Ca Statement
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FINANCIAL DATA QUESTIONNAIRE STUDENT VISA APPLICATION AMERICAN CONSULATE GENERAL, CHENNAI
I,, Partner of ., Chartered Accountants, Member of the Institute of Chartered Accountants of India (Membership No.*****) do hereby certify that I have reviewed the financial condition of Mr. S/o Mr.R. and with a view of establishing his ability to pay the educational and living cost at University of ***********, U.S.A., which has been estimated to be $ ****** for 12(Up to 12) months.
SOURCE OF FUNDS: A. Personal / Family Savings
$ *****
Rs. *****
B. Current Annual Income
$ *****
Rs. *****
C. Educational Loan
$ *****
Rs. *****
D. Immovable Properties
$ *****
Rs. *****
Total
======= $***** =======
NOTE: 1) Income / Assets of parents of the student have been included. 2) Exchange Rate: US $1 = Rs.43/-
For., Chartered Accountants
Partner Date:
========= Rs. ***** =========
Details of balances of Mr.( of the applicant) & ( of the applicant) referred in page 1 and documents reviewed
A. Savings of Mr.( of the applicant) I.
Deposit with Bank: 1. Fixed deposit with Indian overseas Bank, Mahalingapuram Branch, (RDP No.*************)
Rs. *****
2. Fixed deposit with Indian Bank, Nungambakkam, Chennai, jointly in the name of ******(A/C No.******)
Rs. ***** ======== Rs.****** ========
Total
II. Other Investments & Movable Assets: 1. Paid up value of Investment with LIC, in the Name of *****. (Policy No.*****, ******, **** & ****)
Rs. *****
2.
CAR
Rs. *****
3.
BIKE
Rs. *****
4.
Jewellery - as per present market value
Rs. *****
(add ur shares, mutual funds, bonds and other liquid details over here)
Total
======== Rs. ***** ========
B. Current Annual Income: 1. Gross Annual Income of Mr.as per Form 16
Rs. ***** ======== Total Rs. ***** ========
C. Educational Loan 1. Educational loan from Indian Bank, Nanganallur, Chennai as per sanction letter Total
Rs. ***** ======== Rs. ***** ========
C. Immovable Assets:
1. Land & Building Owned by As per valuation report
Rs. *****
2. Land & Building, at owned by as per Valuation Report. Total
For., Chartered Accountants
Partner Date:
Rs. ***** ======== Rs. ***** ========
I,
SOURCE OF FUNDS: A. Personal / Family Savings
$ *****
Rs. *****
B. Current Annual Income
$ *****
Rs. *****
C. Educational Loan
$ *****
Rs. *****
D. Immovable Properties
$ *****
Rs. *****
Total
======= $***** =======
NOTE: 1) Income / Assets of parents of the student have been included. 2) Exchange Rate: US $1 = Rs.43/-
For
========= Rs. ***** =========
Details of balances of Mr.
A. Savings of Mr.
Deposit with Bank: 1. Fixed deposit with Indian overseas Bank, Mahalingapuram Branch, (RDP No.*************)
Rs. *****
2. Fixed deposit with Indian Bank, Nungambakkam, Chennai, jointly in the name of ******(A/C No.******)
Rs. ***** ======== Rs.****** ========
Total
II. Other Investments & Movable Assets: 1. Paid up value of Investment with LIC, in the Name of *****. (Policy No.*****, ******, **** & ****)
Rs. *****
2.
CAR
Rs. *****
3.
BIKE
Rs. *****
4.
Jewellery - as per present market value
Rs. *****
(add ur shares, mutual funds, bonds and other liquid details over here)
Total
======== Rs. ***** ========
B. Current Annual Income: 1. Gross Annual Income of Mr.
Rs. ***** ======== Total Rs. ***** ========
C. Educational Loan 1. Educational loan from Indian Bank, Nanganallur, Chennai as per sanction letter Total
Rs. ***** ======== Rs. ***** ========
C. Immovable Assets:
1. Land & Building Owned by
Rs. *****
2. Land & Building, at owned by
For
Rs. ***** ======== Rs. ***** ========
