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    GOVERNMENT OF GUJARAT Submit Date : 12/11/2024

    Application No:
    (BCk-6.1) Post Matric Scholarship for SC students (Government of 242500000001474440
    India Scheme)(Freeship Card Student Only)
    Fresh Application

    Student Basic Details

    Name of Student : PARMAR DEV VINODBHAI


    Name of Student (As per Aadhar) : PARMAR DEV VINODBHAI
    Mother's Name : JAGRUTIBEN
    Date of Birth : 12/05/2007 Gender : Male
    Category : SC(7ȵkɅl‡ISĤiS  Religion :Hindu
    Caste : Hindu Vankar ˆeƛȳkaRD^ 

    Aadhaar Status Verified: Yes(12/11/2024 10:34:35)

    Ration Card No. : 119302002912069 Ration Card Member No. : 119302002912069007


    Name As Per Ration Card: (Parmar Dev Vinodbhai / X^\h^U°aiaWsU[h9
    EKYC Status As Per Ration Card: Yes EKYC Date: 11-11-2024
    Aadhar Number Matched With Ration Card: Yes
    Consent Status: I hereby give my consent to use my personal data available with food and civil supply department. I hereby give my consent to
    government of Gujarat for fetching my identity for the purpose of post matric scholarship.

    Annual Income of Parents/Guardian/Husband (Rs): 184000 Habitation Type: Urban


    Mobile Number : 9904839835 E-mail Address : vindoparmar8286@gmail.com
    Aadhar No : 60xxxxxx7732 Parent/Guardian occupation: Pvt-Service(EhWFjWsD^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 390021 PinCode 390021

    Address:1396, AMBIKA NAGAR, OPP DUTT NAGAR GOTRI Address:1396, AMBIKA NAGAR, OPP DUTT NAGAR GOTRI
    ROAD - VADODARA - 390021. ROAD - VADODARA - 390021.

    Student Bank Account Detail/Aadhar Bank Detail


    I voluntarily give my consent to use my Aadhaar details.
    Aadhar Number : 60xxxxxx7732 Bank name : -
    NPCI Date : 11/12/2024 12:00:00 AM NPCI Status : Accept
    I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
    Account No : 41xxxxxx9127 IFSC Code : SBIN0010968
    Student Name(As per Bank Name): PARMAR DEV VINODBHAI

    Name of Bank : STATE BANK OF INDIA

    Branch Name & Address : GOTRI ROAD


    I hereby accept that
    1.Details provided by me are correct to best of my knowledge

    Page 1 of 3 242500000001474440 Print Date :12/11/2024


    2.Shall not make any claims if amount is transferred to a wrong account due to incorrect details provided by me
    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.

    Student Academic Details


    Present Course/Class/Trade Type: Engineering & Technology

    Present Course/Class/Trade Name : DE (Diploma Engineering )

    Present Course/Class/Trade Year : 3RD YEAR(5th Semester/6th Semester)

    Studying in : Gujarat Enrollment No: 226480307057

    Present Institute District : Vadodara Present Institute : Sigma Institute of Technology And Engg.( Polytechnic)
    648
    Admission Type : Regular Paid Seat (Self Finance) Present Branch Course : -

    Enter Your Research/Thesis Subject :


    Present Class Start Date : 22-Jul-2024 Present Course Completion Date : 22-Mar-2025

    Fees Amount
    Admission Fees (Rs) 150
    Tution Fees (Rs) 43000
    Misc.Fee(NonRefundable Fees) 5000
    Exam Fees(Rs) 1100

    Total (Rs) 49250

    Previous stream :DE (Diploma Engineering ) Previous Class/Course : 2ND YEAR(3rd Semester/4th Semester)
    Previous Passing Year : 2024 Previous (%) : 79.00

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


    Freeship Card Detail
    Freeship Card No: 1363
    Freeship Card Issued Date: 19/10/2022
    Freeship Card Issued by District:Vadodara

    Previous Education Detail


    Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
    Engineering & Technology DE (Diploma Engineering ) COMPUTER 22648030 2024 8.05
    ENGINEERING 7057

    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 From the Competent Authorities

    2 First Page Of Bank PassBook/Cancelled Cheque

    3 Income Certificate (Competent Authority)(Form no.16 required For Govt. Employee)

    4 Std:10 Marksheet

    5 Freeship Card

    6 Identity Card (College/School)

    Page 2 of 3 242500000001474440 Print Date :12/11/2024


    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 : 12/11/2024

    Verify Mobile Number : Yes 12/11/2024

    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.

    This is to certify that student has regularly attended classes and maintained minimum attendance criteria till date for the A.Y. 2024
    -2025. If student will irregular, than we will immediately reported to the said authority.

    The actual School/College/University year began on __________________ and will be ended on _____________________

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

    Place :

    *Note : Stamp Signature will not be accepted

    Date :

    Page 3 of 3 242500000001474440 Print Date :12/11/2024

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