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Department of Backward Classes: Fresh 2012-13

This document is an application for a matric scholarship renewal submitted by Santosh Kumar Reddy, a male student born on June 2, 1993 from Ichchapuram, Andhra Pradesh. He is currently studying in the second year of a BTech in Mechanical Engineering at Gokaraju Rangaraju Institute of Engineering and Technology and is applying for the scholarship to help cover costs of studying at a student managed hostel that is 985 km from his home. The application includes details of his income, education qualifications, bank account, and verification by his college principal and the verification officer.

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57 views3 pages

Department of Backward Classes: Fresh 2012-13

This document is an application for a matric scholarship renewal submitted by Santosh Kumar Reddy, a male student born on June 2, 1993 from Ichchapuram, Andhra Pradesh. He is currently studying in the second year of a BTech in Mechanical Engineering at Gokaraju Rangaraju Institute of Engineering and Technology and is applying for the scholarship to help cover costs of studying at a student managed hostel that is 985 km from his home. The application includes details of his income, education qualifications, bank account, and verification by his college principal and the verification officer.

Uploaded by

venkat
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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vernment of Andhra Pradesh

tment of Backward Classes

nt Application cum Verification


Report for
Matric Scholarship Fresh 2012-13

cation No: 2012 0152 9853 2. Application Date: 13-12-2012 3. Caste / Sub Caste: BC-A / Reddika(Sl.No.-29)

5. Gender : Male
nt Name : GUMUDI SANTOSH KUMAR REDDY

r / Mother Name : GUMUDI HERAMBO REDDY

ss & Mobile No : 7-2-28 ,Ichchapuram , Telukunchi ,Srikakulam & 8500272742

9. Pass Year -Pass Type : 2009-


HT No : 05110525 10. Date of Birth: 02-06-1993
Regular
y Annual Income (in Rs.): 41000 12. Ration Card :

me Certificate Details: SD07212040 , 01-01-0001 ,


lege Details : gokaraju rangaraju institute of engineering technology bachupally quthbullapur , Quthbullapur,Ranga Red
e ,JNTU HYDERABAD

se Name /Course Year /Duration of Course : BTECH (MECHANICAL) / II Yr / 4Yrs

ege Admission No / Admission Date(of this year): 12245A0310 / 04-08-2012 17. Distance (in Kms.) : 985

larship Type : Student Managed Hostel 19. DAH Name : -

k Name / IFSC Code: SBIN-ICHAPURAM /SBIN0000983 21. Bank A/c No : 32410991939

I.Declaration

hereby certify that that above information furnished is true. I have not availed any other scholarship for this purpose from any ot
s. I shall abide by the terms and conditions of the sanction of the scholarship. If any discrepancies are found later, I hereby abide
scholarship amounts claimedand also am liable for action by the Department. .

Signature of the Student


e:

II.Verification Report of College Principal

his is to certify that the information furnished above is verified with the records and found to be correct. He / She is a bonafide s
llege studying in BTECH (MECHANICAL) / II Yr (Course & Course Year) during 2012-13 .

Signature of the Principal


e:
(With College Seal)

III.Verification Report of Verification Officer/ ABCWO

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

te : Yes No Income: Yes No SSC: Yes No TC: Yes No Ration Card: Yes

er Details/Certificates if any:
ommend for sanction of Post-matric Scholarship under DS SMH CAH D
not recommend the sanction of scholarship for the following reasons. (Please specify)

e physically verified the SSC Certificate in person

Signature of
:
Verification O

January 23, 2013 07:52:54 PM

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