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  DIRECTORATE OF TECHNICAL EDUCATION  
 

DIRECTORATE OF TECHNICAL EDUCATION

 

3, MAHAPALIKA MARG, POST BOX NO. 1967, MUMBAI - 400 001

Application Form for Rajarshi Chhatrapati Shahu Maharaj Shikshan Shulk Shishyavrutti Yojana for the Academic Year 2017-18

Application ID : DSE15198189

Version No : 4

MahaDBT Application No : POSSV022170000810633

Personal Details

 

Candidate Name

VAIDYA SUYASH VILAS

   
  Candidate Name VAIDYA SUYASH VILAS    
 

Gender

Male

 

DOB (DD/MM/YYYY)

09/06/1996

 
 

Candidature Type

Maharashtra - Type A

 
 

Category

OPEN

 

Mother Tongue

Marathi

 

Religion

Hindu

 

Region

Pune

 

Permanent Address

ganesh nager,chordiya chawl,chinchwad,pune-411033 Taluka - Haveli District - Pune State - Maharashtra PIN - 411033

 
 

Mobile No

9762554272

   

E-Mail ID

suyash.vaidya90@gmail.com

Admission Details

 
 

Admission Year

2015

 

Program Type

Direct Second Year Degree in Engineering-Technology

 
 

Institute Name

6185 - Sinhagad Institute of Technology, Lonavala

 
 

Course Name

Electronics and Telecommunication Engg[Second Shift]

 
 

Choice Code

618537220

   

Seat Type

CAP

 

Admission Date

10/08/2015

   

Reporting Date

10/08/2015

 

CAP Round

1

 

CAP Merit No

29912

Other Personal Details

 
 

Father's Name

vilas

 

Mother's Name

anjali

 

Guardian's Name

vilas

 

Guardian's Native Place

chinchwad

 

Candidate's Birth Place

mumbai

 

SSC Roll Number

C057750

 

Current Studying Year

Final Year

 

PRN / Enrollment Number

71640196H

 

Name of School / Institute Last Attended

PAD.DR.D.Y Patil Polytechnic Akurdi

 
 

Address of School / Institute Last Attended

D. Y. Patil Educational Complex, Sector 29, Nigdi Pradhikaran,, Akurdi, Pune, Maharashtra 411044

 

Applied For Any Other Scholarship / Concessions

None

 

Child Number

1

 

Aadhaar Number

256155028761 (Aadhaar Number Verification Incomplete)

 

Candidate’s Name (As Per Aadhaar Record)

SUYASH VILAS VAIDYA

 

Family Income Details (For Financial Year 2016-17)

 
 

Total Family Income (Including Both Parents)

Rs. 90,000/-

 

Income Certificate Issuing Authority

Tahsildar

 

Income Certificate Number

41935017291

 

Income Certificate Issue Date

29/06/2017

Candidate's Bank Details

 
 

Candidate’s Name (As Per Bank Record)

SUYASH VILAS VAIDYA

 
 

Bank Name

Bank of Maharashtra

 
 

Branch Name

CHINCHWAD

 
 

Account Number

68018205674

   

IFSC Code

MAHB0000127

 

MICR Code

411014046

   

Account Seeded with Aadhaar

Yes

Qualification List (Starting from SSC till Last Exam Passed)

 
 

Qualification

 

Year of Study

 

Result

Passing Month & Year

Marks

Marks

Type

SSC

 

SSC

Distinction

June, 2012

Percentage

452.00/550.00 (82.18)

Diploma

 

Diploma

First Class

June, 2015

Percentage

1200.00/1700.00 (70.59)

Direct Second Year Degree in Engineering- Technology

Second Year

Second Class

January, 2016

Percentage

791.00/1500.00 (52.73)

Direct Second Year Degree in Engineering- Technology

Third Year

Second Class

January, 2017

Percentage

792.00/1500.00 (52.80)

Exam Fee / Tution Fee Details

 
 

Odd Semester Exam Fee

Rs. 1,330/-

 

Even Semester Exam Fee

Rs. 1,555/-

 

Tution Fee

Rs. 88,246/-

 

Total DBT Amount

Rs. 45,566/-

List of Documents Required

 

Sr. No.

 

Document Name

 

1.

Family Income Certificate of Financial Year 2016-17 issued by Tahsildar / Sub Divisional Officer / Deputy Collector / Collector of the District / Metropolitan Magistrate.

2.

Domicile Certificate of Maharashtra / Maharashtra Karnataka Border.

 

3.

Statement of Marks of Last Year attested by the Principal. (If Applicable)

 

4.

GAP Affidavit. (If Applicable)

 

5.

Death Certificate of Father, If Not Alive. (If Applicable)

 

6.

Aadhaar Card.

7.

Bank Passbook Front Page Copy / Cancelled Cheque.

 

8.

Leaving Certificate.

9.

CAP Admission Allotment Letter.

Declaration

The above information given by me for Rajarshi Chhatrapati Shahu Maharaj Shikshan Shulk Shishyavrutti Yojana as a parent is true to the best of my knowledge & belief. If at later stage, it is found that I have furnished wrong information and /or submitted false certificates, I am aware that my sons/daughters admission stands cancelled. I am aware that if my family income is found above the limit fixed by the Authority, I will have to pay two fold of amount sanctioned by the Authority. The authority may recover the amount from me, from my heritor or as dues on land revenue in case of not returning the amount.

Place :

Printed On : 3/3/2018 12:29:15 PM

Last Modified On : 3/3/2018

12:29:10 PM

Date :

Father/Mothers/Guardian Signature

Candidate Signature (VAIDYA SUYASH VILAS)