GOVERNMENT OF GUJARAT
Umbrella Scheme for Education of ST Students Post-Matric
Scholarship
Student Basic Details
Name of Student : GAMIT MOHITKUMAR BABJIBHAI
Name of Student (As per Aadhar) : MOHITKUMAR BABJIBHAI GAMIT
Mother's Name : RAMILABEN
Date of Birth : 16/12/1994 Gender : Male
Category : ST Religion :Hindu
Caste : Gamit
Aadhaar Status : No(13/10/2017 [Link])
Annual Income of Parents/Guardian/Husband (Rs): 45000 Habitation Type: Rural
Mobile Number : 9898675344 E-mail Address : gamitmohit@[Link]
Aadhar No : 616561053904 Parent/Guardian occupation: Farm Labour(Ep\l^
Is Orphan: NO Day Scholar / Hosteller : Day Scholar
Marital Status : Unmarried Hostel Type:
Current Address: Permanant Address:
District Gandhinagar District Gandhinagar
Taluka Gandhinagar Taluka Gandhinagar
Village Village Kudasan
PinCode 382041 PinCode 382421
Address:IV,22/11 , GSECL,G.E.B. COLONY,SECTOR- Address:BRAHMANVAS,KUDASAN,GANDHINAGAR
30,GANDHINAGAR
Student Bank Account Detail/Aadhar Bank Detail
I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 616561053904 Bank name : -
Mandate Date : - Status :
I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
Account No : 20237721560 IFSC Code : SBIN0014975
Student Name(As per Bank Name): MOHITKUMAR
BABJIBHAI GAMIT
Name of Bank : STATE BANK OF INDIA
Branch Name & Address : KUDASAN
I hereby accept that
[Link] provided by me are correct to best of my knowledge
[Link] not make any claims if amount is transferred to a wrong account due to incorrect
[Link] refund the amount transferred to someone elses account due to incorrect details provided by me
4.I will refund the excess amount credited to my account, if any.
Student Academic Details
Present Course/Class/Trade Type: Engineering & Technology
Present Course/Class/Trade Name : M.E Master Of Engineering
Present Course/Class/Trade Year : 1ST YEAR(1st Semester/2nd Semester)
Studing in : Gujarat
Present Institute District : Gandhinagar Present Institute :
030 L.D.R.P. INSTITUTE OF TECH. &
RESEARCH., GANDHINAGAR (Id: C-322)
Admission Type : Regular Paid (Self Finance)Seat Present Branch Course : Mechanical (Thermal Engg.)
Courtesy :: National Informatics Centre, Gujarat Page 1 of 2 170000555545 Print Date :17/10/2017
Present Class Start Date : 12-Aug-2017 Present Course Completion Date : 15-Aug-2019
Fees Amount
Admission Fees (Rs) 0
Tution Fees (Rs) 110000
[Link](NonRefundable Fees) 0
Total (Rs) 110000
Educational Break : Yes No. Of. Year in Break : 1
Are You Employed in any Organization/Establishment with leave without pay? : Not Applicable
Education Details
Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
9th Std/10th Std 10TH GUJRATI A B4647 2010 72
MEDIUM
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 Income Certificate From the Concerned Authorised Authority/Persons
2 Self Attested Caste Certificate From the Competent Authorities
3 Self Attested Copy of Aadhar Card
4 Fee Receipt of Current Course Year
5 Self Attested Certificate of Previous academic marksheet
6 First Page Of Bank PassBook/Cancelled Cheque
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 havent 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 : 10/17/2017
Place : Signature of the applicant
Courtesy :: National Informatics Centre, Gujarat Page 2 of 2 170000555545 Print Date :17/10/2017
