ACADEMIC (UG) SECTION IIT KHARGPUR

NOTICE FOR MCM SCHOLARSHIP (RENEWAL) FOR 2011-12

Date : 19th April, 2011

Applications are invited for RENEWAL of Merit-cum-Means(MCM) Scholarship & Free-studentship for the Session 2011-12 from the UG Students (2nd year onwards) who were awarded MCM Scholarship & Freestudentship for the year 2010-11 and meeting the eligibility criteria. Eligible students are advised to download Scholarship Application Form given in the Institute Website : www.iitkgp.ac.in Click on > For Students >MCM Scholarship(RENEWAL) for the session 2011-2012. Application Form and relevant annexure to be downloaded as per guardian’s occupational status and thereafter to be filled accordingly. Filled Application with all requisite documents in support of guardian’s Annual Income in the prescribed format applicable as per different types of guardians’ occupational status as stated in the Annexure-II (‘List of Documents’- given in the website ), to be submitted to the Academic (UG) Section on or before 12th August, 2011 (Friday ).
Students may send their filled application with all requisite documents by post to the Assistant Registrar (UGS) IIT, Khargpur, PO: Tech.Khargpur-721 302 Dist: Midnapore(W), WEST BENGAL.

Under No circumstances Scholarship Application Form for RENEWAL will be accepted beyond 12th August, 2011 (Friday ).
( S. K. Poddar) Assistant Registrar(UGS)

N.B.: Students of following categories are NOT ELEGIBLE:
1) Those students against whom Disciplinary Action have been taken or pending against them during the preceding year ( i.e. in 2010-11) or they have been punished by the competent authority under examination malpractice and involved in violation of code of conduct in Institute/Hall of Residence/Department /Gymkhana. 2) Students who have backlog in any subject(s) and could not cleared during the same session . i.e. in 2010-11, they need not apply for MCM Scholarship & Freestudentship for 2011-21.

3) 5th Year Students of M.Tech. Dual Degree (2007 Batch) cannot apply.
To: All the Head of Deptt. , Wardens, Hall of Residence , Chairman, HMC, President TSG, VP, TSG : - With the request to bring it to the notice of the concerned students.

4.000/-( Rupees Four Lakhs Fifty thousand) N. Contd…2 .00 without any back log subject(s) and clearing all prescribed credit requirements during the session 2010-11. Students who have backlog in any subject(s) and could not cleared during the same session .e. MERIT CRITERION : The students’ academic performance in the two consecutive semesters of the preceding Session(2010-11) i.ACADEMIC (UG) SECTION INDIAN INSTITUTE OF TECHNOLOGY KHARAGPUR – 721 302 No. who were awarded in 2010-11) for RENEWAL of MERIT-CUM-MEANS SCHOLARSHIP/ FREE STUDENTSHIP for the Academic Session 2011-12. 2011 NOTIFICATION ( in details) for inviting applications for RENEWAL of Meritcum-Means (MCM) Scholarship for the Session 2011-12 Applications are invited in the prescribed forms from the students of B.e.Course (including 2nd year of 2-Year M. they need not apply for MCM Scholarship & Freestudenship for 2011-12. in 2010-11.e. in 2010-11) or they have been punished by the competent authority under examination malpractice and involved in violation of code of conduct in Institute/Hall of Residence/Department /Gymkhana. MEANS CRITERION : The Gross Annual Income of a student’s parents/ guardian and his family from all sources in the preceding financial year of 2010-11 (from 1st April 2010 to 31stMarch.Tech. M.Arch..Sc.(including Dual Degree upto 4th Year) B. must not be lower than 7. the GPA (Credit based weighted average) of preceding two semesters as updated after the Supplementary Examination which followed the Session. 2011) must not exceed Rs. i.50./ Int. are NOT ELEGIBLE FOR AWARD OF MCM SCHOLARSHIP & FREESTUDENTSHIP.IIT/ACD/(UG)/MCM Schol/2011-12 Date: 19th April .Sc. B: 1) Number of MCM Scholarship awardees shall be restricted to 25% of the students admitted in each year 2) Those students against whom Disciplinary Action have been taken or pending against them during the preceding year ( i.

2011 (Friday) by hand. ACSSC (10) Sr. (7) Librarian ( 8) All the Members of MCM Scholarship Committee (9) PSM. 2) Dean(UGS) (3) Dean (S/A) (4) Chairman. . Guardians’ Income Certificate etc. T. Students are advised to obtain the MCM Scholarship Application Forms (to be downloaded from Institute Web page>For Students ) as applicable according to their guardians’ occupation along with all Annexures . ACADEMIC (UG) SECTION.:2: FREE STUDENTSHIP ELIGIBILITY : Those students who satisfy the specified “Means Criterion” as stated above . Information Cell (6) President.O. 2011 (Friday).. Registrar’s Office 12) VicePresident . HALL OF RESIDENCE – With the request to kindly bring it to the notice of the students concerned. Instt.. Director’s Office (11) Sr.Supdt. before they leave the Campus for Summer Break and submit the Application forms duly completed with all relevant documents as stated in the Annexure-II (“ List of Documents “) to the Academic(UG) Section (Scholarship Group) on or before 12th August . IIT KHARAGPUR P. Students may also send their filled MCM Applications with all requisite documents by post to the ASSISTANT REGISTRAR(UGS). Details of Guardian’s Annual Income are shown in the Annexure-I. NO APPLICATION WILL BE ENTERTAINED UNDER ANY CIRCUMSTANCES BEYOND 12th AUGUST.S. HMC(5) PIC.G. Poddar ) Assistant Registrar(UGS) NOTICE BOARD Copy to : 1) All HODs/HOCs/WARDENS. TSG 13) Circular File . K.KHARAGPUR – 721 302 DIST: MIDNAPORE(W). WEST BENGAL so that it should reach to the above sated addressee on or before 12th August . subject to approval on merit of each case by the competent authority subject to clearing all prescribed credit requirement during the session 2010-11 and having no backlog subject(s). but do not satisfy “Merit Criterion” . may be granted exemption from payment of Tuition Fee. Supdt.: TECH.2011(FRIDAY) ( S.

Annexure : I GUARDIANS’ ANNUAL INCOME : i) In the case of SALARIED PERSON AND_PENSIONER (i.2011)shall be taken into account for computing gross annual income of the employee/pensioner: (Copy of IT Form 16 to be issued by the concerned Employer / ITR Form duly attested by the Employer must be submitted alongwith MCM Application for the purpose).: a) Annual Income Affidavit in Non-Judicial Stamp as stated in Annexure-IVMANDATORY b) Attested copy of Income Certificate to be issued from local District Authorities like S. received in the Financial Year 2010-11 (from 1st April 2010 to 31st March. total emoluments including all allowances. D.D.MANDATORY c) Attested copy of ITR/Income Tax Return /SARAL Form etc. the Income from all sources of both parents and income in student’s name.Relief/ HRA./M. Such persons required to submit the following documents in support of their Annual Income. Self-employed person etc. Contractor.R./D./TAHASILDER Local Municipal Corporation /Gram Pancheyat etc.2011) will be taken into consideration for computing their Gross Annual Income.(Other than Salaried Class and Pensioners). Industrial Consultant. as applicable.O. bonus special pay etc. . ii) In case of NON-SALARIED CLASS such as Businessman. Agriculturist.A.O. Private Tutor. ./B.IF APPLICABLE. in prescribed form alongwith MCM Application.e. their Gross Income for the financial year 2010-11 (from 1st April 2010 to 31st March. NOTE : While computing the Total Income. if any. Investors. Medical/Legal Practitioner. students parents/guardian(s) who is/are in employment /pensioners).O. ******** . honorarium..D.P. will also be taken into consideration for applying the Means Criterion for all the classes. Retired without Pension. D.

if any (i. if any : 4. GPA of Autumn & Spring Semester .INDIAN INSTITUTE OF TECHNOLOGY KHARAGPUR APPLICATION FORM FOR MERIT-CUM-MEANS SCHOLARSHIP & FREE STUDENTSHIP For RENEWAL ONLY ( 2011-12) LAST DATE OF SUBMISSION: 12th August. 2011 N. if any to be mentioned) TOTAL of 5 (i) +(ii) +(iii) above : : : :Rs:______________ 6.2010-101without any backlog): (To be filled up by Academic Section ):___________ : MEANS STATUS ANNUAL INCOME OF FAMILY 5. 6 above Such as SERVICE/ BUSINESS/ AGRICULTURE /PENSIONER/ LEGAL PRACTITIONER/ MEDICAL PRACTITIONER /RETIRED WITHOUT PENSION/ CONSULTANCY/AGENCY/PRIVATE TUTOR/ SELF EMPLOYED / ANY OTHER ( Delete which is not applicable) Contd…2 . of the Student. i) Father’s Gross Annual Income ii) Mother’s Gross Annual Income (if any) iii) Annual Income from other source . 1. : PH)(Tick as applicable) (Delete which is not applicable) 3. Investment in Bank/ Post Office/UTI/LIC/ Share/Debenture/Landed property/ Income in the name of student etc.: Before filling the form. read carefully the enclosed Notificatoion.No. Name of Applicant 2 (.e. MERIT STATUS : (GPA(Credit based weighted average) of preceding two semesters i. “List of Documents to be Submitted “(Annexure-II) along with the application form to be download from Institute Web Page. Father’s/ Mother’/Guardian’s Occupation :_________________________________ Write specific present occupation against Col. e-mail ID & Mobile Ph.B.e.i) Institute Roll No: Category (GE/ OBC/ SC/ ST/ : (ii) Hall & Room No.

not failed in any subject at any stage and cleared all the prescribed curriculum upto preceding session Further I/we aware that. to be enclosed) 9) Present Postal Address : Following Documents to be submitted as per Guardians’ Occupational Status A) if Employed : In Govt.from any other source. as applicable: i) Name & Address of Firm : /Organisation/Shop ii) Nature of Business/Trade : if Pensioner : ( PP Certificate in Form ‘C’ as stated in Annex.) to be enclosed) Following to be filled in case of Businessman. or Pvt. are found false/incorrect. as asked in the item 1 a & b of Annexure-II ‘List of documents to be submitted”) to be enclosed.Service (Income/Salary Certificate in Form ‘A’ as stated in Annexure-III to be enclosed duly filled in along with attested copies all Income Tax documents for the current year. B) if Businessman/ Agriculture/Medical/Legal Practitioner/ Retired without Pension/Self-Employed/Private Tutor/Consultant /Agent etc. authority WHICH ARE MANDATORY. Salary Certificate as stated in Form “A” (Annex:III) with attested copies of Income Tax documents for the current year to be enclosed duly filled in) 8) i) ii) Name of Father Name of Mother : : iii) Name of Present Guardian : (if parents are not alive and his relationship with student. Income Tax documents etc. _____________________________________ SIGNATURE OF THE FATHER/ GUARDIAN WITH DATE with all requisite Income Tax documents for current year as asked. ii) I am not in receipt of any other Scholarship/Stipend /Fin. iii) I have no Back-log subject(s)in the preceding session 2010-11. as asked in the item 2 a & b of Annexure-II ‘List of documents to be submitted”. the information/statement given above. Assistance etc. (Delete which is not applicable) ______________________________________ SIGNATURE OF THE STUDENT WITH DATE Enclo : Guardian’s/ Annual Salary/Income Certificate/Affidavit in prescribed form .:2: 7) Mother’s occupation : ( If employed . : (Affidavit for Family Annual Income as per format given in Form ‘B’ –Annex:IV along with Annual Income Certificate from Govt. if at any stage.Medical/Legal Practitioner/Consultant/Agent etc. my candidature will automatically be rejected and I shall bound to refund the entire amount( if paid to me towards MCM Scholarship & Freestudentship) to the Institute immediately. Legal documents for such guardian .V with all relevant documents as asked in the item i ) Name & Address of Ex-Employer : -----------------------------------------------------------------------------------------------------------------------------------------------10) Declaration I declare the following: i) No disciplinary action has been taken against me by Institute in the preceding session 2010-11.

SUBMISSION THESE TWO DOCUMENTS as stated in 3 (a & b) above. for the year 2010-11 (Assessment Year 2011-12): THESE TWO DOCUMENTS(a & b)ARE MANDATORY 2) For Non-Salaried Class (Guardian’s who are not in Service such as Businessmen.03.:SUBMISSION THESE TWO DOCUMENTS as stated in 2 (a & b) above.Annexure : II LIST OF DOCUMENTS TO BE SUBMITTED FOLLOWING DOCUMENTS TO BE SUBMITTED ALONG WITH MCMSCHOLARSHIP APPLICATION FOR 2011-12 for different Classes of Occupation 1) For Salaried Class ( Guardians’ who are in Service either Govt. Copy of Registration Certificate must be submitted in case of Medical Practitioner and Legal Practitioner. N. if applicable. ARE MANDATORY FOR THE GUARDIANS WHO ARE EITHER PENSIONER OR FAMILY PENSIONER.Retired without Pension/Self-employed persons.) c) Attested copies of ITR Form/IT Return as applicable ( to be attested by a Govt. /M. Private Tutors. (’to be downloaded from Web page ) . Superannuating/Retirement/Termination letter and attested copies of I./TAHASILDER/ Chairman/Executive Officer of Municipal Corporation etc.D.10 to 31.O. or Private) a) Salary Certificate for the Financial Year 2010-11 (from 01. Chairman/ Executive Officer of Municipal Corporation etc. /M. for the year 2010-11 also to be submitted in addition to other documents as stated in item 3) a & b above.O.11) in prescribed Form ‘A given in Annexure III(to be downloaded from Web page ) duly sealed/stamped by the Salary Disbursing Officer.D. Local Municipal Corporation etc . Consultants./M. Income Tax documents . b) An Income Certificate from local District Authorities like S.D. Business class.T. / B. as stated in item 2) a. a) An Annual Income Affidavit for the financial year 20010-11 in a Non-Judicial Stamp for Rs.sworn in before preferably a First Class Magistrate / Notary Public as per the format given in Form “B” Annexure IV . Income & Non-employment Certificate from local District Authorities like S.B. for the current year .O.D. if any ( such as ITR Form / IT Form16. b. for the year 2010-11 (Assessment Year 2011-12) duly stamped/sealed from concerned Income Tax Office. self-employed. / B.O. Legal/Medical Practitioners/Retired without Pension/Private Tutors/Contractors/Consultants etc.THIS IS MANDATORY b) An Income& Non-employment Certificate from local District Authorities like S. 3) For Pensioners/Family Pensioners : a) Annual Pension Payment Certificate for the year 2010-11 in prescribed For ‘C’ given in Annexure V (to be downloaded from Web page ) to be issued by the Pension Disbursing Officer.O.O. ARE MANDATORY FOR ANY CLASS OF OCCUPATION IN CASE OF NON-SALARIED GUARDIANS.R. Those who Retired without Pension. Legal/Medical Practitioners.D.O.. b)Attested Copy of IT Form 16 to be issued by employer/attested copy of ITR Form as applicable.(such as Agriculture. etc)./ TAHASILDER. Officer).R. in addition to Income Affidavit./ TAHASILDER.R. if applicable). & c above. ******* . they have to submit Retirement/Termination/ Superannuating letter/documents/papers etc.20/. Documents. Agriculture.D. IT return etc.O./B.04.O. c) Copy of PPO. in addition to Income Affidavit and other documents as stated above & below.

:________________ Employer’s Signature : Designation Date : (Official Seal) N.Annexure : III FORM – A ANNUAL INCOME CERTIFICATE FOR THOSE GUARDIANS WHO ARE IN SERVICE (Govt or Pvt.) PART – I : Income from Salary : 1. R. . Bonus Arrears. iv) Special Pay & Honorarium. Certified that ____________________________________________ is employed in this Organisation in the Post of _______________________________.(current year).(Designation held by the employee) and that the break-up of his Gross Annual Income from Salary received in the Financial Year ___________ is as follows : ITEM i) Basic Pay ii) D/Pay iii) DA/ADA/Relief iv) H. they have to submit (i) a certificatefrom Employer/Salary disbursing officer sating that their annual income is Not Taxable and they need not produceITForm 16 and (ii) Annual Income Certificate for 2010-11 from Local district authority as stated in Col. 2) Guardians whose annual gross income is low and need not submit IT Form16. Name and Address of the Employer : 2. : Contd…2 . if any TOTAL : : : : TOTAL AMOUNT FOR 12 MONTHS : : Rs.2(b) of Annexure-II : These two documents are Mandatory for Low Income Group who could not submit Income Tax documents.etc.B. 1): All the entries as stated in Column 2 above must be supported by attested copy of IT Form 16 / ITR Form for the corresponding year.A.if any v) Other Allowances.

( Pl.to the scholarship awarding authority immediately. Date : Signature of the Father /Guardian Full Name Address with Pin Code Phone No.Assistance etc. without assigning any reason. by any Govt. ---------------------------------------Total: Rs. I shall bound to refund the entire amount of Scholarship/Freestudentship/Stipend/Financial Assistance etc . see pre-page) Gross Annual Income : RS: _______________ Further I declare that the information given above are true. If subsequently (after award of MCM Scholarship to my ward) it is found that he/she has been granted any other Scholarship/Stipend /Fin. if any : : : : . : Rs.:2: PART – II : Income from other sources : DECLARATION BY THE FATHER /GUARDIAN OF THE STUDENT I declare that my/my family’s Annual Income from other sources during the Financial Year ____________________ was as follows in addition to my Salary Income: Income from : a) Landed Properties (Certificate from Tahsilder/Gram Panchayat) b) c) d) e) Agriculture : Rs. being proved incorrect/false later on.2) i to v of Part-I Rs. + Total of Salary Income as stated in item No. organisation for the same period. Kharagpur.: Share Certificates/Debentures Other sources : : Rs. I understand that the Meritcum-Means Scholarship/Free Studentship/ if awarded to my son/daughter . I shall also be personally held responsible for the refund of the Scholarship/Freestudentship amount (paid to my son/daughter by the Institute )in the event of any information in this declaration and also in the enclosed scholarship application form.. is liable to be withheld or discontinued at the discretion of the authorities of the Indian Institute of Technology./Non-govt. Investment in Bank/Post Office/Unit Trust etc. Rs. Rs.

Courses in the Branch of _______________________________________ 4. during the period from 1st April. Retirement Benefits for VRS/VSS etc.a.a. Kharagpur.20/and sworn in before a First Class Magistrate/Notary Public) I.___________ p. Contd…2 . in 4-year B.Arch.___________ p. My son/daughter Shri/Miss ____________________________________________ is currently studying at the Indian Institute of Technology.) / 5-Year Dual Degree / 5-Year B. if any (B) Income of my wife/husband (if any) ( if employed. Salary certificate from Employer to be enclosed) (C) Income in the name of my son/ward (if any) GROSS TOTAL INCOME (A+B+C) :- Rs.a.a.___________ p. Income from Share Certificates/Debentures Income from any other sources(i.___________ p. ___________ to 31st March. Shri/Smt.___________ p. / 2-Year M.___________ p. He/She is an applicant for the award of Merit-cum-Means Scholarship / Free Studentship for the Academic Year __________________________. Income from Landed Properties Income from Investment in Bank/Post Office etc._______________ Rs. Rs.a.___________ p. 5. Rs.Sc. Rs.Tech.(H) / 5-Year M.a.e.a. I declare that my spouse is employed/not employed and that the Annual Income of my family in the Financial Year ___________________ i.___________ p.e.Sc. Rs.Annexure : IV FORM – B FORMAT OF INCOME AFFIDAVIT (FOR USE OF THOSE GUARDIANS WHO ARE NOT IN EMPLOYMENT ANYWHERE AND DERIVES INCOME FROM SOURCES OTHER THAN SALARY/PENSION) (To be submitted on Non-Judicial Stamp paper of Rs.(Hons. Rs.a. ii) iii) iv) v) vi) Income from Agriculture Rs. ________________ was as mentioned hereunder (Supported by document) : (A) From my own profession as indicated : i) Income from Business/Medical practice Legal Practice/Engineering Consultancy etc. _______________________________________________ a resident of ________________________________________________________________________ solemnly declare that : 3. Rs..

If subsequently (after award of MCM Scholarship to my ward) it is found that he/she has been granted any other Scholarship/Stipend /Fin. I shall bound to refund the whole amount of Scholarship/Freestudentship/Stipend/Financial Assistance etc . without assigning any reason. Kharagpur./Non-govt. by any Govt.Assistance etc. (SEAL) _______________________________________ Signature of First Class Magistrate /Notary Public .:2: Further I declare that the information given above are true. being proved incorrect later on.to the scholarship awarding authority immediately. I shall also be personally held responsible for the refund of the Scholarship/Freestudentship amount (paid to my son/daughter by the Institute )in the event of any information in this declaration and also in the enclosed scholarship application form. organisation for the same period. _________________________ (Signature of Father/Guardian) Sworn before me this _________________ day of ____________________ 200_____ and signed. is liable to be withheld or discontinued at the discretion of the authorities of the Indian Institute of Technology. I understand that the Meritcum-Means Scholarship/Free Studentship/ if awarded to my son/daughter .

Annexure : V FORM – C (FOR PENSIONER/FAMILY PENSIONER ONLY) (INCOME /SALARY CERTIFICATE FOR THOSE GUARDIANS WHO ARE IN PENSION (RETIRED FROM SERVICE OR THEIR WIVES ARE GETTING FAMILY PENSION PART – I 1. Certified that __________________________________________________ was employed in this Organisation/superannuated from in the capacity of __________________________(post held by the retired employee) and that the break-up of his/her Annual Income from Pension /Family Pension received in the financial year____________ is as follows : ITEM i) ii) iii) Basic Pension/F. 2. if any : : TOTAL AMOUNT FOR 12 MONTHS : _____________________ Total : _____________________ Signature of Ex-Employer/Pension Disbursing Authority : _______________________ Designation : ______________________________ Date : (Official Stamp) Contd…2 . No. Pension Dearness Relief Other Allowances.P.O. Arrears. : Income from Pension / Family Pension : : Name and address of the Ex-Employer with P.

Rs. organisation for the same period.: Share Certificates/Debentures Other sources : : Rs.R. is liable to be withheld or discontinued at the discretion of the authorities of the Indian Institute of Technology.D. Investment in Bank/Post Office/Unit Trust etc.V) . Annexure. ( Pl.O. If subsequently (after award of MCM Scholarship to my ward) it is found that he/she has been granted any other Scholarship/Stipend /Fin. I understand that the Merit-cum-Means Scholarship/Free Studentship/ if awarded to my son/daughter .: 2: PART – II : Income from other sources DECLARATION BY THE GUARDIAN I declare that my/my family’s Annual Income from other sources during the Financial Year ____________________ was as follows in addition to my pension income : Income from : a) b) c) d) e) Landed Properties (Certificate from Tahsilder/Gram Panchayat) Agriculture : : Rs.2) (i to v) of Part-I Rs. being proved incorrect later on. Anchal Officer. see pre-page) _________________ Gross Annual Income : RS: Further I declare that the information given above are true./Non-govt. they must have to submit an Income & Non-Employment Certificate from local District Authorities like S. by any Govt.O.to the scholarship awarding authority immediately. / B. ---------------------------------------Total : Rs. I shall also be personally held responsible for the refund of the Scholarship/Freestudentship amount (paid to my son/daughter by the Institute )in the event of any information in this declaration and also in the enclosed scholarship application form. as applicable along with Annual Pension Certificate duly filled in as per above stated format (Form-C. Rs. + Total of Pension Income as stated in item No. Rs./ TAHASILDER.O. Kharagpur. I shall bound to refund the whole amount of Scholarship/Freestudentship/Stipend/Financial Assistance etc .D. without assigning any reason.Assistance etc.B. Date : Signature of the Father/Guardian Full Name Address with Pin Code Phone No: )if any) : : : : N. Chairman/Executive Officer of Municipal Corporation etc. /M. : Those Pensioners who need not to file Income Tax Return (ITR) due to Low Annual Pension/Income.