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    akshay gopal
    1. This document is a student application and verification report for a post-matric scholarship and fee concession from the Government of Karnataka Department of Backward Classes Welfare. 2. It provides details about a student named Akshay Kumar G, such as his name, father's name, address, school details, college details, course of study, income, bank account, and aadhaar information. 3. College administrators and a verification officer have verified and confirmed the student's information and recommended sanctioning of the scholarship.

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    Print - Application

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    akshay gopal
    102 views2 pages
    1. This document is a student application and verification report for a post-matric scholarship and fee concession from the Government of Karnataka Department of Backward Classes Welfare. 2. It provides details about a student named Akshay Kumar G, such as his name, father's name, address, school details, college details, course of study, income, bank account, and aadhaar information. 3. College administrators and a verification officer have verified and confirmed the student's information and recommended sanctioning of the scholarship.

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    1. This document is a student application and verification report for a post-matric scholarship and fee concession from the Government of Karnataka Department of Backward Classes Welfare. 2. It provides details about a student named Akshay Kumar G, such as his name, father's name, address, school details, college details, course of study, income, bank account, and aadhaar information. 3. College administrators and a verification officer have verified and confirmed the student's information and recommended sanctioning of the scholarship.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    102 views2 pages

    Print - Application

    Uploaded by

    akshay gopal
    1. This document is a student application and verification report for a post-matric scholarship and fee concession from the Government of Karnataka Department of Backward Classes Welfare. 2. It provides details about a student named Akshay Kumar G, such as his name, father's name, address, school details, college details, course of study, income, bank account, and aadhaar information. 3. College administrators and a verification officer have verified and confirmed the student's information and recommended sanctioning of the scholarship.

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    Government of Karnataka

    Department of Backward Classes Welfare

    Student Application cum Verification Report for


    Post-Matric/Food & Accomodation/Fee Concession (OR)
    Nursing Renewal 2019-20

    1. Application No: 2019 0197 0772 2. Application Date: 24-10-2019 3. Caste Category / Caste: CAT-IIA / SwakulaSali/SwakulaSale(Sl.No-76-(q))

    4. Student Name : AKSHAY KUMAR G 5. Gender : Male

    6(a). Father Name : GOPALA R 6(b). Mother Name : R YERAMMA

    7. Address & Mobile No : I P NAGR PEENYA 2ND STAGE ,Bbmp , Ward No.70 ,BANGALORE URBAN & 80XXXXXX81

    9. Pass Year: 2013-Karnataka


    8. SSLC HT No : 20XXXXXXX35 10. Date of Birth: 18-07-1998
    SSLC Board
    11.Family Annual Income (in Rs.):
    12. SATS ID : -NA- 12(a). Ration Card : -NA-
    45000
    13.College Details(college Nature) : DON BOSCO INSTITUTE OF TECHNOLOGY , Bangalore South,Bangalore Urban , (Private Aided College)
    ,Visvesvaraya Technological University (VTU), Belgaum
    14. Course Name /Course Year /Duration of Course : BE (Mechanical Engineering) / IV Yr / 4 Yrs 
    15. College Admission No / Admission Date(of this year): / Admission
    16. Distance (in Kms.) : 30
    Through DBIT004014 / 12-10-2019 / Government Quota

    18. Scholarship Applied for: 1.Post-Matric/Food & Accomodation,2.Fee


    17. Scholarship Type : Day Scholar
    Concession
    19. Bank Name / IFSC Code: STATE BANK OF INDIA /SBIN0013445 20(a). Bank A/c No : XXXXXXX9022

    (a).Income Caste Cert. No. : (c).Aadhaar No. / Name / Demo Aadhar Status: XXXXXXXX8242 / AKSHAY
    (b).Cat-1 Caste Cert. No.: -NA-
    RD003819XXXXXX1 KUMAR G / NOT DONE

    I. Declaration and Aadhaar Consent


             I hereby consent for the use of my Aadhaar number of XXXX / XXXX / 8242 , provided in the application for Scholarship, to carryout Identity
    Validation,to make Direct Benefit Transfer of Scholarship to the Bank Account and also to seed the said Aadhaar number into ePASS Scholarship.
    Further, I also consent to obtain its Aadhaar Number and to use the Aadhaar number, so obtained, to carryout Identity validation and also to make
    Direct Benefit Transfer of Scholarship to the Bank Account."
             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 :
                

    II.Verification Report of College Principal


            This is to certify that the information furnished above is verified with the records and found to be correct. He / She is a bonafide student of our
    college studying in BE (Mechanical Engineering)  /  IV Yr   (Course & Course Year) during 2019-20 .
       
    Signature of the Principal
        Date :
              (With College Seal)           

    III.Verification Report of Verification Officer/ 


            I have verified the contents of scholarship  Renewal  application with reference to the college records and original certificates, physically
     
    identified the student verified the following certificates

    Yes No Yes No Yes No Yes No Yes No


    Caste : Income: SSLC: TC: Ration Card:

    SATS Yes No Yes No Bank Yes No Yes No Previous Yes No


    Aadhaar: PHC:
    ID: Passbook: Marks:
    Other Details/Certificates if  
    any:
    I recommend for sanction of :
     
         Post-Matric/Food & Accomodation/Fee Concession (OR) Nursing
     
      I do not recommend the sanction of scholarship for the following reasons. (Please specify)
       
      I have physically verified the SSLC Certificate in person
     
      Date : Signature of the Verification Officer
     
    Print Back
    October 24, 2019 02:35:35 PM

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