Website: www nitandhra.ac.in OME OSs18-281700, Fans OS 18 = 1705 ail-id-admissions(@ nitandhra.ae.in Ye wsgra alee fateh eeenar- srierAer in NATIONAL INSTITUTE OF TECHNOLOGY ANDHRA PRADESH : BESIDE NIT-16, KONDRUPOLU TADEPALLIGUDEM ~ 54102, WEST GODAVARI DIST, ANDIIEA PRADESIL EXDLS UNDERTAKING FOR TUITION FEE REMISSION : Ks Sein father / mother of K:VenkataSaidoraleae 4 Roll No. SUAS studying B. Tech cee branch at NIT, Andhra Pradesh hereby state that my family income during the financial year 2019-2015 Rs. JS,O00 (in words_Sexcetiy ue Tawronnel was only) Income Details: Income Reported * (as per valid bcd MAU proof of income Income Proof | jature of Income submitted) {__ Father : Tneome Intome Coolie kK SRINU 45,000 | Certificate | Moth | oe K. DURGA oO _ = Total income ofthe | 75,000 ]_ Family: | ' declare that the information provided by me is true and | will abide by the rules and regulations of the institute in this connection The remission amount may please be transferred to the bank account as detailed below: Accountwumber: [} OTS R | [ofolah KT [sap Name of Account Holder: | K 5R INU - a Bank and Branch LANDHRA BANK K Air By PASS toad brinch: IFSC code: | ANDBOOOIDsQ | (1/2) (P..0)Signature of Parent: kK Name of the Parent: -S Qi NU Parent Mobile: BOOTIE 815A padhaar Nos UB | AS88 S495 Address: a-3/1, mR: palli, “Trrapothi Place: “Tru, pots Date: JB} 2020 5 beds Signature of Student KS ¢ Name of the Student: : Yrrot Rollo: Si 4a.5 section: CCE padhaar No: 3748 41S 3053 | Student Mobile, 1133929919, (2/2)