DRUK PNB BANK LIMITED Photograph APPLICATION FORM FOR EDUCATION LOAN SCHEME (Please read the Application form before filling in and should be submitted in duplicate) To The Branch Incumbent, Branch Office Place Date 20 Dear Sir, 1. I hereby apply for a term loan of Nu calculated as under, repayable in monthly installments starting from years after the disbursal of the loan to enable me to pursue higher education in. The detailed relevant information as required by your Bank is provided below. 2. Personal Background of the Student: a. Full Name : b. Date of Birth/age : c. National ID No : (if ID card is issued) d. What is the Student doing Now : e. Marital status : Married/Unmarried, if married No of Children f. Present/Mailing Address : Permanent Address : Yue Geog Dungkhag Dzongkhag g. If you re existing customer of DPNB give your Customer ID No. : 3. Personal Information of Father/Guardian a. Name : b. Age c. National ID No : d. Telephone No : (Fixed) (Mobile) e. Permanent Address : Yue Geog : Dungkhag Dzongkhag Present Address : f. Relationship with student : (in case of Guardian) g. If you re existing customer of DPNB give your Customer ID No. : 4. Existing Educational Qualifications (from 10 th Grade on wards upto date DPNB/112 Page 1 of 5
Examination Institution/University from which passed Year of Passing Percentage of Marks Obtained Division Obtained (Please enclose copies of mark sheet and certificate of the latest examination cleared) 5. Scholarship/Prizes/Awards won for Academic Distinction: Examination Specify the Academic distinction for which Scholarship/Prize was awarded Name of the Scholarship/Prizes Amount of Scholarship/Prizes Duration of Scholarship From To 6. Father/Guardian s financial Status/particulars: a. Occupation (give full details) :. b. Date of Joining Service :.. (if employed) c. PF Account No :.. (if employed) d. Income Source :. e. Annual Income : Nu f. No of Dependents :.. 7. Particulars of proposed course for which loan is required: a. Name of the Course :. b. Duration :. c. Institution/University :. d. Other particulars: i. College/University fees: 1 st year of the course 2 nd year of the course 3 rd year of the course 4 th year of the course 5 th year of the course 6 th year of the course. ii. Essential Books DPNB/112 Page 2 of 5
Stationary items Equipments, Instruments Uniforms etc iii. Examination fees 1 st year of the course 2 nd year of the course 3 rd year of the course 4 th year of the course 5 th year of the course 6 th year of the course. Total : iv. Hostel fees/rent v. Food cost vi. Sundries cost Grand 8. Sources of Finance to Fund the Course: a. Funds available from family source :. b. Part scholarship, if any :. c. Arranged from other source :. d. Bank finance (Loan) required :. Grand 9. Other Information: a. Please state in brief how this proposed course going to help the student in improving the prospect of earning his livelihood. b. Expected Income per Month Expected Monthly Expenses Amount available for repayment 10. Details of Collateral Security Offered (Value should be atleast equivalent to loan amount required) Type of Property Area Plot/Thram/ Certificate/Dep osit No Present Value Location(give full address) Owner s Name DPNB/112 Page 3 of 5
11. Do you want to service the Interest accrued during study period (or repayment holiday)? 12. Any other useful Information:.. I certify that the information furnished herein is true and correct to the best of my knowledge and belief. I promise to abide by the terms and conditions governing this loan facility. (Signature of Applicant) CHECK LIST OF DOCUMENTS REQUIRED WITH AN APPLICATION 1. ID Card copy of Applicant 2. Passport Size Photograph (2 Nos) 3. ID Card copy of Guarantor 4. Consent letter from Guarantor 5. Pay Slip in case of Employed 6. Ownership Certificate of Collaterals 7. Valuation of Collaterals 8. Irrevocable letter from Employer 9. Copy of Course Prospectus 10. Admission Letter DPNB/112 Page 4 of 5
FOR INTERNAL USE OF DPNB APPRAISAL & SANCTION The application submitted by Dasho/Mr/Mrs/Miss has been scrutinized and found in order and the documents in the check list and the NOC from other Financial Institutions have been obtained. Therefore, education loan of Nu may be sanctioned which shall be repayable in installments with interest rate of % p.a at monthly rest. Any other comments from the Appraisal Official(s): Dealing Official Branch Incumbent (if it is not within his sanction power) Sanctioned by: Sanctioned on Place Branch Incumbent Management Committee/CEO/Dy.CEO/EVP Sanctioned on Place DPNB/112 Page 5 of 5