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ConfirmationPage 200310396180

Mohit Singh has applied and paid ₹650 for the January 2020 JEE(Main) exam. He is providing his personal details including name, date of birth, category, gender, place of residence, and contact information. He has selected English as the question paper medium and chosen exam cities in Jharkhand including Dhanbad, Bokaro Steel City, and Ranchi. Mohit has uploaded his photograph and signature and declared that all information provided is true.

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mohit
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64 views1 page

ConfirmationPage 200310396180

Mohit Singh has applied and paid ₹650 for the January 2020 JEE(Main) exam. He is providing his personal details including name, date of birth, category, gender, place of residence, and contact information. He has selected English as the question paper medium and chosen exam cities in Jharkhand including Dhanbad, Bokaro Steel City, and Ranchi. Mohit has uploaded his photograph and signature and declared that all information provided is true.

Uploaded by

mohit
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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JANUARY JEE(MAIN) 2020

Confirmation Page

Application No. 2003 1039 6180 C


DO NOT SEND THIS PAGE TO NATIONAL TESTING AGENCY (NTA).
CANDIDATE IS REQUESTED TO RETAIN THE PRINTOUT OF CONFIRMATION PAGE FOR FUTURE REFERENCE.

Personal Details
Candidate's Name MOHIT SINGH Date of Birth 04-08-2001
Mother's Name NITU SINGH Category General
Father's Name MUKESH KUMAR SINGH Gender Male
If you are a PwD Candidate, do you have No Nationality Indian
benchmark disability (40% or more /
“Severe” where percentage is not defined)
?
Place of Residence Urban State Code of Eligibility JHARKHAND
Are You Diabetic? NO Mode of Preparation Tutorial Classes

Apply For
Apply For B.E./B.Tech. Only Question Paper Medium English
Exam City 1st JHARKHAND - DHANBAD Exam City 2nd JHARKHAND - BOKARO STEEL CITY
Exam City 3rd JHARKHAND - RANCHI Exam City 4th JHARKHAND - JAMSHEDPUR

Additional Details
Are you a Twin No

Contact Details
Address NEW BANK COLONY, STEEL GATE, SARAIDHELA Locality
City/Town/Village DHANBAD District DHANBAD
State/UT JHARKHAND Pin Code 828127
Email Address muk**********@gmail.com Mobile Number (+91) 960****768
Land Line No. with --
STD code or any
other Contact No.

Fee Payment Details


Payment Mode: Pay through SBI(MOPS) Transaction ID: CPU7849276
Exam Fee: 650 /- Date of Transaction: 18/09/2019 13:45:29
Fee Submitted On: 18/09/2019
DECLARATION
I hereby declare that all the particulars given by me in this form are true to the best of my knowledge and belief and any mistake / misinformation, detected at the time
of admission or at any stage in future, will result in the cancellation of admission/candidature. I have read the information bulletin and understood all the procedures. In
case I furnish any false information, my result will not be declared/ my candidature will automatically stand cancelled. I shall abide by terms and conditions therein.

Images Uploaded by Candidate


Photograph Signature

List of Document Uploaded


Photograph,Signature

IP Address : 47.9.246.182 Date of Downloading : 17/10/2019 11:48:43 AM

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