GOVERNMENT OF GUJARAT Submit Date : 27/11/2024

Application No:
(BCK-13) Scholarship/Stipend to SC Students for ITI/Professional 242500000000827861
Courses
Fresh Application

Student Basic Details

Name of Student : PARMAR JIGARKUMAR TRIBHOVANBHAI

Name of Student (As per Aadhar) : Jigarkumar tribhovanbhai parmar
Mother's Name : gomatiben
Date of Birth : 14/07/2003 Gender : Male
Category : SC(7ȵkɅl‡ISĤiS  Religion :Hindu
Caste : Hindu Chamar ˆeƛȳkI\h^ 

Aadhaar Status Verified: Yes(24/10/2024 20:17:30)

Ration Card No. : 103004001388380 Ration Card Member No. : 103004001388380005

Name As Per Ration Card: (Jigarkumar Tribhovanbhai Parmar / ĥF^Ȣk\h^í[saW[h9X^\h^
EKYC Status As Per Ration Card: Yes EKYC Date: 24-01-2024
Aadhar Number Matched With Ration Card: Yes
Consent Status: I hereby give my consent to use my personal data available with food and civil supply department. I hereby give my consent to
government of Gujarat for fetching my identity for the purpose of post matric scholarship.

Annual Income of Parents/Guardian/Husband (Rs): 70000 Habitation Type: Rural

Mobile Number : 7359454360 E-mail Address : [email protected]
Aadhar No : 55xxxxxx8493 Parent/Guardian occupation: Agriculture(EpSj
Is Orphan: NO Day Scholar / Hosteller : Day Scholar
Marital Status : Unmarried Hostel Type:

Current Address: Permanant Address:

State Gujarat State Gujarat

District Patan District Patan

Taluka Sidhpur Taluka Sidhpur

Village Village
PinCode 384151 PinCode 384151

Address:rohitvas , nagvasan Address:rohitvas , nagvasan

Student Bank Account Detail/Aadhar Bank Detail

I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 55xxxxxx8493 Bank name : -
NPCI Date : 10/24/2024 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 : 66xxxxxx0724 IFSC Code : UBIN0566331
Student Name(As per Bank Name): Jigarkumar tribhovanbhai parmar

Name of Bank : UNION BANK OF INDIA

Branch Name & Address : NAGVASAN

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

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 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: ITI

Present Course/Class/Trade Name : ITI Industrial Training Institute (2 Year Course)

Present Course/Class/Trade Year : 1ST YEAR(1st Semester/2nd Semester)

Studying in : Gujarat Enrollment No: 116820081

Present Institute District : Patan Present Institute : SIDDHPUR-ITI

Admission Type : Regular Seat(Government Quota) Present Branch Course : REFRIGERATION & AIR CONDITIONING
MECH.
Enter Your Research/Thesis Subject :
Present Class Start Date : 01-Sep-2024 Present Course Completion Date : 31-Jul-2026

Course Duration In Years : 2

Educational Break : Yes No. Of. Year in Break : 1

Previous Education Detail

Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
9th Std/10th Std 10TH GENERAL A7735260 2023 42

List of documents which you have attached :

1 Caste Certificate From the Competent Authorities

2 First Page Of Bank PassBook/Cancelled Cheque

3 Break Affidavit(If Break Gap is More than One Year)

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

5 School Leaving Certificate (If Any)

6 Identity Card (College/School)

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 : 03/03/2025

Verify Mobile Number : Yes 13/01/2025

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. 2024
-2025. 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 _____________________

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

Place :

*Note : Stamp Signature will not be accepted

Date :

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