Government of Telangana
Department of Backward Classes
Student Application cum Verification Report for
Post-Matric Scholarship Renewal 2024-25
1. Application No: 2024 1089 0448 2. Application Date: 27-09-2024 3. Caste / Sub Caste: BC-B / Padmasali(Sl.No.-17)
4. Student Name : KOKKULA SAI KIRAN 5. Gender : Male
6. Father / Mother Name :KUMARASWAMY
7. Address & Mobile No : 54-89 RAMAKRISHNAPUR ,Mandamarri , Kyethenpalle ,MANCHERIAL & xxxxxx4720
8. SSC HT No : 1903110231 9. Pass Year -Pass Type : 2019-Regular 10. Date of Birth: 06-07-2003
11.Family Annual Income (in Rs.): 98000 12. UID(aadhar) : xxxxxxxx1284
13. Income Certificate Details: ,
,
14.College Details : BALAJI INSTITUTE OF TECHNOLOGY SCIENCES MAHESWARAM , Narsampet,Warangal , Private College
,JNTU HYDERABAD
15. Course Name /Course Year /Duration of Course : BTECH (EEE) / IV Yr / 4Yrs
16. College Admission No / Admission Date(of this year): 30675 / 01-08-2024 17. Distance (in Kms.) : 150
18. Scholarship Type : Day Scholar 19. DAH Name : -
20. Bank Name / IFSC Code: -RAMAKRISHNA PURAM /SBIN0020895 21. Bank A/c No : 38729638376
I.Declaration
I hereby certify that that above information furnished is true. I have not availed any other scholarship for this purpose from any other
sources. I shall abide by the terms and conditions of the sanction of the scholarship. If any discrepancies are found later, I hereby abide for refund
of the scholarship amounts claimedand also am liable for action by the Department. .
Signature of the Student
Date :
