GOVERNMENT OF GUJARAT Submit Date : 06/01/2024

Application No:
PM -YASASVI Post Matric Scholarship for OBC, EBC and DNT 232400000000402211
Students
Renewal Application

Previous Application No: 222300000001963671

Previous Paid Scholarship:

Student Basic Details

Name of Student : PATEL URVI CHANDRAKANT
Name of Student (As per Aadhar) : URVI CHANDRAKANT PATEL
Mother's Name : DAXABEN
Date of Birth : 04/05/2003 Gender : Female
Category : SEBC Religion :Hindu
Caste : Koli Ds`Ž 

Aadhaar Status Verified: Yes(28/10/2023 17:46:00)

Annual Income of Parents/Guardian/Husband (Rs): 90000 Habitation Type: Rural

Mobile Number : 9313889441 E-mail Address : [email protected]
Aadhar No : 85xxxxxx9568 Parent/Guardian occupation: Pvt-Service(EhWFjWsD^Ž
Is Orphan: NO Day Scholar / Hosteller : Hosteler
Marital Status : Unmarried Hostel Type: Grant In AID Hostel

Current Address: Permanant Address:

State Gujarat State Gujarat

District Navsari District Navsari

Taluka Jalalpore Taluka Gandevi

Village Village
PinCode 396450 PinCode 396380

Address:MAITRY GIRL HOSTEL NAVSARI Address:MOTA FALIYA MOTI DEVSAR GANDEVI ROAD

Student Bank Account Detail/Aadhar Bank Detail

I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 85xxxxxx9568 Bank name : -
NPCI Date : 11/2/2023 12:00:00 AM NPCI Status : Accept
I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
Account No : 33xxxxxx0752 IFSC Code : SBIN0007770
Student Name(As per Bank Name): URVI CHANDRAKANT PATEL

Name of Bank : STATE BANK OF INDIA

Branch Name & Address : DEVSAR

I hereby accept that
1.Details provided by me are correct to best of my knowledge
2.Shall not make any claims if amount is transferred to a wrong account due to incorrect details provided by me
3.Shall refund the amount transferred to someone else¶s 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: Agriculture, Horticulture,Forestry,Fishries

Present Course/Class/Trade Name : B.Sc (Hons) Agriculture Bachelor of Science (Agriculture Honours)

Present Course/Class/Trade Year : 4TH YEAR(7th Semester/8th Semester)

Studying in : Gujarat Enrollment No: 3010120104

Page 1 of 3 232400000000402211 Print Date :16/01/2024

 Present Institute District : Navsari Present Institute : N.M.College of Agriculture

Admission Type : Regular Seat(Government Quota) Present Branch Course : -

Enter Your Research/Thesis Subject :

Present Class Start Date : 21-Aug-2023 Present Course Completion Date : 20-Aug-2024

Fees Amount
Admission Fees (Rs) 1000
Tution Fees (Rs) 0
Misc.Fee(NonRefundable Fees) 7750
Exam Fees(Rs) 1000

Total (Rs) 9750

Previous stream :B.Sc (Hons) Agriculture Bachelor of Science Previous Class/Course : 3RD YEAR(5th Semester/6th Semester)
(Agriculture Honours)
Previous Passing Year : 2023 Previous (%) : 70.49

Educational Break : No No. Of. Year in Break :

Previous Education Detail

Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
9th Std/10th Std 10TH GSEB B2391652 2018 85.16

11th Std/12 Std 12TH GSEB B114197 2020 75.53

Agriculture, B.Sc (Hons) Agriculture Bachelor of Science NAVSARI 30101201 2021 75.65
Horticulture,Forestry,Fishries (Agriculture Honours) AGRICULTURAL 04
UNIVERSITY
Agriculture, B.Sc (Hons) Agriculture Bachelor of Science NAVSARI 30101201 2021 89.29
Horticulture,Forestry,Fishries (Agriculture Honours) AGRICULTURAL 04
UNIVERSITY
Agriculture, B.Sc (Hons) Agriculture Bachelor of Science NAVSARI 30101201 2022 72.56
Horticulture,Forestry,Fishries (Agriculture Honours) AGRICULTURAL 04
UNIVERSITY
Agriculture, B.Sc (Hons) Agriculture Bachelor of Science NAVSARI 30101201 2022 67.78
Horticulture,Forestry,Fishries (Agriculture Honours) AGRICULTURAL 04
UNIVERSITY
Agriculture, B.Sc (Hons) Agriculture Bachelor of Science NAVSARI 30101201 2023 71.73
Horticulture,Forestry,Fishries (Agriculture Honours) AGRICULTURAL 04
UNIVERSITY
Agriculture, B.Sc (Hons) Agriculture Bachelor of Science NAVSARI 30101201 2023 70.49
Horticulture,Forestry,Fishries (Agriculture Honours) AGRICULTURAL 04
UNIVERSITY

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 Caste Certificate From the Competent Authorities

2 First Page Of Bank PassBook/Cancelled Cheque

3 Fee Receipt of Current Course Year

4 Self Attested Certificate of Previous academic marksheet

5 Hostel Certificate(Only For Hosteller Student)

6 Income Certificate (Competent Authority)(Form no.16 required For Govt. Employee)

7 School Leaving Certificate (If Any)

8 School/College Current Year Bonafide Certificate

9 Identity Card (College/School)

Page 2 of 3 232400000000402211 Print Date :16/01/2024

 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 haven¶t 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 : 16/01/2024
Verify Mobile Number : Yes 06/01/2024
Place : Signature of the applicant

It is certified that the information filled in the above mentioned fields by the students are correct to the best of my knowledge and
all the Documents has been checked.

It is also certified that in case the applicant leaves institution or otherwise discontinues the studies or detained or accepts any other
regular scholarships/stipend/ fellowship the fact will be immediately reported to the said authority

Certified that the student is eligible for scholarship amount subject to Central/State government rules and the student is
recommended for sanction of scholarship.

This is to certify that student has regularly attended classes and maintained minimum attendance criteria till date for the A.Y. 2023
-2024. If student will irregular, than we will immediately reported to the said authority.

The actual School/College/University year began on __________________ and will be ended on _____________________

Signature Of Head Of The School/College/Institute/University With Official Seal

Place :
*Note : Stamp Signature will not be accepted

Date :

Page 3 of 3 232400000000402211 Print Date :16/01/2024