GOVERNMENT OF GUJARAT Submit Date : 26/11/2024

Application No:
PM -YASASVI Post Matric Scholarship for OBC, EBC and DNT 242500000000242034
Students
Renewal Application

Previous Application No: 232400000000998093

Previous Paid Scholarship:

Student Basic Details

Name of Student : VIHOL JINALBEN RAJENDRASINH

Name of Student (As per Aadhar) : vihol jinalben rajendrasinh
Mother's Name : niruba
Date of Birth : 01/10/2007 Gender : Female
Category : EBC(8iTD^ŽSpXJhSaF½  Religion :Hindu
Caste :
Aadhaar Status Verified: Yes(26/11/2024 18:54:41)

Ration Card No. : 104006010983406 Ration Card Member No. : 104006010983406004

Name As Per Ration Card: (Vihol Jinalben Rajendrasinh / iaes_ĥW_ZpW^hȐƛ̃id„e
EKYC Status As Per Ration Card: Yes EKYC Date: 07-01-2023
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): 70000 Habitation Type: Rural

Mobile Number : 7622908154 E-mail Address : [email protected]
Aadhar No : 86xxxxxx1153 Parent/Guardian occupation: Agriculture(EpSj
Is Orphan: NO Day Scholar / Hosteller : Day Scholar
Marital Status : Unmarried Hostel Type:

Current Address: Permanant Address:

State Gujarat State Gujarat

District Mahesana District Mahesana

Taluka Vijapur Taluka Vijapur

Village Pilvai Village Pilvai

PinCode 382850 PinCode 382850

Address:ASHAPURA SOCIERTY, PILVAI Address:ASHAPURA SOCIERTY, PILVAI

Student Bank Account Detail/Aadhar Bank Detail

I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 86xxxxxx1153 Bank name : -
NPCI Date : 11/26/2024 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 : 22xxxxxx7967 IFSC Code : BKID0002201
Student Name(As per Bank Name): JINALBEN RAJENDRASINH
VIHOL
Name of Bank : BANK OF INDIA

Branch Name & Address : PILVAI

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

Page 1 of 3 242500000000242034 Print Date :24/02/2025

 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: 11th Std/12 Std

Present Course/Class/Trade Name : 12TH

Present Course/Class/Trade Year : 12TH

Studying in : Gujarat Enrollment No:

Present Institute District : Mahesana Present Institute : SHETH G.C. HIGH SCHOOL Sec and H.Sec
(24040805906)
Admission Type : Regular Seat(Government Quota) Present Branch Course : -

Enter Your Research/Thesis Subject :

Present Class Start Date : 15-Jun-2024 Present Course Completion Date : 30-Apr-2025

Fees Amount
Admission Fees (Rs) 100
Tution Fees (Rs) 0
Misc.Fee(NonRefundable Fees) 0
Exam Fees(Rs) 0

Total (Rs) 100

Previous stream :11TH Previous Class/Course : 11TH

Previous Passing Year : 2023 Previous (%) : 63.10

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

Previous Education Detail

Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
9th Std/10th Std 10TH general A7193493 2023 63.16

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 Fee Receipt of Current Course Year

4 Self Attested Certificate of Previous academic marksheet

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

6 School Leaving Certificate (If Any)

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 : 24/02/2025

Verify Mobile Number : Yes 26/11/2024

Page 2 of 3 242500000000242034 Print Date :24/02/2025

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 :

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