SCHOLAR LOAN APPLICATION FORM FOR SBI IIM AHMEDABAD BRANCH

PARTICULARS DETAILS

LOAN TO BE APPLIED Rs. (Max: Rs. 50.00 Lakh) Photo

COURSE NAME PGP BATCH: 2024-26

1 SBI SAVING A/C NO.
2 STUDENT NAME
3 FATHER NAME
4 MOTHER NAME
5 SPOUSE NAME (IF MARRIED)
6 CASTE GENERAL / ST / SC / OBC / OTHER
7 ANNUAL INCOME FROM ALL SOURCES Rs.
8
CURRENT RESIDENCE ADDRESS

9
PERMANENT RESIDENCE ADDRESS

10
OFFICE ADDRESS

11 CORROSPONDENCE ADDRESS CURRENT ADDRESS / PERMANENT ADDRESS

11 1) 2)
MOBILE NO. (SELF)
12 E-MAIL ID (SELF)
13 ALTERNATE MOBILE NO. (FATHER /
MOTHER / SPOUSE)
14 ALTERNATE EMAIL ID (FATHER /
MOTHER / SPOUSE)
15 EDUCATION % SCHOOL / COLLEGE NAME STATE NAME YEAR OF PASSING

SSC
HSC
GRADUATE
POST GRADUATE
16 1st REFERRENCE NAME, ADDRESS,
CONTACT NO., E-MAIL ID (OTHER THAN
FAMILY MEMBERS)

17 2nd REFERRENCE NAME, ADDRESS,

CONTACT NO., E-MAIL ID (OTHER THAN
FAMILY MEMBERS)

I/ We hereby apply for a loan from SBI to the extent indicated above of this application form. I / We declare that the
foregoing particulars and information furnished in this application form are true, accurate and complete and that they
shall form the basis of any loan SBI may decide to sanction to me / us. I/We agree and give consent for the disclosure
by SBI of all or any such; (a) information and data relating to me/us (b) the information or data relating to any credit
facility availed of/to be availed of by me/us and (c) default, if any, committed by me/us in discharge of my/our such
obligation, as SBI may deem appropriate and necessary, to Credit Information Companies (CICs) and any other agency
authorized in this behalf by Reserve bank of India / Government of India/ SBI.

Applicant’s Signature: ___________________________ Date: