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Scholarship Application Form
ST&SC and MBC Welfare Department
Academic Year 2024-25 STSC92411286794508
Government of Odisha
Basic Information
Department Scheme Academic Year Application Type
ST&SC and MBC Welfare Post Matric Scholarship 2024-25 New
Department
Applicant Details
Applicant Name Category Applicant Gender
ADITYA KUMAR PAIKA OBC/SEBC Male
Religion Date of Birth Aadhaar No.
Hindu 04 Jul 2004 (20 Year) XXXXXXXX8152
Bank account is seeded with Aadhaar when applied by student.
Mobile No. Alternative Mobile No. e-Mail Id
9777294998 8114341554 adityakumarpaik@gmail.com
Father's Name Father Educational Status Father Occupational Status
MINAKETAN PAIKA Literate death
Mother's Name Mother Educational Status Mother Occupational Status
MANJUSHREE PAIKA Literate House Wife
Guardian Name Individual/ Family Information
VIEW
-- Beneficiary of NFSA
Address Information
District Block/ULB GP/Ward
Gajapati Nuagada Khajuripada
Village Pin Code Address
Khajuripada 761214 KHAJURIPADA
Educational Qualification Details
For : Matric-Annual
Passing Total Secured Percentage Marksheet/
Course Board Roll No. Year Mark/CGPA Marks/CGPA (%) Certificate
X BSE, 343DB0117 2020 600 446 74.33 Uploaded
Odisha
Institute / Course Information (Current Education Information)
Institute Type
Pvt. Unaided
Institute District Block/ULB
BCCM, Bhanjanagar Ganjam Bhanjanagar
Nature of Course Course Branch/Stream/Trade
Self Financing Bachelor of Computer Application (BCA) Bachelor of Computer Application (BCA)
Course Year (Current Year of Study) Admission/Registration No. Admission/Readmission Date
3rd Year 468162022 25 Nov 2024
Enrollment No. Enrollment Date
BCMB142323 26 Nov 2024
Any Exam Conducted during current academic year? : Yes
Exam Type Total Mark/CGPA Secured Mark/CGPA Percentage (%)
2nd Semester/Periodic 400 298 74.50
Residential Status
Whether
Day Scholar
Details of Last Exam Passed
Course Course Year Passing Year
Bachelor of Computer Application (BCA) 2nd Year 2024
Total Mark/CGPA Secured Marks/CGPA Percentage (%)
400 298 74.5
Certificate
Uploaded
Eligibility Information
Income Certificate No. Family Income (in Rs.) To Whom the Certificate Issued
E-NIC/2022/105501 41000.00 MANJUSHREE MAHARANA
Issuing Authority Issue Date Income Certificate
Revenue Officers not below the rank of 15 Sep 2022 Uploaded
Tahasildar / Additional Tahasildar
Matriculation Certificate No. Issuing Authority Matriculation Certificate
201278567 BSE, Odisha (Annual) Uploaded
Caste Certificate No. To Whom the Certificate Issued Issuing Authority
E-SEB/2020/35588 Aditya Kumar paika Revenue Officers not below the rank of
Tahasildar / Additional Tahasildar
Issue Date Caste Certificate
19 Aug 2020 Uploaded
Institute Declaration Certificate
NA
Bank Information
Account Holder Name IFSC Code Account No.
ADITYA KUMAR PAIKA UBIN0800651 006512010000610
Whether account number tagged /seeded with
the Aadhaar number?
Yes
Bank Name Branch Name
UNION BANK OF INDIA BHANJANAGAR
Passbook front page
Uploaded
Student Declaration
1. I have read and understood the conditions of award of Scholarship.
2. I am aware that my application is liable to be rejected, if it is found at any stage, that Aadhaar number provided by me is wrong or Aadhaar number is
of someone’s else.
3. I am aware that if more than one application is found, all my applications are liable to be rejected.
4. I am aware that for any wrong entry or mis-match of the Bank-account details, the State Government will not be responsible for mis-credit and I will
be held responsible for diversion of public money on this ground.
Date ........................
Place ........................
Full Signature of Applicant
