GOVERNMENT OF GUJARAT Submit Date : 29/12/2020

Application No:
BCK-81A Post Matric Scholarship of Government of India for the 202100000001815738
OBC students
Renewal Application

Previous Application No: 192000000000739647

Previous Paid Scholarship:3800

Student Basic Details

Name of Student : MISTRI JAY SANJAYBHAI
Name of Student (As per Aadhar) : MISTRI JAY SANJAYBHAI
Mother's Name : PRABHABEN
Date of Birth : 21/08/2002 Gender : Male
Category : SEBC Religion :Hindu
Caste : Suthar(ɅkTh^ 

Aadhaar Status Verified: Yes(29/12/2020 11:00:00)

Annual Income of Parents/Guardian/Husband (Rs): 120000 Habitation Type: Urban

Mobile Number : 9327567006 E-mail Address : mistryjay62@gmail.com
Aadhar No : 84xxxxxx7554 Parent/Guardian occupation: Business(V5Vs
Is Orphan: NO Day Scholar / Hosteller : Day Scholar
Marital Status : Unmarried Hostel Type:

Current Address: Permanant Address:

State Gujarat State Gujarat

District Ahmadabad District Ahmadabad

Taluka Vejalpur Taluka Vejalpur

Village Village
PinCode 380051 PinCode 380051

Address:B-02 SHRADDHA APPT VEJALPUR AHMEDABAD Address:B-02 SHRADDHA APPT VEJALPUR AHMEDABAD

Student Bank Account Detail/Aadhar Bank Detail

I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 84xxxxxx7554 Bank name : XXXX Bank
Mandate Date : 7/12/2017 12:00:00 AM Status : Active
I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
Account No : 46xxxxxx4934 IFSC Code : BARB0JIVRAJ
Student Name(As per Bank Name): jay sanjaybhai mistry

Name of Bank : BANK OF BARODA

Branch Name & Address : JIVRAJ PARK,AHMADABAD,GUJ

I hereby accept that
1.Details provided by me are correct to best of my knowledge
2.Shall not make any claims if amount is transferred to a wrong account due to incorrect
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.
5.I voluntarily give my consent to use my Aadhaar details
6.I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar

Student Academic Details

Present Course/Class/Trade Type: Commerce

Present Course/Class/Trade Name : B.Com Bachelor Of Commerce

Present Course/Class/Trade Year : 1ST YEAR(1st Semester/2nd Semester)

Studying in : Gujarat Enrollment No: 201903114578

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 Present Institute District : Ahmadabad Present Institute : R. J. Tibrewal Commerce College

Admission Type : Regular Seat(Government Quota) Present Branch Course : -

Enter Your Research/Thesis Subject :

Present Class Start Date : 20-Jun-2019 Present Course Completion Date : 25-Apr-2020

Fees Amount
Admission Fees (Rs) 0
Tution Fees (Rs) 1200
Misc.Fee(NonRefundable Fees) 820
Exam Fees(Rs) 500

Total (Rs) 2520

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 GSEB A7069850 2017 80.16

11th Std/12 Std 12TH GHSEB G654398 2019 83

Commerce B.Com Bachelor Of Commerce Bcom sem1 5991 2019 61

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 Fee Receipt of Current Course Year

2 Income Certificate issued by Competent Authorities

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 : 11/01/2021
Verify Mobile Number : Yes 29/12/2020
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 online/blended education and maintained minimum attendance criteria till date
for the A.Y. 2020 ±

The actual School/College/University online/blended education year began on ________________________ and will be ended on
________________________

Signature Of Head Of The School/College/Institute/University With Official Seal

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Place :
*Note : Stamp Signature will not be accepted

Date :

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