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10rs Post (Declaration) - Compressed

The document is a declaration of family income and minority status for a student named Namsanjay Komar, confirming an annual income of Rs. 3,69,000 and belonging to the Jain minority community as recognized by the Government of Maharashtra. It states that any false information may lead to withdrawal of scholarship benefits and potential legal action. The declaration is signed by both the student and the guardian, with a date and residential address provided.

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jsshah2006
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50 views1 page

10rs Post (Declaration) - Compressed

The document is a declaration of family income and minority status for a student named Namsanjay Komar, confirming an annual income of Rs. 3,69,000 and belonging to the Jain minority community as recognized by the Government of Maharashtra. It states that any false information may lead to withdrawal of scholarship benefits and potential legal action. The declaration is signed by both the student and the guardian, with a date and residential address provided.

Uploaded by

jsshah2006
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
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Annexure-I

DECLARATION OF FAMILY INcOME AND MINORITY STATUS


(To be attached in original to )

I.20njy.komar, hah .(Father IMother/Guardian)


of..namsanj ay komqr. sh ah (Name of Student) who is studying
......hereby declare that my annual
income from all sources is Rs ...3.,6.9..aA.o. in word Rs.

Ttslakk..An, HhæNAand..uxthund-td.a.fe4t,..only.
lalsodeclare that I belong to J a i n minority community declared as Minority Community by
Government of Maharashtra, General Administrative Department Notification Community by Government of
Maharashtra, General Administrative Department Notification No. RAA/2005/89/C.R.19/2005/35, dtd 9th
October , 2006 & No.SAC.2015/C.R.177/D-9, dtd 2-july-2016.

If at any stage,it is found that the information given by me is false/not true, all benefits given to the student
under the scheme of "'Scholarship Schemne for pursuing All courses after HSC (Arts, commerce and Science
etc. Studies to the students belonging to Minority Communities" could be withdrawn and legal action as
deemed fit, may be taken against me or my ward.

Signature Signature
Student (Mother/Father/Guardian)
Date 12l2l2s.

Residential Address :;

10 215 Nimal a...wal.


COURT
an.diy.Li Doad

HOY TEN,RUPEES Pemki.as..

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