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* marked fields are mandatory
Online Loan Application for Edu LOAN: Part - A (Mandatory)
Whether maintaining a/c with the bank* Yes No
If Yes, enter Account No.* Cust-Id    
Name of the Applicant*
Date of Birth(dd/mm/yyyy) *
E-mail Id
Telephone No.
Mobile No.*
Address : State  *
Sub-District *
Town/Village *
House No.
Social Category*
If under minority category
Residential Status*
Id Proof
Id Proof No.
Issuing Authority
Date of Issue(dd/mm/yyyy)
Valid up to(dd/mm/yyyy)
Address Proof
Address Proof No.
Issuing Authority
Date of Issue(dd/mm/yyyy)
Valid up to(dd/mm/yyyy)
Security Key*
Online Loan Application for Edu LOAN: Part - B (Mandatory)
Application No.
Type of Course Pursuing *
Admission Secured in College/ University (Name) *
Admission secured through* Merit Channel Management Quota
Total Estimated Expenditure for the Course*
Amount of loan required *
Branch preference, where Loan is required
b) District *
c)Branch Office *
Online Loan Application for Edu LOAN: Part - C (Optional)
Application No.
Father's/Guardian's Financial status/FamilyParticulars:
Relationship with the student
Address: a) State  
e)House No.
Office Address   
Pin Code
Mobile No.
E-mail Id
Residential Status
Applicant Statement of Assets and Liabilities, if any
Liabilities Assets
Outstanding Loans/Advances Amount Immovable properties Amount
Bank Land
Employer Building
Provident Fund Moveable properties
Relatives and friends Cash
Others Deposits with Bank
Investment in govt. securities
Total Total
Years at current residence
Income per month from all sources
Date of Birth
Date of retirement
Number of Dependants
Passport/Voter ID/Driving Licence Number
Additional details of the Applicant
Educational Qualifications (from S.S.C onwards up to date)
Examination Passed Institution/University Year of passing Percentage of marks Class / Division / Grade obtained
Details of the fees and charges for proposed course
Examination Tuition Fees(Rs) Boarding and Lodging Expenses (Rs) Books /computer/Travel/other charges(Rs) Total
1st year of course    
2nd year of course    
3rd year of course    
4th year of course    
Sources of finance apart from bank loan
Non-repayable scholarship/studentship/fellowship or other financial assistance
@ Rs. p.a. for years commencing from(dd-mm-yyyy) Rs.
Repayable loan scholarship or other financial assistance Rs.
Funds available from family sources@Rs. per year for
Requirement of Bank Finance
Whether availed Education loan or any other loan from any Bank or Financial Institution. If "yes", please give brief particulars of loan availed .i.e.
Date, Amount, Name of Branch and the amount outstanding      
Declaration :
The information given in the loan application is true and nothing has been concealed. The undersigned undertakes to inform the Bank any change in residence/ office address and to provide any further information that the Bank may require. The undersigned is aware of the charges/ fee to be levied by the Bank and agrees to pay upfront fee, documentation charges, etc. as applicable and charged by the Bank. The undersigned hereby agree to be bound by these terms and conditions or by the revised additional terms and conditions which may at any time hereafter be made while the loan obtained by me/us is still outstanding. Applicant authorises the bank to contact through mobile/SMS/email for the purpose of above Loan Application. Bank reserves the right to call for any other information/documents, if necessary, and/or reject the proposal without assigning any reason thereof
Online Loan Application for Edu LOAN: Final Submit (Mandatory)
Online Loan Application for Edu LOAN: Final Submit (Mandatory)
Application No.
@Copy right PNB