Submit Date : 27/10/2023

Application No:
GOVERNMENT OF GUJARAT 232400000001035941

VKY-157 Food Bill Assistance in College Attached Hostels

Fresh Application

Student Personal Details

Name of Student : Nayka Bhavinkumar Girishbhai
Name of Student (As per Aadhar) : Nayka Bhavinkumar Girishbhai
Mother's Name : Nayka Hemaben Girishbhai
Date of Birth : 01/05/2002 Gender : Male
Category : ST(7ȵkɅl‡ISKWĤiS  Religion :Hindu
Caste : Nayaka Wh]Dh 

Aadhaar Status Verified: Yes(24/10/2023 18:42:00)

Annual Income of Parents/Guardian/Husband (Rs): 75000 Habitation Type: Rural

Mobile Number : 7069878836 E-mail Address : [email protected]
Aadhar No : 62xxxxxx7327 Parent/Guardian occupation: Farm Labour(EpĂ\ȩl^
Is Orphan: NO Day Scholar / Hosteller : Hosteler
Marital Status : Unmarried Hostel Type: Private Hostel
Current Address: Permanant Address:
State Gujarat State Gujarat

District Surat District Surat

Taluka Bardoli Taluka Mahuva
Village Village Vaheval
PinCode PinCode 394248
Address:S.R.PATEL hostel,umrakh Address:Hatwada faliyu, vaheval

Student Bank Account Detail/Aadhar Bank Detail

I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 62xxxxxx7327 Bank name : -
Mandate Date : 10/25/2023 12:00:00 AM Status : Accept
I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
Account No : 44xxxxxx5562 IFSC Code : BARB0VAHEVA
Student Name(As per Bank Name): Bhavinkumar Girishbhai Nayka

Name of Bank : BANK OF BARODA

Branch Name & Address : VAHEVAL,SURAT,GUJ

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 details provided by me
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.

Student Academic Details

Present Course/Class/Trade Type: Engineering & Technology

Present Course/Class/Trade Name : B.E. (Bachelor of Engineering)

Present Course/Class/Trade Year : 4TH YEAR(7th Semester/8th Semester)

Courtesy :: National Informatics Centre, Gujarat Page 1 of 3 232400000001035941 Print Date :22/11/2024
 Studying in : Gujarat Enrollment No: 200490119017

Present Institute District : Surat Present Institute :

SHRI SITARAMBHAI NARANJI PATEL INSTITUTE
OF TECHNOLOGY,(MANAGED BY VIDYABHARTI TRUST,UMRAKH -
BARDOLI) 049
Admission Type : Regular Paid Seat (Self Finance) Present Course Branch : -
Present Class Start Date : 27-Jul-2023 Present Course Completion Date : 26-Jun-2024

Hostel Detail
Is Hostel run by Department No

Is Hostel attached With College Yes

Free facilities provided by Hostel? No

Previous stream :B.E. (Bachelor of Engineering) Previous Class/Course : 3RD YEAR(5th Semester/6th Semester)
Previous Passing Year : 2023 Previous (%) : 79.00

Are You Employed in any Organization/Establishment with leave without pay? : No

Previous Education Detail

Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
9th Std/10th Std 10TH SSC B2415683 2018 66

11th Std/12 Std 12TH HSC B178787 2020 57

Engineering & Technology B.E. (Bachelor of Engineering) Mechanical 20049011 2020 85

Engineering 1st sem 9017
Engineering & Technology B.E. (Bachelor of Engineering) Mechanical 20049011 2021 86
Engineering 2nd 9017
sem
Engineering & Technology B.E. (Bachelor of Engineering) Mechanical 20049011 2021 81
Engineering 3rd sem 9017
Engineering & Technology B.E. (Bachelor of Engineering) Mechanical 20049011 2022 81
Engineering 4th sem 9017
Engineering & Technology B.E. (Bachelor of Engineering) Mechanical 20049011 2022 74
Engineering 5th sem 9017
Engineering & Technology B.E. (Bachelor of Engineering) Mechanical 20049011 2023 79
Engineering 6th sem 9017

List of documents which you have attached :

1 Caste Certificate From the Competent Authorities

2 First Page Of Bank PassBook/Cancelled Cheque

3 Fee Receipt of Current Course Year

4 Self Attested Certificate of Previous academic marksheet

5 Income Certificate From the Concerned Authorised Authority/Persons

6 Hostel Certificate(Only For Hosteller Student)

7 Std:12 Marksheet(If Any)

8 Identity Card (College/School)

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.

Courtesy :: National Informatics Centre, Gujarat Page 2 of 3 232400000001035941 Print Date :22/11/2024
 Verify Mobile Number: Yes 27/10/2023

Place : Signature of the applicant

Date : 22/11/2024
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.

This is to certify that student has regularly attended classes and maintained minimum attendance criteria till date for the A.Y. 2023
-2024.If student will irregular, than we will immediately reported to the said authority.

The actual School/College/University year began on __________________ and will be ended on _____________________

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

Place :

*Note : Stamp Signature will not be accepted

Courtesy :: National Informatics Centre, Gujarat Page 3 of 3 232400000001035941 Print Date :22/11/2024