Application Number: 238553 Personal Information Name: SUDHARSAN R Communication Address: 228, VR ROAD, PUTHUR, TRICHY ‘State: Tamilnadu Communicaion address pincode: 620017 Covi satus of Native: Coxporaton Gender: Male Nationality: tnlen Religion: Hedy Name of he Caste: Gavara, Gvaral & Vadugar(Vaduvar) ‘Special Reservation Information \Whsther you have Sports Certifeates of District / Divisional State! National! Intemational ©x-Servicomen (Only AimyiNavy! Airforce services are Eligible): No Ditlerertly Able Type: Scholarship Information Parent Occupation: Se Employes st Graduate Tution Fee Concession. Yos AICTE Tuition Fee Waiver(TFW) Scheme: Yes ‘School of Study Information ‘Studied Vi, 1, X, XI, Xllin Tamilnada Yes GOVERNMENT QP VANES NAL DIRECTORATE OF TECHNICAL EDUCATION TAMIL NADU ENGINEERING ADMISSION - 2020 Name of the ParentGuardian: RAJESH S Permanent Adgtess: 228, VR ROAD, PUTHUR. TRICHY District: Teuchrappalt Nate Distict: Truchrapplt Date of Bits (DD-MM-YYYY): 05-08-2003 Mother Tongue: Tari Nativity: Tami Name of the Communiy: 8C ‘Aadhar Number (optional): 813347411802 Eminent Sports Person: No Diferenty Abled Person: No TFC Contor for certiicate vericaton Governmant Colle of Enjearng, Svangam, Thruehierpall Distt 620 012 ‘Annual Income: 1 bio 25 Lak ‘Aled Fist Graduate Tution Fee Concession: Yos Post Matric Scholarship (SCISCAVSTIConverted Chrstans}: No (Csi status of school Panchayat Union lass Yea of Passing Name ote schoo Diseet state vs 2016 "ANITA VDYALA Trucirspealt Tart radu xs, zor ARITA VDYALAM “Tehirappalt Tart radu xsva a8 ARITA VYALAM. Truetirapral Tatras x1 2010 RITA VOWALAM ‘Thehiopoal Tart nad ‘Academic Information ‘Qualiying Examination: CBSE HSCIEquivalnt register number; 20638843 HSC Group Medium oF Instruction: Eraish Name of the Board of Examination; Cental Board of Secondary Education ‘Qualified Year; 2020 Group Code: Physics! Chemisty Mats! Optional Subject (001) ‘Subjects (General Register Number ont Your asm Mark bane Ware Physics 042 arch 2020 00 aGOVERNMENT OP VANES NAL DIRECTORATE OF TECHNICAL EDUCATION TAMIL NADU ENGINEERING ADMISSION - 2020 Application Number: 238553 Aix recent Pa or size Photo DECLARATION BY THE APPLICANT |, SUDHARSAN R (Son / Daughter) of RAJESH S hereby solemnly declare thatthe information furnished and the statements glven in the application and the enclosures are true, correct and complete. | further deciare that should it be found otherwise, twill be liable to forfet my seat and / or removal from the rolls of the Institution at whatever stage of study | may be, besides making me liable for criminal prosecution, | am fully aware that as per the directions of the Hon'ble Supreme Court of India and Tamil Nadu Prohibition of Ragging Act 1997, Ragging is an offence, as is banned in the Institutions and anyone indulging in ragging is liable to be punished such as expulsion from the Institutions and / or rigorous imprisonment up to 3 years, and / or fine up to Rs.25,000)- Place: Date: {Signature of the Applicant ) DECLARATION BY THE PARENT/ GUARDIAN |, RAJESH S (Parent / Guardian) of SUDHARSAN R hereby solemnly declare that | am fully aware of the declaration made by the applicant, and | declare and bind myself on the same terms contained in the above declaration, The statements and the information given are true, correct and complete. If tis found otherwise, the applicant is liable to forfeit the seat and / or removal from the rolls, of the Institution at whatever may be the stage of study, besides making me liable for criminal prosecution | am fully aware that as per the directions of the Hon'ble Supreme Court of India and Tamil Nadu Prohibition of Ragging Act 1997,Ragging is an offence, as is banned in the Institutions and anyone indulging in ragging is liable to be punished such as expulsion from the Institution and Jr rigorous imprisonment up to 3 years, and / or fine up to RS. 25,000/- Place: Date: ( Signature of Parent / Guardian ) Note: Guardian can execute the above declaration, only if both the parents are not alive.GOVERNMENT OP VANS NAO DIRECTORATE OF TECHNICAL EDUCATION TAMIL NADU ENGINEERING ADMISSION - 2020 Application Number: 238553 The following Certificates copy have to be uploaded to our system when it is asked, Date and Time of the certificate upload will be communicated later. 1. Transfer certiicate 2. 10th Mark Sheet 3.12th Mark Sheet 4, HSC Hall Ticket 5. Permanent Community Cerificate Card for BC (Permanent card / Electronic form / Digitally Signed E-Certiicate) 6.Income Certificate of the Parent 7. Special Reservation Form for Sports and relevant certificates 8. Special Reservation Form for Ex-Serviceman and relevant certificates 8. Special Reservation Form for Blindness & Low Vision and relevant certificates.