GOVERNMENT OF GUJARAT Submit Date : 20/11/2018

Application No:
(BCK-5) Post Matric Scholarship for SC girls student only (Having 181000000001194119
annual family income between 2.50 Lac to 6 Lac)(State Government
Scheme)
Fresh Application

Student Basic Details

Name of Student : KOTADIYA RIDDHI NARENDRABHAI
Name of Student (As per Aadhar) : RIDDHI KOTADIYA
Mother's Name : LEENABEN
Date of Birth : 23/08/2001 Gender : Female
Category : SC(7ȵkɅl‡ISĤiS  Religion :Hindu
Caste : Hindu Vankar(ˆeƛȳkaRD^ 

Aadhaar Status Verified: Yes(20/11/2018 08:18:00)

Annual Income of Parents/Guardian/Husband (Rs): 547030 Habitation Type: Urban

Mobile Number : 9408131016 E-mail Address : riddhikotadiya1122@gmail.com
Aadhar No : 99xxxxxx0416 Parent/Guardian occupation: Govt.Service(d^Dh^ŽWsD^Ž
Is Orphan: NO Day Scholar / Hosteller : Day Scholar
Marital Status : Unmarried Hostel Type:

Current Address: Permanant Address:

State Gujarat State Gujarat

District Gandhinagar District Gandhinagar

Taluka Mansa Taluka Mansa

Village Village
PinCode 382845 PinCode 382845

Address:A/14 Radhe Bunglows , Nr. fatehpura road , mansa , Address:A/14 Radhe Bunglows , Nr. fatehpura road , mansa
382845

Student Bank Account Detail/Aadhar Bank Detail

I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 99xxxxxx0416 Bank name : -
Mandate Date : - Status :
I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
Account No : 21xxxxxx2901 IFSC Code : BKID0002115
Student Name(As per Bank Name): RIDDHI NARENDRAKUMAR
KOTADIYA
Name of Bank : BANK OF INDIA

Branch Name & Address : MANSA(GANDHINAGAR)

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: Science

Present Course/Class/Trade Name : B.Sc Bachelor Of Science

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

Courtesy :: National Informatics Centre, Gujarat Page 1 of 3 181000000001194119 Print Date :09/04/2019
 Studying in : Gujarat Enrollment No: 201802107360

Present Institute District : Gandhinagar Present Institute : SHANKARSINH VAGHELA BAPU INSTITUTE OF
SCIENCE, VASAN
Admission Type : Regular Seat(Government Quota) Present Branch Course : -

Enter Your Research/Thesis Subject :

Present Class Start Date : 01-Jul-2018 Present Course Completion Date : 31-Dec-2018

Fees Amount
Admission Fees (Rs) 20000
Tution Fees (Rs) 5000
Misc.Fee(NonRefundable Fees) 750
Exam Fees(Rs) 400

Total (Rs) 26150

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 GENERAL A4128506 2016 78

11th Std/12 Std 12TH SCIENCE B 151909 2018 67

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 Std:10 Marksheet

6 School Leaving Certificate(If any)

7 Std:12 Marksheet(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 : 09/04/2019
Verify Mobile Number : Yes 09/04/2019
Place : Signature of the applicant

Courtesy :: National Informatics Centre, Gujarat Page 2 of 3 181000000001194119 Print Date :09/04/2019
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.

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

Place :
*Note : Stamp Signature will not be accepted

Date :

Courtesy :: National Informatics Centre, Gujarat Page 3 of 3 181000000001194119 Print Date :09/04/2019