Anda di halaman 1dari 2

‫ڤځښڑ‬Ḛ‫ڏ‬Ṁ‫ڀٱڤژ‬

GOVERNMENT OF GUJARAT
(BCk-6.1) Post Matric Scholarship for SC students (Government
of India Scheme)

Student Basic Details


Name of Student : Parmar Krunalkumar Hargovanbhai
Name of Student (As per Aadhar) : Krunalkumar Hargovanbhai Parmar
Mother's Name : Rashmikaben
Date of Birth : 19/08/1998 Gender : Male
Category : SC Religion :Hindu
Caste : Hindu Chamar
Aadhaar Status : Yes(10/12/2017 00:00:00)

Annual Income of Parents/Guardian/Husband (Rs): 48000 Habitation Type: Urban


Mobile Number : 7405990414 E-mail Address : parmarkrunal06@gmail.com
Aadhar No : 962772080060 Parent/Guardian occupation: Business(V5Vs
Is Orphan: NO Day Scholar / Hosteller : Hosteler
Marital Status : Unmarried Hostel Type: Government Hostel
Current Address: Permanant Address:
District Vadodara District Mahesana

Taluka Vadodara Taluka Visnagar

Village Village Visnagar (Rural)

PinCode 390002 PinCode 384315


Address:Samras Boys Hostel, Vadodara Address:27/Jagamba society,Kansa N.A.,Visnagar

Student Bank Account Detail/Aadhar Bank Detail


I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 962772080060 Bank name : BANK OF BARODA
Mandate Date : 10/5/2016 12:00:00 AM Status : Active
I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
Account No : 05780100014449 IFSC Code : BARB0DANDIA
Student Name(As per Bank Name): Krunalkumar Hargovanbhai
Parmar
Name of Bank : BANK OF BARODA

Branch Name & Address : DANDIA BAZAR BRANCH


I hereby accept that
1.Details provided by me are correct to best of my knowledge
2.Shall not make any claims if amount is transferred to a wrong account due to incorrect
3.Shall refund the amount transferred to someone else¶s account due to incorrect details provided by me
4.I will refund the excess amount credited to my account, if any.

Student Academic Details


Present Course/Class/Trade Type: Engineering & Technology

Present Course/Class/Trade Name : B.E. (Bachelor of Engineering)

Present Course/Class/Trade Year : 3RD YEAR(5th Semester/6th Semester)

Studing in : Gujarat

Present Institute District : Vadodara Present Institute : Facuty of Technology and Engineering (Id: C-58344)

Admission Type : Regular Seat(Government Quota) Present Branch Course : Chemical Engineering

Courtesy :: National Informatics Centre, Gujarat Page 1 of 2 170001542623 Print Date :11/12/2017
Present Class Start Date : 19-Jun-2017 Present Course Completion Date : 31-May-2018

Fees Amount
Admission Fees (Rs) 9140
Tution Fees (Rs) 0
Misc.Fee(NonRefundable Fees) 0
Exam Fees(Rs) 0

Total (Rs) 9140

Previous stream :B.E. (Bachelor of Engineering) Previous Class/Course : 2ND YEAR(3rd Semester/4th Semester)
Previous Passing Year : 2017 Previous (%) : 54.14

Educational Break : No No. Of. Year in Break :

Education Details
Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
9th Std/10th Std 10TH Secondary School A681413 2013 83.33

Engineering & Technology DIPLOMA Chemical D608583 2016 98.4


Engineering

Disablity Detail
Is Disability : No Type of Disability : -

Percentage of disability : - Required Guide/Coaching Guide: No


Guide Name: -
Guide Address: -

List of documents which you have attached :

1 Std:10 Marksheet

2 Hostel Certificate(Only For Hosteller Student)

3 Income Certificate (Competent Authority)(Form no.16 required For Govt. Employee)

4 Graduate Marksheet(If Any)

5 Other Marksheets/Last Year Marksheet

6 School Leaving Certificate

7 Fee Receipt of Current Course Year

8 Self Attested Caste Certificate From the Competent Authorities

9 Self Attested Copy of Aadhar Card

10 First Page Of Bank PassBook/Cancelled Cheque

I have read all above terms and conditions and understand them fully, I hereby declared that here I am submitting only one
application for scholarship and I haven¶t received any other scholarship/stipend or fellowship in this current session under any
other central/state government scheme. I further state that all information furnished by me is correct to my knowledge in case of
any the false information or suppression of necessary data proved in my application is liable to get cancelled at any stage of the
scholarship process and the entire amount of scholarship will be refunded by me or recovered from me. Government decision
shall be final and binding on me.

Verify Mobile Number : Yes 11/12/2017

Date : 12/11/2017
Place : Signature of the applicant

Courtesy :: National Informatics Centre, Gujarat Page 2 of 2 170001542623 Print Date :11/12/2017

Anda mungkin juga menyukai