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JEE Main 2020 Confirmation Page

This document is a confirmation page for D Keerthi's January JEE(Main) 2020 application. It provides her personal details like name, date of birth, category, gender, nationality, address, contact information, and fee payment details. It also lists the exam cities selected and documents uploaded as part of the application.

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M JEEVARATHNAM NAIDU
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© © All Rights Reserved
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29 views1 page

JEE Main 2020 Confirmation Page

This document is a confirmation page for D Keerthi's January JEE(Main) 2020 application. It provides her personal details like name, date of birth, category, gender, nationality, address, contact information, and fee payment details. It also lists the exam cities selected and documents uploaded as part of the application.

Uploaded by

M JEEVARATHNAM NAIDU
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

JANUARY JEE(MAIN) 2020

Confirmation Page

Application No. 2003 1054 5459 -


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 D KEERTHI Date of Birth 09-07-2003
Mother's Name D THULASI Category OBC- NCL (Central List)
Father's Name D NAGARAJA Gender Female
In case of Girl candidate, Are you only girl NO If you are a PwD Candidate, No
child of your parents? do you have benchmark
disability (40% or more /
“Severe” where percentage is
not defined) ?
Nationality Indian Place of Residence Rural
State Code of Eligibility ANDHRA PRADESH Are You Diabetic? NO
Mode of Preparation Self Study

Apply For
Apply For B.E./[Link]. Only Question Paper Medium English
Exam City 1st ANDHRA PRADESH - CHITTOOR Exam City 2nd ANDHRA PRADESH - TIRUPATHI
Exam City 3rd TAMIL NADU - VELLORE Exam City 4th ANDHRA PRADESH - NELLORE

Additional Details
Are you a Twin No

Contact Details
Address GUNDLAKATTAMANCHI Locality SATARAM
City/Town/Village BANGARUPALYAM District CHITTOOR
State/UT ANDHRA PRADESH Pin Code 517416
Email Address kee**************@[Link] Mobile Number (+91) 957****646
Land Line No. with --
STD code or any
other Contact No.

Fee Payment Details


Payment Mode: Pay through SBI(MOPS) Transaction ID: CPU8667052
Exam Fee: 325 /- Date of Transaction: 21/09/2019 [Link]
Fee Submitted On: 21/09/2019
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 : [Link] Date of Downloading : 21/09/2019 [Link] AM

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