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    Government of Gujarat: Student Basic Details

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    Ankur Vayde
    The document is an application by Om Govindbhai Vayde for the Post Matric Scholarship of Government of India for OBC students. [1] It contains details about the student like name, date of birth, category, annual family income, contact details, current and permanent addresses. [2] It also provides details of the student's current engineering course, fees paid, previous educational qualifications and documents attached for verification. [3] The student declares that all information provided is correct and undertakes to refund the scholarship amount if any rules are violated.

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    © All Rights Reserved
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    Government of Gujarat: Student Basic Details

    Uploaded by

    Ankur Vayde
    84 views3 pages
    The document is an application by Om Govindbhai Vayde for the Post Matric Scholarship of Government of India for OBC students. [1] It contains details about the student like name, date of birth, category, annual family income, contact details, current and permanent addresses. [2] It also provides details of the student's current engineering course, fees paid, previous educational qualifications and documents attached for verification. [3] The student declares that all information provided is correct and undertakes to refund the scholarship amount if any rules are violated.

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    Report (3).pdf

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    The document is an application by Om Govindbhai Vayde for the Post Matric Scholarship of Government of India for OBC students. [1] It contains details about the student like name, date of birth, category, annual family income, contact details, current and permanent addresses. [2] It also provides details of the student's current engineering course, fees paid, previous educational qualifications and documents attached for verification. [3] The student declares that all information provided is correct and undertakes to refund the scholarship amount if any rules are violated.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    84 views3 pages

    Government of Gujarat: Student Basic Details

    Uploaded by

    Ankur Vayde
    The document is an application by Om Govindbhai Vayde for the Post Matric Scholarship of Government of India for OBC students. [1] It contains details about the student like name, date of birth, category, annual family income, contact details, current and permanent addresses. [2] It also provides details of the student's current engineering course, fees paid, previous educational qualifications and documents attached for verification. [3] The student declares that all information provided is correct and undertakes to refund the scholarship amount if any rules are violated.

    Copyright:

    © All Rights Reserved
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    of 3

    GOVERNMENT OF GUJARAT Submit Date : 14/10/2019

    Application No:
    BCK-81A Post Matric Scholarship of Government of India for the 192000000001423093
    OBC students
    Fresh Application

    Student Basic Details


    Name of Student : vayde om govindbhai
    Name of Student (As per Aadhar) : om govindbhai vayde
    Mother's Name : Hasuben
    Date of Birth : 27/03/2001 Gender : Male
    Category : SEBC Religion :Hindu
    Caste : Bhoi([s: 
    Aadhaar Status Verified: Yes(14/10/2019 20:15:00)

    Annual Income of Parents/Guardian/Husband (Rs): 100000 Habitation Type: Urban


    Mobile Number : 9913352749 E-mail Address : [email protected]
    Aadhar No : 24xxxxxx0520 Parent/Guardian occupation: Retired Employee(iWɂmS
    D\½Ih^Ž

    Is Orphan: NO Day Scholar / Hosteller : Day Scholar


    Marital Status : Unmarried Hostel Type:

    Current Address: Permanant Address:


    State Gujarat State Gujarat

    District Vadodara District Vadodara

    Taluka Vadodara Taluka Vadodara

    Village Village
    PinCode 390006 PinCode 390006

    Address:No.5 madhuvan society ,kisanwadi,harniwarasiya ring Address:No.5 madhuvan society ,kisanwadi,harniwarasiya ring
    road,vadodara. road,vadodara.

    Student Bank Account Detail/Aadhar Bank Detail


    I voluntarily give my consent to use my Aadhaar details.
    Aadhar Number : 24xxxxxx0520 Bank name : -
    Mandate Date : - Status :
    I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
    Account No : 36xxxxxx0794 IFSC Code : SBIN0010971
    Student Name(As per Bank Name): om govindbhai vayde

    Name of Bank : STATE BANK OF INDIA

    Branch Name & Address : HARNI WARASIA RING ROAD


    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.
    5.I voluntarily give my consent to use my Aadhaar details
    6.I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar

    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 : 2ND YEAR(3rd Semester/4th Semester)

    Courtesy :: National Informatics Centre, Gujarat Page 1 of 3 192000000001423093 Print Date :15/10/2019
    Studying in : Gujarat Enrollment No: 190143109028

    Present Institute District : Bharuch Present Institute : GOVERNMENT ENGINEERING COLLEGE,


    BHARUCH 014
    Admission Type : Regular Seat(Government Quota) Present Branch Course : -

    Enter Your Research/Thesis Subject :


    Present Class Start Date : 18-Jul-2019 Present Course Completion Date : 31-May-2020

    Fees Amount
    Admission Fees (Rs) 0
    Tution Fees (Rs) 1500
    Misc.Fee(NonRefundable Fees) 1800
    Exam Fees(Rs) 1700

    Total (Rs) 5000

    Previous stream :DE (Diploma Engineering ) Previous Class/Course : 3RD YEAR(5th Semester/6th Semester)
    Previous Passing Year : 2019 Previous (%) : 91.10

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

    Previous Education Detail


    Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
    9th Std/10th Std 10TH general B5161389 2016 62

    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 Caste Certificate issued by Competent authorities

    2 Fee Receipt of Current Course Year

    3 Marksheet of Previous academic last board/university examination

    4 Income Certificate issued by Competent Authorities

    5 School Leaving Certificate(If any)

    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.

    Date : 15/10/2019
    Verify Mobile Number : Yes 14/10/2019
    Place : Signature of the applicant

    It is certified that the information filled in the above mentioned fields by the students are correct to the best of my knowledge and
    all the Documents has been checked.

    It is also certified that in case the applicant leaves institution or otherwise discontinues the studies or detained or accepts any other
    regular scholarships/stipend/ fellowship the fact will be immediately reported to the said authority

    Certified that the student is eligible for scholarship amount subject to Central/State government rules and the student is
    recommended for sanction of scholarship.

    Signature Of Head Of The School/College/Institute/University With Official Seal

    Courtesy :: National Informatics Centre, Gujarat Page 2 of 3 192000000001423093 Print Date :15/10/2019
    Place :
    *Note : Stamp Signature will not be accepted

    Date :

    Courtesy :: National Informatics Centre, Gujarat Page 3 of 3 192000000001423093 Print Date :15/10/2019

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