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Applicant Details
Applicant Photo
ApplicationID :1920VJO1000020174

Application ID Scheme Name

1920VJO1000020174 Post Matric Scholarship to OBC
Students

Department Name Applied Date

VJNT,OBC and SBC Welfare 22/08/2019
Department

Personal Details
ApplicationID :1920VJO1000020174

Full Name Mobile Number. Email ID

Mrunal Somnath Dusane 9370765320
Date Of Birth
18/03/2000

Gender Age Religion

Male 19 Hindu

Marital Status Applicant Full Name (As Per Parent's/Guardian Mobile No

Unmarried SSC Marksheet/ L.C.) 9370765320
DUSANE MRUNAL SOMNATH
Dependent Type
-

Permanent address Details

ApplicationID :1920VJO1000020174

Address State District

369,KUSUMBA ROAD,AMBIKA Maharashtra Nashik
MATA
MANDIR,Malegaon,423203
Taluka Village
Malegaon
Pincode
423203

IsCorrespondence Address
same as Permanent?
No

Correspondence Address Details

ApplicationID :1920VJO1000020174

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Address State District

369,KUSUMBA ROAD,AMBIKA MAHARASHTRA Nashik
MATA
MANDIR,Malegaon,423203
Taluka Village
Malegaon
Pincode
423203

IsCorrespondence Address
same as Permanent?
No

Income Details
ApplicationID :1920VJO1000020174

Do you have Income Certificate? Does your Certificate have a Family Annual Income
Yes Barcode? 40000.00
No
Income Certificate No
41461238437

Issuing Authority Date of Issue

Tahsildar 28/06/2019

Domicile Details
ApplicationID :1920VJO1000020174

Are you Domicile of Do you have Domicile Relationship Type

Maharashtra? Certificate? Self
Yes Yes
Domicile Certificate No.
41461064288

Does your Certificate have a Applicant Name Issuing Authority

Barcode? DUSANE MRUNAL SOMNATH Tahsildar
No
Date of Issue
18/09/2017

Caste Details
ApplicationID :1920VJO1000020174

Do you have Caste Certificate? Caste Category Does your Certificate have a
Yes (OBC) Other Backward Class Barcode?
No

Caste Certificate Number Issuing District Applicant Name

232 Dhule DUSANE MRUNAL SOMNATH

Issuing Authority
Sub Divisional Officer(SDO)
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Personal Eligibility Details

ApplicationID :1920VJO1000020174

Are you Salaried? Disability of any Type?

No No

Parent's/Guardian's Details
ApplicationID :1920VJO1000020174

Is Father Alive? Father Name Is Father Salaried?

Yes SOMNATH DEOCHAND DUSANEYes

Father Occupation Is Mother Alive? Mother Name

Labour Yes PRATIBHA SOMNATH CHAVAN

Is Mother Salaried?
No

Past Qualification Details

ApplicationID :1920VJO1000020174

Qualification Level Stream Completed

S.S.C. (10 Std) SSC Completed

Institute State Institute District Institute Taluka

MAHARASHTRA Nashik Malegaon

College Name / School Name Course Name Board/University

SSC MAHARASHTRA STATE BOARD
OF SECONDARY AND HIGHER
SECONDARY EDUCATION

Mode Admission Year Passing Year

Regular 2015 2016

Result Percentage Attempts

Passed 65.40 1

Is Gap? Qualification Level Stream

No H.S.C. (12 Std) Arts

Completed Institute State Institute District

Completed MAHARASHTRA Nashik

Institute Taluka College Name / School Name Course Name

Nashik MSG ARTCOMM SCI COLLEGE 12th Arts
MALEGAON CAMP
Board/University
MAHARASHTRA STATE BOARD
OF SECONDARY AND HIGHER
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SECONDARY EDUCATION

Mode Admission Year Passing Year

Regular 2017 2018

Result Percentage Attempts

Passed 56.46 1

Is Gap?
No

Current Course Details

ApplicationID :1920VJO1000020174

Admission Year In Current Institute State Institute District

Course MAHARASHTRA Nashik
2018
Institute Taluka Qualification Level
Malegaon Under Graduate Course

Stream College Name/school Name Course Name

Arts M.S.G.Art Scince Commerce B.A.
College Malegaon-Camp
Admission Type
-

Application Admission ID/CAP Year Of Study Completed Or Continue

ID Second Year Pursuing
-
Admission Date Admission Year in
01/07/19 College/Institute
-

Percentage Result Fees Paid

- - 0.00

Course Type Admission Through Open Or Gap Year

Aided Reserved Category? 0
(OBC) Other Backward Class
Mode
Regular

Gap Reason CET / Merit Percentage Admission Year In Current

0 Course
2018

Institute State Institute District Institute Taluka

MAHARASHTRA Nashik Malegaon

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Qualification Level Stream College Name/school Name

Under Graduate Course Arts M.S.G.Art Scince Commerce
College Malegaon-Camp

Course Name Admission Type Application Admission ID/CAP

B.A. - ID
-

Year Of Study Completed Or Continue Admission Date

First Year Completed -

Admission Year in Percentage Result

College/Institute 46.17 Passed With ATKT
2018
Fees Paid Course Type
Aided

Admission Through Open Or Gap Year Mode

Reserved Category? 0 Regular
(OBC) Other Backward Class
Gap Reason CET / Merit Percentage
0

Hostel Details
ApplicationID :1920VJO1000020174

Hosteller / Day Scholor Type

Day Scholar

Additional Question
ApplicationID :1920VJO1000020174

Question Answer
Is this a Renewal Application? No Question
Leaving Certificate

Answer
Question Answer
lc.jpg
Declaration certificate of AF.jpg
parents/guardians about
number of children
beneficiaries
Question
Have you applied for any other
scholarship

Answer
Question Answer
No
Caste Validity – (Mandatory for
Professional Degree courses,
Professional Post Graduate. For
Non Professional courses cast Question
validity is not mandatory) Ration Card for identify number
of children in family
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Answer
Question Answer
ration.jpg
How many boys child (including 1
you) in your family of the same
parents?

Benefits
ApplicationID :1920VJO1000020174

Tution Fee

0.00
Exam Fee

0.00
Number of Months for which
benefit is allotted

10.00

Maintenance Allowance per

month

120.00

Total Maintenance Allowance

1200.00

I / We agree to the terms and conditions of this scholarship. All information given in this application is valid to
best of my knowledge. I /We am /are punishable with penalties / punishments if any of the above mentioned
details is false as per the Indian Penal Code, 199 and 200. The decision given by the competent authority will be
final and will be accepted by me. If any surplus amount is received from the scholarship due to any reasons, then
I / We will return the amount at the earliest. I / We will be responsible for taking action against me / my child
against falsehood. I / We promise that we will take the scholarship / education fees as per the terms and
conditions of the concerned scheme. All the documents that I have linked to the application have been received
from the competent authority / authorities and the documents are valid and have been received by following the
required legal procedures. There is no modification / correction / alteration performed on them. I hereby certify
that the information provided is true and they are not false or fake. I am fully responsible for the false or fake
surveillance of the attached documents, and I am fully aware that I will be entitled to the penalty imposed by the
Indian Penal Code, 199 and 200.

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