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2025FORMPHADSIR

The document outlines the application details for a scholarship aimed at VJNT students, including personal, income, domicile, caste, and educational information for the applicant, Vaishnavi Vitthal Phad. It specifies the benefits of the scholarship, including tuition and examination fees, and includes a declaration of the truthfulness of the information provided. The application was submitted on 09/03/2025 and includes various supporting documents related to the applicant's qualifications and family background.

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0% found this document useful (0 votes)
5 views

2025FORMPHADSIR

The document outlines the application details for a scholarship aimed at VJNT students, including personal, income, domicile, caste, and educational information for the applicant, Vaishnavi Vitthal Phad. It specifies the benefits of the scholarship, including tuition and examination fees, and includes a declaration of the truthfulness of the information provided. The application was submitted on 09/03/2025 and includes various supporting documents related to the applicant's qualifications and family background.

Uploaded by

hemrajpache
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Applicant Details

Applicant Photo
ApplicationID :2425VJT1000377935

Application ID Scheme Name


2425VJT1000377935 Tuition Fees and Examination
Fees to VJNT Students

Department Name Applied Date


OBC, SEBC, VJNT & SBC 09/03/2025
Welfare Department

Personal Details
ApplicationID :2425VJT1000377935

Full Name Mobile Number. Email ID


Vaishnavi Vitthal Phad xxxxxx2616
Date Of Birth
2005

Gender Age Religion


Female 20 Hindu

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


Unmarried SSC Marksheet/ L.C.) xxxxxx2616
PHAD VAISHNVI VITTHAL
Dependent Type
-

Permanent address Details


ApplicationID :2425VJT1000377935

Address State District


,,11, Near Hanuman Maharashtra Beed
Temple,Pattiwadgaon,431519
Taluka Village
Ambejogai MURTI

Pincode IsCorrespondence Address


431519 same as Permanent?
Yes

Correspondence Address Details


ApplicationID :2425VJT1000377935

Address State District


,,11, Near Hanuman Maharashtra Beed
Temple,Pattiwadgaon,431519
Taluka Village
Ambejogai MURTI

Pincode
431519

Income Details
ApplicationID :2425VJT1000377935

Do you have Income Certificate? Does your Certificate have a Family Annual Income
Yes Barcode? 1166809.00
No
Income Certificate No
42253507103

Issuing Authority Date of Issue


Tahsildar 11/02/2025

Domicile Details
ApplicationID :2425VJT1000377935

Are you Domicile of Do you have Domicile Relationship Type


Maharashtra? Certificate? Self
Yes Yes
Domicile Certificate No.
42253057971

Does your Certificate have a Applicant Name Issuing Authority


Barcode? PHAD VAISHNVI VITTHAL Tahsildar
No
Date of Issue
26/12/2017

Caste Details
ApplicationID :2425VJT1000377935

Do you have Caste Certificate? Caste Category Does your Certificate have a
Yes (VJNT) Vimukta Jat Nomadic Barcode?
Tribes No

Caste Certificate Number Issuing District Applicant Name


370 Beed PHAD VAISHNVI VITTHAL
Issuing Authority
Sub Divisional Officer(SDO)

Personal Eligibility Details


ApplicationID :2425VJT1000377935

Are you Salaried? Disability of any Type?


No No

Parent's/Guardian's Details
ApplicationID :2425VJT1000377935

Is Father Alive? Father Name Is Father Salaried?


Yes VITTHAL Yes

Father Occupation Is Mother Alive? Mother Name


Service Yes SANGITA

Is Mother Salaried?
No

Past Qualification Details


ApplicationID :2425VJT1000377935

Qualification Level Stream Completed


H.S.C. (12 Std) Science Completed

Institute State Institute District Institute Taluka


Maharashtra Latur Latur

College Name / School Name Course Name Board/University


RAJARSHI SHAHU JR. 12th Science MAHARASHTRA STATE BOARD
COLLEGE OF SECONDARY AND HIGHER
SECONDARY EDUCATION

Mode Admission Year Passing Year


Regular 2022 2023

Result Percentage Attempts


Passed 86.50 1

Is Gap? Qualification Level Stream


No S.S.C. (10 Std) SSC

Completed Institute State Institute District


Completed Maharashtra Latur

Institute Taluka College Name / School Name Course Name


Latur SSC

Board/University Mode Admission Year


MAHARASHTRA STATE BOARD Regular 2020
OF SECONDARY AND HIGHER
SECONDARY EDUCATION
Passing Year Result
2021 Passed

Percentage Attempts Is Gap?


100.00 1 No

Current Course Details


ApplicationID :2425VJT1000377935

Admission Year In Current Institute State Institute District


Course Maharashtra Gondiya
2023
Institute Taluka Qualification Level
Gondiya Under Graduate Course

Stream College Name/school Name Course Name


Health Science Government Medical College, Bachelor of medicine &
Gondiya Bachelor of Surgery(MBBS)

Admission Type Application Admission ID/CAP Year Of Study


Through CAP/Govt. Quota ID/CLAT Admit Card No Second Year
230410300648
Completed Or Continue
Pursuing

Admission Date Admission Year in Percentage


03/10/24 College/Institute -
-
Result
-

Fees Paid Course Type Admission Through Open Or


0.00 Aided Reserved Category?
(VJNT) Vimukta Jat Nomadic
Tribes

Gap Year Mode Gap Reason


0 Regular
CET / Merit Percentage / CLAT
Score
97.76
Admission Year In Current Institute State Institute District
Course Maharashtra Gondiya
2023
Institute Taluka Qualification Level
Gondiya Under Graduate Course

Stream College Name/school Name Course Name


Health Science Government Medical College, Bachelor of medicine &
Gondiya Bachelor of Surgery(MBBS)

Admission Type Application Admission ID/CAP Year Of Study


Through CAP/Govt. Quota ID/CLAT Admit Card No First Year
230410300648
Completed Or Continue
Completed

Admission Date Admission Year in Percentage


- College/Institute 65.66
2023
Result
Passed

Fees Paid Course Type Admission Through Open Or


Aided Reserved Category?
(VJNT) Vimukta Jat Nomadic
Tribes

Gap Year Mode Gap Reason


0 Regular
CET / Merit Percentage / CLAT
Score
97.76

Hostel Details
ApplicationID :2425VJT1000377935

Hosteller / Day Scholor Type Hostel Type Hostel Name


Hosteller Govt. Govt. Medical College,

Is Hostel Aided? Hostel Address Is Mess Available ?


GOVT. MEDICAL COLLEGE No
GONDIA
Rent Per Month

State District
Maharashtra Gondiya
Additional Question
ApplicationID :2425VJT1000377935

Question Answer
Ration card for identify number AADHARS.jpg Question
of children’s in family CAP Allotment Letter (For
Professional Courses)

Answer
Question Answer
CAP.jpg
Declaration certificate of DCLRATIONFORM.jpg
parents/guardians about
number of children
beneficiaries
Question
Non Creamy Layer Certificate

Answer
Question Answer
NCL.pdf
Is this a Renewal Application? No

Question
Leaving Certificate

Answer
Question Answer
TC.jpg
Caste Validity Certificate (For VAIL.jpg
Professional Courses As Per GR
Dated 31st July 2008) Exempted
Professional courses to be
identified

Benefits
ApplicationID :2425VJT1000377935

Tution Fee

125700.00
Exam Fee

4150.00

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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