Applicant Details

Applicant Photo
ApplicationID :1920DTR1000265847

Application ID Scheme Name

1920DTR1000265847 Rajarshi Chhatrapati Shahu
Maharaj Shikshan Shulkh
Shishyavrutti Yojna(EBC)

Department Name Applied Date

Directorate of Technical 15/10/2019
Education

Personal Details
ApplicationID :1920DTR1000265847

Full Name Mobile Number. Email ID

Kiran Chandrakant Pankhade xxxxxx0112 K****1@gmail.com

Date Of Birth Gender Age

xx/xx/2000 Female 19

Religion Marital Status Applicant Full Name (As Per

Hindu Unmarried SSC Marksheet/ L.C.)
Pankhade Kiran Chandrakant

Parent's/Guardian Mobile No Dependent Type

xxxxxx3066 -

Permanent address Details

ApplicationID :1920DTR1000265847

Address State District

,,near kala Maharashtra Beed
maruti,Ambajogai,431517
Taluka Village
Ambejogai Ambajogai

Pincode IsCorrespondence Address

431517 same as Permanent?
Yes

Correspondence Address Details

ApplicationID :1920DTR1000265847
Address State District
,,near kala MAHARASHTRA Beed
maruti,Ambajogai,431517
Taluka Village
Ambejogai Ambajogai

Pincode
431517

Income Details
ApplicationID :1920DTR1000265847

Do you have Income Certificate? Does your Certificate have a Family Annual Income
Yes Barcode? 60000.00
No
Income Certificate No
42253108587

Issuing Authority Date of Issue

Tahsildar 07/07/2019

Domicile Details
ApplicationID :1920DTR1000265847

Are you Domicile of Do you have Domicile Relationship Type

Maharashtra? Certificate? Self
Yes Yes
Domicile Certificate No.
42253044788

Does your Certificate have a Applicant Name Issuing Authority

Barcode? Pankhade Kiran Chandrakant Tahsildar
No
Date of Issue
13/07/2017

Caste Details
ApplicationID :1920DTR1000265847

Caste Category
General

Personal Eligibility Details

ApplicationID :1920DTR1000265847

Are you Salaried? Disability of any Type?

No No
Parent's/Guardian's Details
ApplicationID :1920DTR1000265847

Is Father Alive? Father Name Is Father Salaried?

Yes Chandrakant Rambhau No
Pankhade
Is Mother Alive?
Yes

Mother Name Is Mother Salaried?

Jyoti Chandrakant Pankhade No

Past Qualification Details

ApplicationID :1920DTR1000265847

Qualification Level Stream Completed

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

Institute State Institute District Institute Taluka

MAHARASHTRA Beed Ambejogai

College Name / School Name Course Name Board/University

SSC MAHARASHTRA STATE BOARD
OF SECONDARY AND HIGHER
SECONDARY EDUCATION

Mode Admission Year Passing Year

Regular 2014 2015

Result Percentage Attempts

Passed 80.20 1

Is Gap? Qualification Level Stream

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

Completed Institute State Institute District

Completed MAHARASHTRA Beed

Institute Taluka College Name / School Name Course Name

Ambejogai YOGESHWARI JR COLLEGE 12th Science
AMBAJOGAI
Board/University
MAHARASHTRA STATE BOARD
OF SECONDARY AND HIGHER
SECONDARY EDUCATION

Mode Admission Year Passing Year

Regular 2016 2017

Result Percentage Attempts

Passed 64.77 1

Is Gap?
No

Current Course Details

ApplicationID :1920DTR1000265847

Admission Year In Current Institute State Institute District

Course MAHARASHTRA Beed
2017
Institute Taluka Qualification Level
Ambejogai Under Graduate Course

Stream College Name/school Name Course Name

Engineering Mahatma Basaweshwar Bachelor of Technology (B.
Education Society's College of Tech.) - Electronics and
Engineering, Ambejogai Telecommunication Engg

Admission Type Application Admission ID/CAP Year Of Study

Through CAP/Govt. Quota ID First Year
EN17309820
Completed Or Continue
Completed

Admission Date Admission Year in Percentage

- College/Institute 8.12
2017
Result
Passed

Fees Paid Course Type Admission Through Open Or

UnAided Reserved Category?
General

Gap Year Mode Gap Reason

0 Regular
CET / Merit Percentage
0

Admission Year In Current Institute State Institute District

Course MAHARASHTRA Beed
2017
Institute Taluka Qualification Level Stream
Ambejogai Under Graduate Course Engineering

College Name/school Name Course Name Admission Type

Mahatma Basaweshwar
Education Society's College of
Engineering, Ambejogai
Bachelor of Technology (B.
Tech.) - Electronics and
Telecommunication Engg
Through CAP/Govt. Quota
Application Admission ID/CAP
ID
EN17309820

Year Of Study Completed Or Continue Admission Date

Second Year Completed -

Admission Year in Percentage Result

College/Institute 7.45 Passed
2018
Fees Paid Course Type
UnAided

Admission Through Open Or Gap Year Mode

Reserved Category? 0 Regular
General
Gap Reason CET / Merit Percentage
0

Admission Year In Current Institute State Institute District

Course MAHARASHTRA Beed
2017
Institute Taluka Qualification Level
Ambejogai Under Graduate Course

Stream College Name/school Name Course Name

Engineering Mahatma Basaweshwar Bachelor of Technology (B.
Education Society's College of Tech.) - Electronics and
Engineering, Ambejogai Telecommunication Engg

Admission Type Application Admission ID/CAP Year Of Study

Through CAP/Govt. Quota ID Third Year
EN17309820
Completed Or Continue
Pursuing

Admission Date Admission Year in Percentage

09/08/19 College/Institute -
-
Result
 -

Fees Paid Course Type Admission Through Open Or

0.00 UnAided Reserved Category?
General

Gap Year Mode Gap Reason

0 Regular
CET / Merit Percentage
0

Hostel Details
ApplicationID :1920DTR1000265847

Hosteller / Day Scholor Type

Day Scholar

Additional Question
ApplicationID :1920DTR1000265847

Question Answer
Do you avail any scholarship / No Question
stipend ? your number of beneficiary in
family ?

Answer
Question Answer
1
Upload undertaking form that dec.jpg
same year not more than two
beneficiary in family

Question
Is this a Renewal Application?

Answer
Question Answer
Yes
Enter previous year application 1819DTR1000323627
ID

Question Answer
Is taking benefit of TFWS No Question
(Tuition Fee Waiver Scheme)? Is admitted under EWS seat?

Answer
No

Benefits
ApplicationID :1920DTR1000265847

Tution Fee
 65455.00

50% Tution Fee

32727.50
Exam Fee

2000.00
50% of Exam Fee

1000.00

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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