*****::** * ' * * * * : * * : * * * * * * * * ******'*******************

Signature Authentication

To,
The Manager,
Services Limited
HDFC Credila Financial Private Limited)
Financial Services
(Fomerlyknown as HDFC Credila

Date:
Savings/Current Account no.
having a
KET GUPTA is and
This is Mr/Mrs. CHITRA is operative since
at branch. The Account
our
O353O5000 692 our records.
matches with his/her signature as per
his/1cr signature given below

Narne: Mr/Mrs. CHITRA KET GUPTA

A/c No.: O35305000 692

Account Holder Signature:

Ver fied By:

KouhmConn DBM Designation

Name

BANA
Signature with RubbeStamp
APPLICATION FORM FOR EDUCATION LOAN
HDEC
CREDILA
EGD.
PONT
OFFICE ANDER.KURLA POAD, EXT TO
HINOOR CONTINENTAL ANDHEM (EAS) MUMBAI

00 097
he EducationLoan Specihlist ONPOATE IDtNTTY MUMBR U47190M2004P CI59411
HOFC CREDILA FINANCIAL SERMCES LIMITED
TEL21-28244 int FAR Ms ro

Prospect ID PrOduct Group.-

Banch Lotaon APplicotlon Number

Applied Lean Amount (in R).

SourcgChannel.

STUDENT DETAILS
1. Name
Fast NaTe Middle fiomme Sutname

4 ather's / Spousc's
Nar
Middle Name SUrndme
First Name
3. Mother's Name:

First Name Surname

4. Date of Birth| U5.GenderMalFemaleOther 6. Marital StatusMariedSingloOther

. Passpot No:
.PANNoUILU L U 8. Aadhaar No X|x|x|x|xxxx|||U
.

10. CKYCNo II O U
11. Current Residential Address -

Landmark

City tate PIN Code Country:

12. E-mall lD. -

Landine No (Petmanent Residence) 14. Mobile No..

13.
15. Educational Details
||
STD
II1D
pUMOC
EXAM /COURSEYEAR coMPLETED MARKS () SCHOOL/ COLLEGE/ UNIVERSITY NAME OF ENTRANCE TEST SCORE

12
DEGREE
NAME OF DEGREE:.

B COURSEDETAILS
1.
Admission Status Confirmed Awalted 2. Universty/College: -

3. Name of the Course. . University/College City-

State.
5.
CeuntradaUSACanadaotheroo 6. Course Durauon:. years

7. Full TimePartTimeDistance Leaning 8. Type of Course:Engineering(Specaksalent

ManagemenOther (Soec
C LOAN DETAILS
A Purpose Amount () 8. Funds Available Amount ()
1. Tution Fees
1. Own Sources Dotais)
2. Living Expenses Including Hostel & Food Expenses

3. Travelling Expenses 2. Scholarship

4. Others (Specity 3. Others (Specy-

Total of A Total of B|
Loan Required (A -B) = R

DDETAILS OF SECURITY OFFERED

1. Security OfferedYes N o
Type of
Security Offered I tan Residential Commercial
2. Type ofSecuntyOferedtResidentialCommerciaPlot Plot F PropetyMortgaged with HOFC
D Pary Montgaged with HoDFeOesSpesty)
Others 6oo
. FTOperny A c d r e s s -
.Property Address.-

4. Current Value (Rs) 4. Current Value (R5.)}.

Securlty Owned By. | 5. Securlty Owned By.-
E REFERENCE OF STUDENT Note: Reftronce shoulu Ee known to the state tfar mate "ialt e eti
Name
Address.-
City. ate PIN:-
3. Personal E-mail lD- 4) Landline N. - 5) Mobile No.

******************************************************************** "-**-

SAVEINCOME TAX
With HDFC Credila's Education Loan you can get Income Tax Benefits Under Section 80E
Aneducaden loan not onl funds your hgher stucies but also helps you save tax. The interest paid on the educetion loan can be claimed as deduston, as per
Section 80E of the Income TaxAct of lndia, 1961

However to avail the income tax benefits, the education loan should be taken from any of the scheduled banks in India or below 2 Gazete Notified Financial
insttutions as per the Income Tax Act of India,1961

HDFC Credila FInanclal Services Limited

HDFC Ltd. CAppy Consult Income Tax Advisar for Further Detais
 F CO-APPLICANT DETAILS
1Beintomnp Wonh St.denhe hetpoussereltieGUPTA
e
by 2.

3.
Name

Fbther's / Spouse
t Nahe Mdle Hame

NATH GUPTA
KAASHI
Nme e t NwTe he Name Surname

DEV
DEEPA
4. Mother's Narme
w41e Nam Surneme
irst N

5. Dnlte of Brth 3 o | ] 6GrnderMneFomaleother 7 Martl Status MariedSingleOther

10. Passport No
8. PAN NO A:|POF3000 ,. Andhnar No X XXXXXXX|I
11. cKYC No ] 20unldfcationsUnder.GndunteoblonaGndusteDoctorate/ P
13. Current Residential Address
NA LIG 38, SHARDA BIHAR, WARD 7

Lendmark
KORBA State PIN Code 5||| Country INDJA
ity
14. Current Resldence Self Owned Fomly Provided by Employer Rented
1. Permanent Residential Address: . LIG 38, SHARDA BIHAR, WARD 7
Landmark:
ty KORBA - StateHHATTISGARH PIN Code: 5 7 Country NOIA
16. Londline No (Current) U UI 17. Londllne No. (Permanent: FI II
wwBER)
MOER
18. Mobile No.91 0 P E 0 0 0 0 0 19. Personal E-mail ID CHITRAKETGUPTA@GMAIL.cOM

20 Number of Dependents 21, Years In Current Resldentlal Address. 2 0

G BANK DETAILS

Name of AccountHolder Name of Bank Branch

Account Number MICR Code
1.CHITRA KET GUPTA ICICIEBANK 035301512762 495229302
2.MS.EQUIPMENT CARE ICICI BANK 035305500353 495229302
H EMPLOYMENT/BUSINESS DETAILS OF CO-APPLICANT
1.
OccupationEmployed Self Employed Professional pe Lawet, Docto CA. etc) Retred others (5pecilyt
2. Name of the Employer/ Business:MS-EQUIPMENT CARE
3. Address of the Employer/Business LIG 38, SHARDA VIHAR, WARD 7

C ORSA State: HHATTISGARH - PIN Code: | | 5 | e | 7 | ] Country:DA

State
Landline No. of Employe: / Business
TD)
E 1 NUM6ER)
Ext. No:: U
Designation / Profession: oeauTE 6. Official E-Mail ID-

Age of Retirement: Years 8. No. of Years in Current Employmen/Business:

9. Gross Monthly Salany /Income o1614 10. Net Monthly Salary /Income: 80000
NA
11. Other Monthly Income (Specity-
FINANCIAL INFORMATION (IN RUPEES)

StudentCo-ApR Outstanding
Student
Monthk
4 APP:
A) Assets B)Llabilities Amount Installmen telmet
Amouin
.HomeL
1. Bank Balances
AVOled tror

2. Fixed Deposits 2.PelsonalEmployer/ other Loans

Avaled rom- 0
3. Investments/ Other C a / Two Whecler Loans

tckRondaununl Fnd v a e d from-

4. Immovable Property 4CredtCard

n e t VaowavandFaim) Avaled from

J REFERENCE OF CO-APPLICANT Note: Relorence sthoa d be knozm to the fo-ianitart lor more thw ow yei
Name: CHETAN GUPTA
2 Address:o 14 ARDA VIHAR KORBA
City. KORBA State: HAHSGARE PIN: 495677
Fesonal E-mall ID: 3. Moblle No.: +91 0764102
Landline No.
DECLARATION
iWe deciare thet li the patculers, suppoting documents and u tormallon pravided in the epplicatlon fomare iue cote
eicn 2) We hercby undertako to indcmrity HDFC CIcdih Finincial Sevvices LImited HDFC Crocila") for ny koss of dats in ary electronic format, any losses or damages that may arito on Account of a malerai a a t

egring HDFc Crnda'sedcaben oan proces s mentione d cn HDFC Credda's webste alang wth Falr Pracice Code and hereby agee to the Rde ol itees fees ca r n em and conaben
e eny do meion auchasenromect vertficalion resienreeverfiealian enninet veiliali a h r
entty to verity O o r ngons, cre reporing agencles ard any othe
y 6 n8y beiequredby law. cus tomary pra.tike Tvdl teporing statitical anaysis and cedt sccring or verifcanon or n'sk manage
mient and stall not hok HDFC Credile Lable foru r Csdowtof

RB, andot an) o'ha entn y/a thorny and thall tako norossary action as coemed ft 6| We are aware that HDEC Credla offers oducationloan under hoatnaratoaaion andera a s ah Er

y oy in notlyog us of such epcton dudng any costs.losses, danages or espenses cr consequerces caused Dy such reiesuon cf c dceton aci nar ssov us er suh reection
Uon, or

e io ime 10we r e a h e lo inorm HOC Credda regarding dhangein our residence employment and to provide any lurther inkomaion that HDFC Creda may require from
enereoY CserA or HoPC Credla to teceyu KYC infomalion Irom CentralKYC Reglstry or from UIDAL 12) LWe hereby. authorize HDFC Credio.ts channel oatsert A0enclet awoe a a s to ed

Pws in rel Mon to the unsolcited communication relered In "National Do Not CallAegstythe "NONC Regiseed down be TELECOM EGULAT
AT0aY AUTHOY OE oBaes ewe conm hat
e e ntmade any Peynert ir cesh.pearercheoue nd lonwth e d o e polcans anti dla does not inslat onprovicing the same. 14) UWe deciare and contem tnat We

Signalure of Co-Applicanl

Acknowledgement:
(To be retained by the HDFC Credila Financlal Services Limited)

Name of the Student/ Co-Applicant AAND FRAKASI

Dear Sir / Madam,

Thereby confirm that, I have recelved the

acknowledgement receipt of my education loan applicatlon

Date M0 Signature of Student / Co-Applicant:.

G
***************************************************8*********************************-*********************"** ****
Acknowledgement: Customer Copy
(To be given to / retairied by the Student/ Co-Applicant)

Name of the Student / Co-Applicont: K ANAND PRAKASH

Dear Sir/ Madam,

This is to acknowledge recelpt of your educatlon loan applicotion form. The oppllcation will be processed In 21 days after recelving a complete set of all required
documents with the supporting intofmation as may be requred by HDFC Credla for appralsal of the
application.
Date: IID For HDFC Credila Financial Services LImited-
HDFC BANK UMRN
1III IDate 10|o6|20|2|2
Tck SponsorBankCode HDF C0|00o o6 o JUity Code NACHOO000000001223
CREATE
AODIFYVWe hereby authorie DCCredila Financial Services Limited to debit (tick/) |S9/CA/cc/S8-NRE/S8-NRO/Other

ANCELBnk a/cmumber03 5 3 0 15 12 76 2 | ILLILLL)

with BankCICI BANKLTD or MICa
95 229 302
an amount of Rupees Fity Lakh
R5000000
FREQUENCY Mthly Qtly H-Yrly Yrly As&when presented DEBITTYPE Fixed Amount Maximum Amount
Reference 1 A2205100284 | Phone No.

Reference 2 AS127567 Email ID

PERIOD T t o r the dobit ef sndate processing tharzae by bank vhom I an aut horizing to deblt account aa por latest sehedule ot ebargee at the bank.

From 1106jf2]o|2|2]|
IIIU|
Or Until Cancelled CHITRA KET GUPTA
3.
his h to confrm that the thecbrat un has been carehuly read, urderstood & maae by me/ us.I am Aulhorijing the User entity/ Corporate to debit my accounk.
have undentosod that l am auethorised to tanseJamend thy mandaln by &ppropriately cbmimAunicating the cancerlatior/ amendaent reque to the Dher enlity/ Corporate or the bank where I nave auttiori ed the deb

HDFC BANK
ttgR TNOPC 8ANK LVITED
UMRN

Tck SponsorBankCode H|D|F|C|ooJolojo|6oJulityCode NACHO00000001223

CREATE wWe hereby authorize HDFC Credila Financial Services Limited to debit (tick) |SB/CA/CCc/s8-NRE/SB-NRO/Other
AODIFY
CANCEL Bank afe mumber
3|s|3|o|i|s|1|2|7|6|2|_II 1IUIU
with Bank ICICI BANK LTD sce I|IUorMCL9|s|2|l2l9|3|o|2|
an amount of Rupees Ten Lakh Thirty Thousand
J1030000
FREQUENCY Mthly Qtly H-Yrly Yrly As &whenpresented DEBITTYPE O Fixed Amount Maximum Amount
Reference 1 A2205100284 Phone No.
Reference 2 AS227567 Email ID
PERIOD
agr*e for the debit ot sandate proceso ng charges by aant vkoe i m authori zung to dabst y accoune * par ~ateat echadule ot ehargme of the baak .

From 1 1 0 6 20 2 2
Or Until Cancelled CHITRA KET GUPTA
3.
h s to cenrm tat the deron nas been caretuy read, urdenstood, & made by me/ us i an authoritng the Usr entv/ Corporate to orbt y count
a O tndtgm gutnorued to caelamend this mandate by appropralektmmun catig the rancetlation/ ame ndment requet tu the User entty/ Corporate or the bank wnete l have ultorard the deba.
 *** *..****

Memorandum Regarding signing

in vernacular
language/ by illiterate/blind person
Prasanjeet Bhowmik, adult and inhabitant of West Bengal India residing at HDFC
Credila Financial Services Ltd, Bharatiya Bhasha Parishad Building, 36 A
Shakespeare Sarani, Kolkata-700017 do hereby record as under:
I have read out and explained the contents of the Application form and the terms and
conditions as referred in the Education Loan agreement and all other ancillary loan
documents, contained herein ("Education Loan Agreement") dated
40/06/2022 from HDFC Credila Financial Services Limited hereinafter
referred as "HDFC Credila" by the Borrower (as defined in the Education Loan
Agreement) to Mr. / Mrs. CK AAND PRAKASH in Hindi language and he
she/they have confirmed that he / she / they has / have understood the same and have
agreed to abide by all the terms and conditions of the Education Loan Agreement and
the aforesaid other documents. Pursuant to the same the aforesaid person(s) is / are
affixing his / her / their signature(s) / thumb impression(s) as given herein below:

C: KHmon
I confirm that whatever I have stated hereinabove is true and correct to the best of my
knowledge and belief.

Signed by Declarant/s
Name/sS Signatures
CnITRA KET GUPTA

Date: 14/o 6/2 022

Place: West Bengal- Kolkata
**the Declarant should be branch/ relationship manager or a respectable person known
to HDFC Credila but not the borrower 1
INCOMETAXDEPARTMENT GOVT.OFINDIA
CHITRA KET GUPTA
KASHI NATH GUPTA
24/01/1973
anatAccount Nnber

AKBPG7268D
 wern

Chitra Ket Gupta

F af DOB: 24/01 1973
F MALE

8155 6758 0759

VID:91569773 1707 5986
AT HTEN, ART T6TT
 Unique ldentiflicationrAuthorty oftndia AADHAAR

TAT:
as 7, RAT, TAT,
THIG495677

Address:
38. SHARDA
S/O: Kaashi Nath Gupta, Lig
BIHAR, ward 7, Korba, Korba,
Chhattisgarh 495677

8155 6758 0759

VID:9156 9773 1707 5986
www.uldat.gov.in
1947 help2 uicdni.gov.in I