Application

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Government of Telangana
Department of Tribal Welfare
Student Application cum Verification Report for
Post-Matric Scholarship Renewal 2023-24

1. Application No: 2023 1084 8549 2. Application Date: 07-12-2023 3. Caste / Sub Caste: ST / Lambadis(Sl.No-29)

4. Student Name : RATHOD TARUN 5. Gender : Male

6. Father / Mother Name : DEVIDAS

7. Address & Mobile No : 1-11 ,Narnoor , Gangapur ,ADILABAD & xxxxxx7622

8. SSC HT No : 1901111108 9. Pass Year -Pass Type : 2019-Regular 10. Date of Birth: 08-05-2004

11.Family Annual Income (in Rs.): 130000 12. UID(aadhar) : xxxxxxxx8430

13. Income Certificate Details: , ,

14.College Details : uni artsscience college hanamkonda , Hanumakonda,Hanumakonda , University College ,KAKATIYA UNIVERSITY
15. Course Name /Course Year /Duration of Course : B.SC(Mathematics-Physics-Geology) / III Yr / 3Yrs

16. College Admission No / Admission Date(of this year): TI2130208354 / 12-06-2023 17. Distance (in Kms.) : 240

18. Scholarship Type : Day Scholar 19. DAH Name : -

20. Bank Name / IFSC Code: -NARNOOR /SBIN0020479 21. Bank A/c No : 62487915615

I.Declaration
I hereby certify that that above information furnished is true. I have not availed any other scholarship for this purpose from any other sources. I
shall abide by the terms and conditions of the sanction of the scholarship. If any discrepancies are found later, I hereby abide for refund of the
scholarship amounts claimedand also am liable for action by the Department. .

Signature of the Student


Date :

 Print  Back
December 28, 2023 12:46:50 PM

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