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Personal Details: Government of Odisha State Scholarship Portal Scholarship Application Form For Academic Year

1) Bishnupriya Das, a female OBC student, has applied for a post-matric scholarship for the 2019-20 academic year to study in class 12 at Prananath Junior College in Khordha, Odisha. 2) She provides details about her family income, caste certificate, academic qualifications, bank account, contact information, and declaration of truthfulness. 3) She must attach documents including an income certificate, caste self-declaration if EBC, Aadhaar card, marksheets, and bank passbook details to complete her application.

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438 views1 page

Personal Details: Government of Odisha State Scholarship Portal Scholarship Application Form For Academic Year

1) Bishnupriya Das, a female OBC student, has applied for a post-matric scholarship for the 2019-20 academic year to study in class 12 at Prananath Junior College in Khordha, Odisha. 2) She provides details about her family income, caste certificate, academic qualifications, bank account, contact information, and declaration of truthfulness. 3) She must attach documents including an income certificate, caste self-declaration if EBC, Aadhaar card, marksheets, and bank passbook details to complete her application.

Uploaded by

aamunmamun dtpcenter
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

Government of Odisha

State Scholarship Portal


Scholarship Application Form For Academic Year 2019-20

Application Number : 3242980 Fresh Application Scheme : Post Matric Scholarship-OBC/SEBC

Personal Details
Name : BISHNUPRIYA DAS Gender : Female
SANTOSH DAS Mother's Name : RANJULATA DAS
Father's Name :
Annual Income : Rs.45000/- Date of Birth : 13/04/2004
Category : OBC/SEBC Religion : Hindu
Special Category : No ADHAAR Card No. : XXXXXXXX8117
Caste Certificate e-OBC/562 of 2019 & 21/09/2019 Caste Certficate REVENUE OFFICER KHORDHA
No. & Date : Issued by :

Academic Details
Institute : Prananath Junior College Tehsil / District : Khurda /Khordha
Course : Plus 2 / Arts,First Year Academic Year : 2019-20
Hosteller : No 10th Class Details: Orissa State Board (Annual) /2019
/010bb0019
Hostel Admission N.A. Last Exam 72.83
Date: Percentage:
Enrolment No. and IA-19-039 & 03/07/2019 Admission date for 03/07/2019
Date : Academic year
(2019-20) :

Contact Details :
Correspondence d/o- santosh das, Permanent d/o- santosh das,
Address at- godi sahi, aranga Address at- godi sahi, aranga
po- kumarbasta po- kumarbasta
ps- khordha, DISTRICT :- Khordha , ps- khordha, DISTRICT :- Khordha ,
STATE :- Odisha , PIN CODE :- 752055 STATE :- Odisha , PIN CODE :-
752055
Contact Numbers : , 8763742840 Email Address : [email protected]

Bank Details :
UCBA0001566 Branch Name : PAIKTIGIRIA, ANGUL
IFSC Code :
Bank Name : UCO BANK Account Number : **********1090
Branch Address: UCO BANKPAIKTIGIRIA

Declaration
I, BISHNUPRIYA DAS S/o / D/o/ W/o/ C/o SANTOSH DAS hereby declare that the information given in the application form is true
as per my knowledge and belief. I also undertake that if, at any stage, it is found to the satisfaction of the sanctioning authority that
the information given by me is false, the entire amount of scholarship will be recovered from me, apart from such penal action as
warranted by law. Further, I hereby consent that I have no objection in authenticating myself with Aadhaar for the purposes of availing
Post-matric Scholarship.

Check List
Document to be attached : -
a. INCOME CERTIFICATE (IN CASE YOU ARE RENEWING YOUR APPLICATION IN A NEW COURSE)
b. SELF DECLARATION OF CASTE AS GENERAL (IN CASE OF EBC STUDENT)
c. AADHAAR
d. SELF-ATTESTED CERTIFICATES/MARKSHEETS OF ALL EXAMS PASSED
e.FIRST PAGE OF BANK PASS BOOK CONTAINING THE NAME OF ACCOUNT HOLDER, ACCOUNT NUMBER, IFSC CODE.

(Signature)

Generated by Odisha Scholarship Portal as on 30/09/2019

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