Credila Financial Services Private Limited (Credila) for any losses or damages that may arise on account on any material misstatement, mis-representation or gross negligence in providing the
particulars, supporting documents and information therein. 2) We have read the Education Loan Application Form and are aware of all the terms and conditions of availing nance from Credila and conrm having received comprehensive and detailed information
regarding Credilas Education Loan scheme & fees, charges, costs etc., payable by us in relation thereto and we have understood and agree to abide by the same. We are also aware that fees paid by us are non refundable. Fees will not be refunded in case of
rejections/withdrawals of Education loan application. 3) We authorize Credila, its associate companies, agents, agencies, partners educational institutions, credit reporting agencies and any other entities to share information and authorize to verify any information
such as enrolment verication, residence verication employment verication, telephone verication, CIBIL or Credit repayment history check, document verication, reference checks etc. We unconditionally agree and accept that such data which is so provide and
inconsistent with, may be construed as fraud/cheating/forgery/manipulation/fabrication of documents against Credila, and agree that Credila shall have every right for reporting such Fraud to RBI and/or any other entities/authorities and shall have liberty for not
processing your Education loan application/rejecting the education loan application and also taking the necessary action as suggested by the RBI/or any other entities/authorities. 4) We authorize Credila to exchange and/or share all the information relating to our
loan details and repayment history information with other Banks, Financial institutions, companies, etc. for any purpose and shall not hold Credila responsible and/or liable in any manner hatsoever, for sharing this information. 5) We acknowledge that rate of interest
on the applied loan to Credila is oating and would be dependent upon market factors, which would be subject to change from time to time, and also include factors such as the students, co-applicants and guarantors risk prole, quality of collateral provided and
other risk verication checks done as per Credilas norms. 6) We understand and acknowledge that Credila would not be able to process our Education Loan application until all information as per the companys credit and underwriting norms is provided by us and till
all verications and checks are completed. Further we agree and understand to fully co-operate with the company or its ofcers or its agents in complying with the same, without demur or protest. 7) We understand and acknowledge that Credila shall have absolute
discretion to reject our Education Loan application and that Credila shall not be responsible/liable in any manner whatsoever to us for such rejection, or any delay in notifying us of such rejection including any costs, losses, damages or expenses or consequences
caused by such rejection of our Education Loan application. 8) We declare that we have not availed an education loan for the further studies of the student from any other bank/nancial institution. 9) We undertake to inform Credila regarding change in our
residence/employment and to provide any further information that Credila may require from time to time. 10) We conrm that we have had no insolvency proceedings initiated against us nor have we never been adjudicated insolvent.