Pulkit ApplicationForm

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Post Matric Scholarship Scheme For BC

Government of Haryana

Application Form for Scholarship - 2022-23


Student Name Pulkit

Father Name Pawan kuamr

Mother Name Seema

Caste BC (A)

Date of Birth 08/03/2004

College J.C. Bose University of Science and Technology, YMCA,


Faridabad, Faridabad
Application Reference ID 1237342

Family Id (PPP) 3RWU0675 Member ID (PPP) QLSX8942

Aadhar No 551348654778 Gender M

Mobile No. 9315403308 Email Id

House No. DC 224 A Street No.

Landmark DC 224 A SHYAM NAGAR District PALWAL


NEAR LAXMI NARAYAN
MANDIR PA
PIN 121102 Family Income 100000

Is BPL Y BPL Card No. (If any)

Course B.Tech in Civil Engg. Course Year I

College Roll No. 22001002028 University No. 22001002028

Admission Date 19/10/2022 Area Type Urban

Boarding Type DayScholar Quota State Quota

Is Divyang N Fresh / Renewal F


Course Type Regular Course Course Category Group 1
Is Lateral Entry No Applied On 28/12/2022

I hereby agree to the below statements:


1. I agree that my application is liable to be rejected if I have provided wrong Aadhaar number or Aadhaar number of someone
else͛s.
2. I agree that if more than one application is found to be made on-line, all my applications are liable to be rejected.
3. I agree that for any wrong entry or mis-match of the Aadhar Linking with Bank Account, I will be responsible for that.
4. I agree that as per the Item 35 of Chapter VII of Aadhaar (Targeted delivery of financial and other subsidies, benefits and
services) ACT, 2016, if a person enter Aadhaar number of any other person and attempt to impersonate another person,
dead or alive, real or imaginary, he/she shall be punishable with imprisonment for a term which may extend to three years
and shall also be liable to a fine which may extend to ten thousand rupees.
5. I have linked my Aadhar with my Bank Account Number and also it is seeded in NPCI mapper. Click here for Aadhar
Seeding Process.
6. I have read and understood the conditions of award of Scholarship.

2/6/2023 8:50:59 PM Report Generated from: Centralized Scholarship Portal Haryana


Post Matric Scholarship Scheme For BC
Government of Haryana

2/6/2023 8:50:59 PM Report Generated from: Centralized Scholarship Portal Haryana

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