Applicant Details

Applicant Photo
ApplicationID :1819VJO1000184715

Application ID Scheme Name

1819VJO1000184715 Post Matric Scholarship to OBC
Students

Department Name Applied Date

VJNT,OBC and SBC Welfare 31/10/2018
Department

Personal Details
ApplicationID :1819VJO1000184715

Full Name Mobile Number. Email ID

Asha Ushtuji Kokode 9767590592
Date Of Birth
15/10/2000

Gender Age Religion

Female 18 Hindu

Marital Status Applicant Full Name (As Per Parent's/Guardian Mobile No

Unmarried SSC Marksheet/ L.C.) 7768963553
KOKODE ASHA USHTUJI
Dependent Type
-

Permanent address Details

ApplicationID :1819VJO1000184715

Address State District

,,at.chindhi chak,,441221 Maharashtra Chandrapur

Taluka Village Pincode

Nagbhir NAGBHIR 441221

IsCorrespondence Address
same as Permanent?
Yes

Correspondence Address Details

ApplicationID :1819VJO1000184715
Address State District
,,at.chindhi chak,,441221 MAHARASHTRA Chandrapur

Taluka Village Pincode

Nagbhir NAGBHIR 441221

Income Details
ApplicationID :1819VJO1000184715

Do you have Income Certificate? Does your Certificate have a Family Annual Income
Yes Barcode? 21000.00
No
Income Certificate No
40664029984

Issuing Authority Date of Issue

Nayab Tahsildar 27/06/2018

Domicile Details
ApplicationID :1819VJO1000184715

Are you Domicile of Do you have Domicile Relationship Type

Maharashtra? Certificate? Self
Yes Yes
Domicile Certificate No.
40664011362

Does your Certificate have a Applicant Name Issuing Authority

Barcode? ASHA USHTU KOKODE Tahsildar
No
Date of Issue
07/09/2016

Caste Details
ApplicationID :1819VJO1000184715

Do you have Caste Certificate? Caste Category Does your Certificate have a
Yes (OBC) Other Backward Class Barcode?
No

Caste Certificate Number Issuing District Applicant Name

4161 Chandrapur ASHA USHTU KOKODE

Issuing Authority
Sub Divisional Officer(SDO)

Personal Eligibility Details

ApplicationID :1819VJO1000184715

Are you Salaried? Disability of any Type?

No No

Parent's/Guardian's Details
ApplicationID :1819VJO1000184715

Is Father Alive? Father Name Is Father Salaried?

Yes USHTU FAGOJI KOKODE No

Is Mother Alive? Mother Name Is Mother Salaried?

Yes SANDHYA USHTU KOKODE No

Past Qualification Details

ApplicationID :1819VJO1000184715

Qualification Level Stream Completed

S.S.C. (10 Std) SSC Completed

Institute State Institute District Institute Taluka

MAHARASHTRA Chandrapur Nagbhir

College Name / School Name Course Name Board/University

SSC MAHARASHTRA STATE BOARD
OF SECONDARY AND HIGHER
SECONDARY EDUCATION

Mode Admission Year Passing Year

Regular 2015 2016

Result Percentage Attempts

Passed 74.60 1

Is Gap? Qualification Level Stream

No H.S.C. (12 Std) Science

Completed Institute State Institute District

Completed MAHARASHTRA Chandrapur

Institute Taluka College Name / School Name Course Name

Nagbhir JANTA B. U. SCHOOL NAGBHIR 12th Science

Board/University Mode Admission Year

MAHARASHTRA STATE BOARD Regular 2017
OF SECONDARY AND HIGHER
SECONDARY EDUCATION
Passing Year Result
2018 Passed
Percentage Attempts Is Gap?
57.85 1 No

Current Course Details

ApplicationID :1819VJO1000184715

Admission Year In Current Institute State Institute District

Course MAHARASHTRA Chandrapur
2018
Institute Taluka Qualification Level
Brahmapuri Diploma Course

Stream College Name/school Name Course Name

Engineering Government Polytechnic, Post S.S.C. Diploma in
Bramhapuri Engineering (Polytechnics) -
Mechanical Engineering

Admission Type Application Admission ID/CAP Year Of Study

Through CAP/Govt. Quota ID Direct Second Year
DSD18121068
Completed Or Continue
Pursuing

Admission Date Admission Year in Percentage

16/08/18 College/Institute -
-
Result
-

Fees Paid Course Type Admission Through Open Or

1750.00 Aided Reserved Category?
(OBC) Other Backward Class

Gap Year Mode GapReason

0 Regular

Hostel Details
ApplicationID :1819VJO1000184715

Hosteller / Day Scholor Type

Day Scholar

Additional Question
ApplicationID :1819VJO1000184715

Question Answer
Question
Caste Validity – (Mandatory for Ration Card for identify number
Professional Degree courses, of children in family
Professional Post Graduate. For
Non Professional courses cast
Answer
validity is not mandatory)
RATION CARD.pdf Question
Leaving Certificate

Answer
Question Answer
LEAVING.pdf
Declaration certificate of DECLARATION.pdf
parents/guardians about
number of children
beneficiaries
Question
Have you applied for any other
scholarship

Answer
Question Answer
No
Is this a Renewal Application? No

Benefits
ApplicationID :1819VJO1000184715

Tution Fee

6000.00
Exam Fee

1200.00
Number of Months for which
benefit is allotted

9.00

Maintenance Allowance per

month

190.00

Total Maintenance Allowance

1710.00

I / We agree to the terms and conditions of this scholarship. All information given in this application is valid to
best of my knowledge. I /We am /are punishable with penalties / punishments if any of the above mentioned
details is false as per the Indian Penal Code, 199 and 200. The decision given by the competent authority will be
final and will be accepted by me. If any surplus amount is received from the scholarship due to any reasons,
then I / We will return the amount at the earliest. I / We will be responsible for taking action against me / my
child against falsehood. I / We promise that we will take the scholarship / education fees as per the terms and
conditions of the concerned scheme. All the documents that I have linked to the application have been received
from the competent authority / authorities and the documents are valid and have been received by following the
required legal procedures. There is no modification / correction / alteration performed on them. I hereby certify
that the information provided is true and they are not false or fake. I am fully responsible for the false or fake
surveillance of the attached documents, and I am fully aware that I will be entitled to the penalty imposed by the
Indian Penal Code, 199 and 200.

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