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ಯ ವರ / Student's Details

Student name(as per Adhaar) / Abhishek

ಯ ಸರು (ಆ ಪ ರ) :

ಯ ಸರು : ಅ ೕ

ತಂ ಯ ಸರು / Father Name : K.S Ravi

ಂಗ/Gender: : ಗಂಡು / Male

ಹು ದ ಂಕ / Date of Birth : 09/04/2006

ವಯಸು / Age : 15

ೖ ಸಂ / Mobile Number : 7204816285

ಂಚಂ ( / ೕಷಕರು) /E-mail abhishekrgowda111@gmail.com

ID (Student/ Guardian) :

ಗ (ಇಂದ) / Pass Route Chapparadahalli

(From) :

category / ವಗ : Others

ಗ (ವ ) / Pass Route Bettadapura

(To) :

ಗ ಬದ ವ ಸಳ / Route Gorahalli
Change Place :

ಅ ರರ ೕ ೂೕ/Applicant
Photo :

ೕ ನ ಸ ಲ ದ Yes
ದುಪ ಡ ಸು ?/Edit the
details if the above data fetched is
not correct :

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 ಮಬ ಟ್ ಐ ಇ ೕ ? / Do Yes
you have SATS ID ? :

Data Fetch is from Family DB : No

ಸ / Address Details
old

ೂೕ / Pin Code old : 571102

ಸ / Address Details

ಯಂ ಸ / Permanent Address: Abhishek S/O Ravi,Chapparadahalli post, Harnahalli hobli,

: Periyapatana taluku, Mysore Dist

ಕ ಸ ಯಂ ಸದಂ Yes
ಇರುತ ೕ ? / Is Temporary
address is same as Permanent
address? :

ಕ ಸ / Temporary Address: Abhishek S/O Ravi,Chapparadahalli post, Harnahalli hobli,

: Periyapatana taluku, Mysore Dist

ಸಂ ಯ ವರಗಳು / Institution Details

:

SATS ID. / ಟ್ ಐ : 070607625

ಗ / Course Sats : 10

Class / ತರಗ : 10

ಜ/State : KARNATAKA

/District : MYSURU

ಲೂಕು / Taluka : PERIYA PATNA

ಮ /Village : CHAPPARADA HALLI

ಸಂ ಯ ಸರು/Education D THAMMAIAH MEMORIAL COMPOSITE P.U. COLLEGE

Institution Name. :

ಸಂ ಯ ಸ/Address of Bettadapura
Institution. :

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 ಸಂ ಯ ಧವನು ಆ / ಸ ಸಂ / Private Institution
Please select type of instituion :

/ ೕಜು ಶುಲ ಕ ರುವ ರ ೕ A1125

ಸಂ /School/college fee Receipt
No/: :

ವ ದ ಂಕ /Date of Receipt: : 20/09/2021

ೕ ವನು SATS ೕ ೕ ಂದ Yes

ಪ ಯ ೕ ೕ/Whether Data needs to
be fetched from SATS Database :

Select the Divisions/ ಗಗಳನು

ಆ

ಗ / Select the division : Mysore Rural

ಘಟಕ / Select the depot : Piriyapattana

ಂಟ / Select the counter : Bettadapura

Declaration/ ೂೕಷ

ೕ ೕ ರುವ ಎ ವರಗಳು ಸತ ರುತ ಎಂದು ೂೕ ಸು ೕ

I declare the information/ details provided above are true to the best of my knowledge.

I Agree : Yes

Annexure List

1) Proof of Residential Address Aadhar

2) Tuition fee paid receipt. Tuition fee paid receipt.

Additional Details

Apply to the Office KSRTC Counter Office(KSRTC Counters- Bettadapura )

Draft Reference No : TC001S210590477

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