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Above SSC Applicationform

This document is a student bus pass application for the Andhra Pradesh State Road Transport Corporation. It collects information such as the student's SSC (10th standard) board and year of pass, personal details like name, father's name, date of birth, gender, address, institution details including name, course, and address, as well as route details from and to locations. It requires enclosures of a bonafide certificate from the student's institution and SSC memo. The bonafide certificate verifies the student's name, date of birth, admission details and confirms the course completion date according to institution records.

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ravi kumar
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327 views1 page

Above SSC Applicationform

This document is a student bus pass application for the Andhra Pradesh State Road Transport Corporation. It collects information such as the student's SSC (10th standard) board and year of pass, personal details like name, father's name, date of birth, gender, address, institution details including name, course, and address, as well as route details from and to locations. It requires enclosures of a bonafide certificate from the student's institution and SSC memo. The bonafide certificate verifies the student's name, date of birth, admission details and confirms the course completion date according to institution records.

Uploaded by

ravi kumar
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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ANDHRA PRADESH STATE ROAD TRANSPORT CORPORATION

STUDENT BUS PASS APPLICATION ABOVE SSC


Previous ID Card No (2016-17) :
1. Student 10th Details
1.1 SSC Board Type :
APSSC
CBSE
ICSE
ORIENTAL
APOS
OTHER BOARD

1.2 SSC Pass Type :


Regular
Supplementary
1.3 SSC Year of pass : 1.4 SSC hall ticket no :
2. Student Details
2.1 Name :
Photo
2.2 Father's / Guardians
Name :
Date of Birth
Male
2.3 (dd/mm/yyyy) : 2.4 Gender :
Female
As Per SSC

2.5 Aadhar No. : 2.6 Mobile No :


2.7 Is Employee Children :
Yes
NO If Yes Enter Emp. Id :
2.8 Email :
3. Residential Address Details
3.1 District : 3.2 Mandal :
3.3 Village : 3.4 Address :
4. Institution Details
4.1 Institution Code : 4.2 District :
4.3 Mandal : 4.4 Institution Name :
4.5 Course Name : 4.6 Present Course Year :
4.7 Admission No : 4.8 Institution Address :
5. Route Details
5.1 Center : 5.2 Pass Type :
5.3 From Place District : 5.4 To Place District :
5.5 From Place: Via: To:
Enclosures: Bonafied Certificate, SSC Memo
I hereby declare that the particulars given above are true and found correct. I will abide by the rules & regulations of
APSRTC governing issue of Bus Passes.

Signature of Head of the Institute Signature of the Student


-------------------------------------------------------------------------------------------------------------------------------------------------------------

BONAFIDE CERTIFICATE

I hereby certify that Sri/kum/Smt is bonafide student of (Name of the

Institution) studying (Name of the course) With Admission No & Roll No His /Her

Date of Birth is (DD-MM-YYYY) as per office records and the course will be completed by

(dd/mm/yyyy).Educational Institute Recognition Code No (As per the D.E.O. records). Course Code No

for the Academic year 2017-2018.

Date:

Place: Principal

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