Satya Jeet School Ar

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21/10/2024, 20:49 HE582410216087506

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Scholarship Application Form


Higher Education Department
Academic Year 2024-25 HE582410216087506
Government of Odisha

Basic Information

Department Scheme Academic Year Application Type


Higher Education Department U.G Merit 2024-25 New

Unique Ref. No. (CAF Barcode)


22D111347

Applicant Details

Applicant Name Category Applicant Gender


Satyajeet Behera General Male

Religion Date of Birth Aadhaar No.


Hindu 13 Aug 2003 (21 Year) XXXXXXXX6325

Mobile No. Alternative Mobile No. e-Mail Id


8018810350 8018810350 sjsatyajeet39@gmail.com

Father's Name Mother's Name Guardian Name


Pitamber Behera Sukanti Behera --

Address Information

District Block/ULB GP/Ward


Cuttack Cuttack Mc Cuttack (M Corp.) - Ward No.7

Pin Code Address


753002 Jagannath Sahi kafla bazar cuttack

Educational Qualification Details

Passing Total Secured Percentage Marksheet/


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

X ICSE, New 7127043 2020 600 432 72.00 Uploaded


Delhi

Plus 2 CHSE, Odisha 210CA004 2022 600 471 78.50 Uploaded

Institute / Course Information (Current Education Information)

Institute Type
Govt. Aided

Institute District Block/ULB


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Christ (Degree) College, Cuttack Cuttack Cuttack Mc

Nature of Course Course Branch/Stream/Trade


General Plus 3 Commerce

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


3rd Year 2023 01 Aug 2023

Details of Last Exam Passed

Course Course Year Passing Year


Plus 3 2nd Year 2023

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


10 6 57.0

Certificate
Uploaded

Eligibility Information

Income Certificate No. Family Income (in Rs.) To Whom the Certificate Issued
e-INC/7563  100000.00 PITAMBER BEHERA

Issuing Authority Issue Date Income Certificate


Revenue Officers not below the rank of 20 Nov 2017 Uploaded
Tahasildar / Additional Tahasildar

Residence Certificate No. To Whom the Certificate Issued Issuing Authority


E-RES/2022/1408528 SATYAJEET BEHERA Revenue Officers not below the rank of
Tahasildar / Additional Tahasildar

Issue Date Residence Certificate


28 Oct 2022 Uploaded

Institute Declaration Certificate


NA

Regd. No. on College ID Card College ID Card Cover Page


BC22-154 Uploaded

Bank Information

Account Holder Name IFSC Code Account No.


SATYAJEETBEHERA SBIN0004612 40794324331

Whether account number tagged /seeded with


the Aadhaar number?
Yes

Bank Name Branch Name


STATE BANK OF INDIA TULASIPUR CUTTACK

Passbook front page


Uploaded

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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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