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    STSC92402033930169

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    sritamkhuntia688
    The document is a scholarship application form for Sweety Maharana to apply for the Post Matric Scholarship scheme for the 2023-24 academic year. It includes her personal details like name, gender, category, date of birth, contact information, family details, address, educational qualifications from class 10 through her current MA program, income details, bank account information, and required documents uploaded like certificates and passbooks. At the end is a student declaration acknowledging the conditions and awareness of the application process.

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    STSC92402033930169

    Uploaded by

    sritamkhuntia688
    39 views4 pages
    The document is a scholarship application form for Sweety Maharana to apply for the Post Matric Scholarship scheme for the 2023-24 academic year. It includes her personal details like name, gender, category, date of birth, contact information, family details, address, educational qualifications from class 10 through her current MA program, income details, bank account information, and required documents uploaded like certificates and passbooks. At the end is a student declaration acknowledging the conditions and awareness of the application process.

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    The document is a scholarship application form for Sweety Maharana to apply for the Post Matric Scholarship scheme for the 2023-24 academic year. It includes her personal details like name, gender, category, date of birth, contact information, family details, address, educational qualifications from class 10 through her current MA program, income details, bank account information, and required documents uploaded like certificates and passbooks. At the end is a student declaration acknowledging the conditions and awareness of the application process.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    39 views4 pages

    STSC92402033930169

    Uploaded by

    sritamkhuntia688
    The document is a scholarship application form for Sweety Maharana to apply for the Post Matric Scholarship scheme for the 2023-24 academic year. It includes her personal details like name, gender, category, date of birth, contact information, family details, address, educational qualifications from class 10 through her current MA program, income details, bank account information, and required documents uploaded like certificates and passbooks. At the end is a student declaration acknowledging the conditions and awareness of the application process.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 4

    Scholarship Application Form

    ST&SC and MBC Welfare Department


    Academic Year 2023-24
    STSC92402033930169
    Government of Odisha

    Basic Information

    Department Scheme Academic Year Application Type


    ST&SC and MBC Welfare Post Matric Scholarship 2023-24 New
    Department

    Applicant Details

    Applicant Name Category Applicant Gender


    Sweety Maharana OBC/SEBC Female

    Religion Date of Birth Aadhaar No.


    Hindu 16 May 2003 (20 Year) XXXXXXXX1695

     Bank account is seeded with Aadhaar when applied by student.

    Mobile No. Alternative Mobile No. e-Mail Id


    7894404208 7750812728 [email protected]

    Father's Name Father Educational Status Father Occupational Status


    SUBASH CHANDRA MAHARANA Literate Unemployed

    Mother's Name Mother Educational Status Mother Occupational Status


    SANGEETA MAHARANA Literate House Wife

    Guardian Name Individual/ Family Information Individual/ Family Information


    Subash chandra maharana Not Applicable Certificate1
    NA

    Address Information

    District Block/ULB GP/Ward


    Deogarh Reamal Naulipada

    Village Pin Code Address


    Bhitarpada 768109 AT BHITARPAD PO NAULIPADA DIST DEOGARH
    PIN 768109 ODISHA

    Educational Qualification Details

    For : Matric-Annual

    Passing Total Secured Percentage Marksheet/


    Course Board Roll No. Year Mark/CGPA Marks/CGPA (%) Certificate

    X BSE, Odisha 090AF0093 2018 600 411 68.50 Uploaded

    Plus 2 CHSE, Odisha 105cc020 2020 600 245 40.83 Uploaded

    Plus 3 Sambalpur University,Jyoti SO1620ODI031 2023 10 6.81 64.70 Uploaded


    vihar,Sambalpur

    Institute / Course Information (Current Education Information)

    Institute Type
    Govt. Aided
    Institute District Block/ULB
    Deogarh (Degree) College, Deogarh Deogarh Debagarh Mpl

    Nature of Course Course Branch/Stream/Trade


    Self Financing M. A. Odia

    Course Year (Current Year of Study) Admission/Registration No. Admission/Readmission Date


    1st Year MA23ODI013 04 Oct 2023

    Enrollment No. Enrollment Date


    MA23ODI013 04 Oct 2023

    Any Exam Conducted during current academic year? : No

    Residential Status

    Whether
    Day Scholar

    Details of Last Exam Passed

    Course Course Year Passing Year


    Plus 3 3rd Year 2023

    Total Mark/CGPA Secured Marks/CGPA Percentage (%)


    10 6.81 64.7

    Certificate
    Uploaded

    Eligibility Information

    Income Certificate No. Family Income (in Rs.) To Whom the Certificate Issued
    E-INC/2023/2025092   75000.00 Subash chandra maharana

    Issuing Authority Issue Date Income Certificate


    Revenue Officers not below the rank of 16 Oct 2023 Uploaded
    Tahasildar / Additional Tahasildar

    Matriculation Certificate No. Issuing Authority Matriculation Certificate


    1801095529 BSE, Odisha (Annual) Uploaded

    Caste Certificate No. To Whom the Certificate Issued Issuing Authority


    E-SEB/2023/89138  SWEETY MAHARANA Revenue Officers not below the rank of
    Tahasildar / Additional Tahasildar

    Issue Date Caste Certificate


    13 Mar 2023 Uploaded

    Institute Declaration Certificate


    NA

    Divyang Disability Percentage Issuing Authority


    NA -- --

    Issue Date Special Category Certificate


    NA

    Bank Information

    Account Holder Name IFSC Code Account No.


    SWEETY MAHARANA SBIN0013615 41221660392

    Whether account number tagged /seeded with


    the Aadhaar number?
    Yes

    Bank Name Branch Name


    STATE BANK OF INDIA REAMAL

    Passbook front page


    Uploaded
    Student Declaration

    1. I have read and understood the conditions of award of Scholarship.


    2. I am aware that my application is liable to be rejected, if it is found at any stage, that Aadhaar number provided by me is wrong or Aadhaar number is of
    someone’s else.
    3. I am aware that if more than one application is found, all my applications are liable to be rejected.
    4. I am aware that for any wrong entry or mis-match of the Bank-account details, the State Government will not be responsible for mis-credit and I will be
    held responsible for diversion of public money on this ground.

    Date ........................

    Place ........................ Full Signature of Applicant

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