For Office Use
Batch: Scrutiny Payment: Online/DD PI
Only Serial:
C. K. Thakur Arts, Commerce and Science College (491)
Application No :
University of Mumbai 38969
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
Academic Year: 2025-2026 Regular
APPLICATION FORM
Course Applied for : B.Com. (Autonomous)(with Credits) - Regular - PRN:2023016401068887
CBCS - T.Y. B.Com.(Autonomous) Sem V (BCOMAUTO1001)
Application Date : 02/07/2025 Payment Category : 13
1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed PATIL VIPUL DILIP
on Mark sheet : [*This name will appear on all University records/documents]
Mother's
Father's/Husband's Name : DILIP MANISHA
Name :
Mother
Marital Status : UnMarried
Tongue :
Place Of Birth : NAVALI Gender : Male Date of Birth (DD/MM/YYYY) : 30/04/2006
Blood Group : Religion : Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
Location Area : Not
State : Maharashtra District : Thane Tehsil : Thane City/Town/Village :
Available
Address (House
no,street/area/suburb HOUSE NO. 38 AT. NAVALI POST. DAHISAR TALE.DIST.THANE NAVALI Pin Code : 400612
etc.) :
Contact details
Mobile
7738344619 Email ID: vipulpatil924@gmail.com
Number
2.Legal Reservation Information
Category Type :
Category : GEN
Open
Is Guardian from EBC (Economic
Is Specially Abled? No
Backward Class)? No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Sem V
BCOM001 - PAPER I BCOM002 - PAPER II
BCOM003 - PAPER III BCOM004 - PAPER IV
Sem VI
BCOM005 - PAPER V BCOM006 - PAPER VI
BCOM007 - PAPER VII BCOM008 - PAPER VIII
Medium of Instruction : English
4.Guardian Information
Occupation of Guardian : Farmer Annual Income of Guardian : 15000
5.Educational Details
Month Exam
Name of Name of Board/University Name of Certificate Mark Out
and Year Seat CGPA %
Examination and State of University School/College No. Obtained of
of Passing No.
MAHARASHTRA STATE
BOARD OF SECONDARY March
Std 10th -- -- 406.00 500.00 -- - -- 81.20
AND HIGHER SECONDARY 2021
EDUCATION,
MAHARASHTRA STATE
Std 12th 12Th BOARD OF SECONDARY
May 2023 -- -- 383.00 600.00 -- - -- 63.83
(Commerce) AND HIGHER SECONDARY
EDUCATION,
Your Last Qualifying Exam:
7.Other Information
Would you like to apply for Hostel accommodation required NA
DECLARATION
I hereby declare that all the information furnished by me in this application form is true, complete and correct to the best of my
knowledge and belief. I do understand that I need to obtain and produce all the required documents. I admit to having
understood what constitutes ragging and sexual harassment. I have read the guidelines related to the same. I hereby affirm that if
found guilty of ragging or sexual harassment I am liable for punishment according to the university regulations.
Place : Date :
( Signature of the Candidate )
Document printed on Wed Jul 02 2025 10:13:57 GMT+0530 (India Standard Time)
