GOVERNMENT OF GUJARAT Submit Date : 08/01/2021

Application No:
Dr. Ambedkar Post Matric Scholarship of Government of India for 202100000001929943
Economic backward class Students
Renewal Application

Previous Application No: 192000000001334240

Previous Paid Scholarship:10500

Student Basic Details

Name of Student : MANDALIA BHARGAV PARAGBHAI
Name of Student (As per Aadhar) : BHARGAV PARAGBHAI MANDALIA
Mother's Name :
Date of Birth : 31/05/1999 Gender : Male
Category : EBC(8iTD^ŽSpXJhSaF½ Religion :Hindu
Caste :
Aadhaar Status Verified: Yes(14/10/2019 19:22:00)

Annual Income of Parents/Guardian/Husband (Rs): 79000 Habitation Type: Rural

Mobile Number : 8200818241 E-mail Address : bhargavsoni07@gmail.com
Aadhar No : 95xxxxxx5427 Parent/Guardian occupation: Business(V5Vs
Is Orphan: NO Day Scholar / Hosteller : Day Scholar
Marital Status : Unmarried Hostel Type:

Current Address: Permanant Address:

State Gujarat State Gujarat

District Anand District Rajkot

Taluka Anand Taluka Rajkot

Village Vallabh Vidyanagar (M) Village

PinCode 388120 PinCode 360001

Address:MBA NRI HOSTEL, Address:1/10 laxmiwadi,

KETIVADI, VALLABH VIDHYANAGAR, ANAND 11-sukhdham appartment,
Rajkot

Student Bank Account Detail/Aadhar Bank Detail

I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 95xxxxxx5427 Bank name : XXXX Bank
Mandate Date : 10/18/2016 12:00:00 AM Status : Active
I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
Account No : 20xxxxxx7606 IFSC Code : SBIN0060069
Student Name(As per Bank Name): BHARGAV PARAGBHAI
MANDALIYA
Name of Bank : STATE BANK OF INDIA

Branch Name & Address : RAJKOT, GUNDAWADI

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
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.
5.I voluntarily give my consent to use my Aadhaar details
6.I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar

Student Academic Details

Present Course/Class/Trade Type: Management

Present Course/Class/Trade Name : MBA (Master of Business Administration)

Present Course/Class/Trade Year : 2ND YEAR(3rd Semester/4th Semester)

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 Studying in : Gujarat Enrollment No:

Present Institute District : Anand Present Institute : Sardar Patel University, Vallabh Vidyanagar

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

Enter Your Research/Thesis Subject :

Present Class Start Date : 01-Aug-2020 Present Course Completion Date : 30-Apr-2021

Fees Amount
Admission Fees (Rs) 0
Tution Fees (Rs) 3080
Misc.Fee(NonRefundable Fees) 9580
Exam Fees(Rs) 1090

Total (Rs) 13750

Previous stream :MBA (Master of Business Administration) Previous Class/Course : 1ST YEAR(1st Semester/2nd Semester)
Previous Passing Year : 2020 Previous (%) : 63.00

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 N/A C1040318 2014 60.5

Management BBA (Bachelor Of Business Administration) Management 061430 2019 68.48

11th Std/12 Std(Commerce) 12TH(Commerce) Commerce G366174 2016 73.43

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 issued by Competent authorities

2 First Page Of Bank PassBook/Cancelled Cheque showing IFSC code and account no

3 Fee Receipt of Current Course Year

4 Income Certificate issued by Competent Authorities

5 School Leaving Certificate(If any)

6 School/College Current Year Bonafide Certificate

7 Identity Card Issued by College/University/School/Institute (If any)

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 : 08/01/2021
Verify Mobile Number : Yes 08/01/2021
Place : Signature of the applicant

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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 online/blended education and maintained minimum attendance criteria till date
for the A.Y. 2020 ±

The actual School/College/University online/blended education 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 :

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