State Bank of India

Xpress Credit Loan Application Form

Please read these instructions carefully before filling up the application form

1. Section-A (Personal Details) and Section-B (Employment and Income Details) are to be filled up and signed by the Applicant.

2. Completely filled up Section-C (Loan Details) and Section-E (Declaration) are to be signed by Applicant.

3. Please complete all particulars in BLOCK letters and tick boxes wherever applicable. In case of multiple options strike out whichever
is not applicable. All dates are to be filled up in DD-MM-YYYY format only

4. To ensure quick disbursal, please submit application form comprising Section-A, Section–B, Section-C and Section-E, fully complete
in all respect with relevant supporting documents as per Document Checklist given below

Document check list (Salaried Employee) Document check list (DSP-PMSP-ICGSP)

1. Application form duly filled by the borrower and submitted along
with 2 Latest Passport size photographs. 1. Application form duly filled by the borrower and submitted along
2. Proof of identity (Photocopies of PAN/Passport/Driver’s License, Voter with 2 latest Passport size photographs.
2. Proof of identity (Photocopies of PAN/Passport/Driver’s License,
ID card/ Aadhaar Card)
Voter ID card/ Aadhaar Card/simplified KYC) #
3. Proof of Residence (photo copies of recent Telephone Bills/
3. Proof of Residence (photo copies of recent Telephone Bills/
Electricity Bill/Property tax receipt/ Passport/ Voters ID card) Electricity Bill/Property tax receipt/ Passport/ Voters ID card) #
4. Copy of identity card issued by the employer. # (NOT REQUIRED FOR EXISTING CUSTOMERS)
5. Latest six months’ Bank Statement of the account where salary is 4. Latest six months Bank Statement of the account where salary is
credited. credited.
6. Last 6 months’ salary slip (optional*). 5. Last 6 months’ salary slip (optional).
7. Irrevocable Letter of Authority addressed to disbursing authority
8. Irrevocable Letter of Authority from the person authorized to disbursed
Salary and allowances
*. *Except for certain categories of employees where it is mandatory

(For Official Use):

Personal Loan Application No: cccccccccccccccccccccc Date: cc-cc-cccc

0 9 0 6 2 0 1 9

Bank Branch Code: ccccccc

2 0 6 5 Bank Branch Name: cccccccccccccc
H O J A I

Referral Group: ccccccc

O C A S Existing LOS Borrower : Yes/No

Sourcing Entity Type: Branch c MPST c Others c Source Code: cccccccccccccc

Source Officer Code: ccccccc Sourcing Officer Name: cccccccccccccc
LOS ID: ccccccc LMS/OCAS ID: cccccccccccccc
3 3 0 6 1 9 0 0 2 6 5 1

(TICK THE RELEVANT BOX BELOW)

Processing Fee Collected Y c N c N. A c Stamp Duty Collected Y c N c N. A c

SBI Life Sold Y c N c N. A c SBI Loan Insurance Sold Y c N c N. A c

SECTION-A (PERSONAL & KYC DETAILS)
cccccccccccccccccccccccccccccccccc
Name S O N U K U M A R S I N G H Gender cM cF

Salutation c Mr c Mrs c Ms c Dr. c Other cccccccccccccccc Date of Birth cc-cc-cccc

0d 2d 1 m 0m 1
y
9y 9y 3y

Marital Status c Married c Unmarried c Other Name of Spouse cccccccccccccccccccccc

Attach your recent
No. of Dependents cc No. of Children cc Name of Father/ Husband ccccccccccccccccc cc passport size
photograph here
Mother’s Maiden Name ccccccccc Nationality ccccccccc
I N D I A N Residential Status c Resident c Non Resident

Category c SC c ST c OBC c General Religion c Hindu (Non Minority) c Christian c Muslim c Sikh c Other Minority

Place of Birth ccccccccccc Disability type c No Disability c Physically Retarded c Visually Impaired c Other Disability
Please sign here

Education Qualification Attained ccccccccccccccccccc

G R A D U A T E Qualifying Year cc-cc-cccc

Driving License No. ccccccccccccccccccc Driving License Valid Upto cc-cc-cccc Please fill at least one
field in this box failing
Passport No cccccccccccccccccccc Passport Valid Upto cc-cc-cccc which the application
will not be accepted
PAN No. cccccc
F U E P S 6 cccc
3 8 9 P Voter ID No. cccccccccc Aadhaar No. cccccccccccc
House Ownership c Rented c Parental c Company Provided c Owned
Residential Address
Present Address: Staying at the present address for the past _________ Years and __________Months.

Proof Particulars ______________________________ Residential Proof No. cccccccccccccccccccc Date cc-cc-cccc

House /Flat / Apartment No. or Name cccccccccccccccccccccccccccccccccccccccc
R A I L WA Y C O L O N Y L A N K A

Street Name & No. and Area/Location cccccccccccccccccccccccccccccccccccccccc

Q U A R T E R N O . . G 3 2 B C

Landmark cccccccccccccccccccccccccccccccccccccccc
P O . L A N K A D I S T . H O J A I ( A S S A M )

City cccccccccccccc District cccccccccccccc

N A G A O N cccccc
Pin Code 7 8 2 4 4 6

State ccccccccccccccccc
A S S A M Country cccccccccccccccccccc
I N D I A

Telephone (Landline) cccccccccccc cccccccccc

Mobile (Primary) 7 9 0 3 0 1 4 6 2 0 Mobile (Secondary) cccccccccc
Email (Personal) cccccccccccccccccccccccccccccccccccccccccccc
S O N U S 9 7 4 2 @G M A I L . C O M

Permanent Address: Is permanent address same as present address? c Yes c No (To be filled if permanent address is different from present address)

House /Flat / Apartment No. or Name cccccccccccccccccccccccccccccccccccccccc

Street Name & No. and Area/Location cccccccccccccccccccccccccccccccccccccccc
Landmark cccccccccccccccccccccccccccccccccccccccc
City cccccccccccccc District cccccccccccccc Pin Code cccccc
State ccccccccccccccccc Country cccccccccccccccccccc
I N D I A

Telephone (Landline 1) cccccccccccc Telephone (Landline 2) cccccccccccc

Office / Business Address
Office / Business Address:

D of Org/Employer, Dept, & Floor

T
.L
N
Name cccccccccccccccccccccccccccccccccccccccc
I N D I A N R A I L WA Y C A T E R I N G A N D T O U R I S M C O R P

Street Name & No. and Area/Location cccccccccccccccccccccccccccccccccccccccc

R A I L WA Y C O L O N Y L A N K A

Landmark cccccccccccccccccccccccccccccccccccccccc
Q . N - G / 3 2 / B - C P O - L A N K A

City cccccccccccccc District cccccccccccccc

N A G A O N cccccc
Pin Code 7 8 2 4 4 6

State ccccccccccccccccc
A S S A M Country I cccccccccccccccccccc
N D I A N

Telephone (Landline) cccccccccccc Fax cccccccccccc Mobile (Secondary) cccccccccccc

Email (Organizational) cccccccccccccccccccccccccccccccccccccccccccc
Repayment Mode c Check-off c ECS (Electronic Clearing System) c PDCs (Post Dated Cheques) c SI (Standing Instruction) c Cash
Relationship with the Bank c Less than 1 year c 1 – 3 years c More than 3 years CIF No. cccccccccccccccccccc (To be filled by Bank’s official)
Reference (Names and address of two referees who are not related to you):
State Bank of India may Name: Name:
make enquiries from the Address: Address:
referees if it deems Pincode Pincode
necessary. Email: Email:
Tel: Mob: Tel: Mob:
SECTION-B (EMPLOYMENT & INCOME DETAILS)

Nature of Occupation c Salaried

Salaried Individual Salaried Individual

D
T
.L
Employer Name cccccccccccccccccccccc
I N D I A N R A I L WA Y C A T E R I N GEmployment
A N D Status T cO U R
Regular I c Probationary
S M C Oc Contractual
R P N

Total Experience cc Yrs cc Months cc cc

Years in Present Job 0 4 Yrs 0 8 Months Years in Previous Job (If Applicable) cc Yrs cc Months
Previous Employer’s Name cccccccccccccccccccccc Contact Number cccccccccccccc
Previous Employer’s Address cccccccccccccccccccccc Current Industry cccccccccccccc
DDO’S Designation _____________________________________________________________________________________

DDO’S Address _________________________________________________________________________________________________________________________________________________________

Organization Type c Public Sector Unit c Listed Private Company c Unlisted Private Company c MNC c Central/State Government c Others

Department cccccccccccccccccccccc Designation cccccccccccccc

Employee No. cccccccc Remaining Service cc Yrs cc Months
Website cccccccccccccccccccccccccccccccccc ccccccc

Defence Personnel Applicable only for Defence Personnel

DEFENCE ARMY c NAVY c AIR FORCE c GREF/BRO c RASHTRIYA RIFLES c ASSAM RIFLES c INDIAN COAST GUARDS c

PARAMILITARY BSF c CRPFc CISFc ITBPc SSBc

Personal/Force Number ____________________________________________________

In case of Army personnel, please furnish your regiment Name ____________________________________________________

Income / Financial Details Income / Financial Details

Income Details (Salaried) Income Head Gross Amount Net Amount Periodicity Mode
Salary RS. 29,900 RS. 24,400

Obligation Details Obligation Head Gross Amount Net Amount Periodicity Remarks

Bank / Financer Name Type of Loan Loan Amount EMI Amount EMIs already Paid Principal Outstanding
Existing Liability (If Any)

Bank Accounts Held Bank Name Branch Account Type Account Number Account held for (Years)
STATE BANK OF INDIA HOJAI 34217942659

Credit Cards Card Number Issuer Name Primary /Supplementary Outstanding Balance Remarks
 FD Number Amount Rate Maturity Date(dd/mm/yyyy) Bank Name
Fixed Deposits

Other Assets (Bonds, Shares, Mutual Fund, Other Investments, Precious metals / Gold / Jewelry /Vehicle / Immovable Property etc)
Asset Type Asset Description Asset No. Asset Value Remarks

Name of Applicant: cccccccccccccccccccccccc

S O N U K U M A R S I N G H
Signature of Applicant

cc-cc-cccc
Date: 0 9 0 62 0 1 9

SECTION-C (LOAN DETAILS)

Scheme Name Xpress Credit to Teacher / Others

Loan Details:
Net Monthly Income ccccccc
2 4 4 0 0 Proposed EMI ccccc
1 1 3 3 8 EMI/NMI Ratio cc Loan Amount ccccccc
5 0 0 0 0 0 Repayment c Monthly

Tenure (Months) cc
6 0 Rate of Interest cc
1 2 . cc
8 5

Check-off c Full c Partial c No

Salary Packages c SGSP c CGSP c PSP c RSP c DSP c PMSP c ICGSP c OTHERS Specify ___________________________________

Loan Purpose c Children’s Marriage c Education of children c Medical c Travel c Purchase of Consumer Durable c others (Please specify) --------------------------------

Corporate and Institutional Tie-ups ____________________________________________ (please specify)

5,725
Processing Fee Rs. ____________________ Concessions if any % cc Concession in Processing fee Rs. ________________

SECTION-D (INSURANCE) - OPTIONAL

Life Insurance

For your benefit and convenience, the following group insurance plan underwritten by SBI Life Insurance Company Ltd is available for your consideration. If you opt for this
cover, SBI would administer your enrolment for the chosen plan. Please note that this insurance cover is optional for the purpose of the loan application and may also be
obtained from other providers.

Do you wish to be covered by …………… Cover e.g. SBI Life?

c Yes c No
If YES, One time premium will be paid by you or you would like to add the premium to the Personal loan?
c I will pay the premium c Please add the premium to the Personal loan amount mentioned above

Loan Insurance

For your benefit and convenience, the following Loan insurance plan underwritten by SBI General Insurance Company Ltd is available for your benefit and protection. If you
opt for this cover, SBI would administer your enrolment for the chosen plan. Please note that this insurance cover is optional for the purpose of the loan application

Do you wish to be covered by SBI General Loan Insurance?

c Yes c No
If YES, One time premium will be paid by you or you would like to add the premium to the Personal loan?
c I will pay the premium c Please add the premium to the Personal loan amount mentioned above
SECTION-E (DECLARATION)

DECLARATION
I/We certify that the information provided by me/us in this application form is true and correct in all respects and State Bank of India is entitled to verify this directly or
through any third party agent. I/We confirm that the attached copies of financials/Bank Statements etc., are submitted by me/us against my/our loan application and
certify that these are true copies. I/We further acknowledge the Bank's right to seek any information from any other source in this regard. I/We understand that all of the
above-mentioned information shall form the basis of any facility that the Bank may decide to grant to me/us at its sole discretion.

I/We further agree that any facility that may be provided to me/us shall be governed by the rules of the Bank that may be in force from time to time. I/We will be bound
by the terms and conditions of the facility/ies that may be granted to me/us. I/We authorize the Bank to debit my Personal loan account with the Bank for any fees,
charges, interest etc. as may be applicable.

I/We acknowledge that the Bank remains entitled to assign any activities to any third party agency at its sole discretion. I/We further acknowledge the right of the Bank
to provide details of my/our account to third party agencies for the purpose of availing support services of any nature by the Bank, without any specific consent or
authorization from me/us.

I/We acknowledge that the existence of this account and details thereof (including details of transactions and any defaults committed by me), will be recorded with credit
reference agencies and such information (including processed information) may be shared with banks/financial institutions and other credit grantors for the purposes of
assessing further applications for credit by me/us and/or members of my/our household, and for occasional debt tracing and fraud prevention. I/We accordingly
authorize the Bank to share information relating to my/our Personal loan account.

I/We understand that as a precondition, relating to grant of loans/advances/other non-fund-based credit facilities to me/us, State Bank of India requires consent for the
disclosure by the Bank, of information and data relating to me/us, of the credit facility availed of/to be availed of by me/us, obligations assumed/to be assumed by
me/us, in relation thereto and default, if any, committed by me/us in discharge thereof.

I/We also understand that the Bank is at the liberty to get confirmed any details furnished by me/us and also to intimate to my/our DDO/Department Head/CEO, the
details of any of the loans sanctioned/disbursed to me/us and I/we accordingly convey my/our consent for such disclosures.

Accordingly, I/we hereby agree and give consent for the disclosure by the Bank 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 the Bank may
deem appropriate and necessary, to Credit Information Bureau (India) Limited (CIBIL) and any other agency authorised in this behalf by Reserve bank of India /
Government of India.

I/We undertake that (a) CIBIL and any other agency so authorised may use, process the said information and data disclosed by the Bank; and (b) CIBIL and any other
agency so authorised may furnish for consideration, the processed information and data or products thereof prepared by them, to banks/financial institutions and other
credit grantors, as may be specified by the Reserve Bank in this behalf.

I/We agree to receive SMS alerts related to my/our application status and account activity as well as product use messages that the Bank will send, from time to time, on
my/our mobile phone number as mentioned in this application form. I/We undertake to intimate the Bank regarding change in my/our occupation/employment/
residential address/mobile number and to provide any further information that the Bank may require.

I/We confirm that I/we do not have any other credit facilities with any bank other than that mentioned above. I/We confirm that if I/we avail of any credit facilities with
any other bank in future, I/ we will furnish the details to State Bank of India immediately. I/We further authorize the bank to credit all sums received by the bank or
standing to the credit in my/our name jointly or severally to the loan account, if necessary. I/We confirm that the funds will be used for stated purpose and will not be
used for speculative purpose. I/We confirm that we are resident Indians

I/We further acknowledge that I / We have read, understood and agree with the Most Important Terms and Conditions governing the Personal loan product chosen by
me/us.

Signature of Applicant

Place……………………………….

09-06-2019
Date………………………………..

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -" (Please tear off this acknowledgement slip along these dotted lines) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

ACKNOWLEDGEMENT RECEIPT
Customer Copy

Cheques received towards payment of

Loan application received on cc-cc-cccc , complete document set received on cc-cc-cccc ived towe nt of Processing Fee
Processing Fee amounting to Rs. cccccccc vide cheque number
cccccc dated cc-cc-cccc ; drawn in favour of “State Bank
of India” and payable at cccccccccccccccccccccccc .
Request will be disposed of and acceptance/rejection notification would be mailed within 15 days from the date of receipt of completed application form with supporting documents.

On behalf of State Bank of India

Contact No: ____________________

Date and Place: ____________________ Authorized Signatory