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    UNIVERSITY FORM

    Uploaded by

    Ok Kuche
    9yddc dcwdcwd c

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    UNIVERSITY FORM

    Uploaded by

    Ok Kuche
    1 views2 pages
    9yddc dcwdcwd c

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    © © All Rights Reserved

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    UNIVERSITY FORM

    Uploaded by

    Ok Kuche
    9yddc dcwdcwd c

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 2

    2/3/2021

    For Office Use


    Batch: Scrutiny Payment: Online/DD PI

    Only Serial:

    Dr. D. Y. Patil College of Law, Nerul (698)


    D.Y,PATIL VIDYANAGARI SEC - 7.NERUL NAVI MUMBAI Thane
    Application No :
    University of Mumbai 3659823
    M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
    Academic Year: 2020-2021
    Regular
    APPLICATION FORM

    Course Applied for : L.L.B. (5 years) - Regular - Revised Pattern (L.L.B.) - F.Y. L.L.B. Sem I (-) PRN:
    Application Date : 03/02/2021 Payment Category :

    1.Personal Information

    Candidate's Name(Regional) : कुचे ओंकार ब ीलाल


    Candidate's Name as printed on Mark KUCHE ONKAR BANSILAL
    sheet : [*This name will appear on all University records/documents]
    Father's/Husband's Name : BANSILAL KUCHE Mother's Name : PUSHPA

    Marital Status : UnMarried Mother Tongue : Marathi


    Place Of Birth : Aurangabad Gender : Male Date of Birth (DD/MM/YYYY) : 12/03/2000
    Blood Group : BPositive Religion : Hindu Country of Citizenship : India
    Height : Not Available Weight : Not Available Hemoglobin : Not Available
    Is Student NRI/ Foreign National : No Domicile State: Maharashtra
    Address For Correspondence :
    City/Town/Village :
    State : Maharashtra District : Aurangabad Tehsil : Aurangabad Location Area : Urban
    AURANGABAD
    Address (House
    5-12-3-245 MUKUNDWADI MUKUNDWADI Pin Code : 431006
    no,street/area/suburb etc.) :
    Permanent Address :
    City/Town/Village :
    State : Maharashtra District : Aurangabad Tehsil : Aurangabad Location Area : Urban
    AURANGABAD
    Address : 5-12-3-245 MUKUNDWADI MUKUNDWADI Pin Code : 431006
    Contact details
    Mobile Number 8379813603 Email ID: okkuche@gmail.com
    2.Legal Reservation Information
    Category Type :
    Category : SC Sub Category : CHAMBHAR
    Reserved
    Is Specially Abled? No
    3.Social Information(Additional Inforamtion)

    Paper Selected for:


    Sem I
    L1 - English I L2 - Logic I
    L3 - Economics
    Sem II

    L4 - History L5 - Political Science I


    L6 - Legal Writing and Legal Language

    Medium of Instruction : English


    4.Guardian Information
    Occupation of Guardian : Laborer Annual Income of Guardian : 40000
    5.Educational Details

    1/2
    2/3/2021

    Month
    Name of Name of Board/University and State of Name of Exam Certificate Mark
    and Year Out of CGPA %
    Examination University School/College Seat No. No. Obtained
    of Passing
    MAHARASHTRA STATE BOARD OF
    SWAMI
    SECONDARY AND HIGHER
    Std 10th VIVEKANAND June 2016 K005680 021611 365.00 500.00 -- - -- 73.00
    SECONDARY
    ACADEMY
    EDUCATION,Maharashtra
    MAHARASHTRA STATE BOARD OF
    ARTS COMMERCE
    Std 12th SECONDARY AND HIGHER
    AND SCIENCE July 2018 R018980 037061 433.00 650.00 -- - -- 66.62
    Science SECONDARY
    JUNIOR COLLEGE
    EDUCATION,Maharashtra
    Your Last Qualifying Exam: HSC/Std 12th [Science]
    7.Other Information
    Would you like to apply for Hostel accommodation required NA
    Required Documents and Certificates Section:
    Passing Certificate of Std 12th / Statement of Marks of Std 12th OR Original Passing Certificate /Statement of Marks of Last Qualifying Exam like
    degree,diploma,etc.

    Certificate of Caste with Category.

    Leaving Certificate.

    Domicile Certificate.

    Self affidavit regarding gap in academic year (Gap Certificate).

    Statement of Marks of Std 10th.

    Father’s Income certificate from Tahsildar.

    Residence Proof (Any) – Copy of Voter ID/ Driving License/Telephone Bill /Electricity Bill /Ration Card/ Society Letter/ Agreement.

    Statement of CET/Certificate of CET.

    DECLARATION
    I hereby declare that all the information furnished by me in this application form is true, complete and correct to the best of my knowledge and belief. I do
    understand that I need to obtain and produce all the required documents. I Application No :3659823 (KUCHE ONKAR BANSILAL) admit to having
    understood what constitutes ragging and sexual harassment. I have read the guidelines related to the same. I hereby affirm that if found guilty of ragging
    or sexual harassment I am liable for punishment according to the university regulations.

    Place : Date :
    ( Signature of the Candidate )
    For College/Institute/Study Center Use Only
    Designation Remarks / Particulars / Recommendations Signature and Date
    Admission Clerk
    Admission
    Committee
    Accountant/Cashier Cash Received: INR Receipt No.: Date:
    Registrar/Office
    Superintendent
    Document printed on Wed Feb 03 2021 00:53:54 GMT+0530 (India Standard Time)

    2/2

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