DEEN DAYAL UPADHYAYA COLLEGE (University of Delhi) Applied under which category (pleasev) : (A) (B)_ (Please give details in the respective portion) Name of the student (in BLOCK LETTERS) Roll No./Form No., Course & Year Father’s Name Residential Address Telephone No. Category As Occupation of Father Official address of Father Monthly income of Father Occupation of Mother Official address of Mother (Attach proof of income)* Monthly income of Mother : (Attach proof of income)* Proof of income: (i) Certificate/Form-16 from employer in case of salaried employees, (ii) Certificate issued by MP/MLA/Councillor/SDM etc. for the year 2019-20 issued after 31 March, 2020 in case of self employed persons. Category B: Last Examination Passed/Percentage of Marks: (Attach photocopy of self attested mark sheet) Position in the University Exam Category-C: Achievement in Sports (Attach copy of documentary evidence) I declare that the above information are true and correct to the best of my knowledge and belief, Signature of Parent/Guardian Name: Name : Signature of Student The following Bank details should be written clearly by the student for payment through RTGS/NEFT: Beneficiary (Student) name ‘Name of the Bank & Address Bank Account No. IFSC Code No. (11 digit) MICR Code Signature of the Student