JVD FIVE STEP VALIDATION FORM

STUDENT DETAILS
STUDENT AADHAR NUMBER STUDENT NAME
FATHER NAME MOBILE NUMBER
COLLEGE DETAILS

COLLEGE NAME COURSE NAME

COURSE YEAR
IS THE ABOVE STUDENT CONTINUING IN SAME COLLEGE AND
YES NO
COURSE FOR THE ACADEMIC YEAR 2021-2022
MOTHER / GUARDIAN DETAILS
MOTHER / GUARDIAN NAME AADHAR NUMBER
BANK ACCOUNT NUMBER BANK IFSC CODE
CONFIRM WHETHER BANK IFSC CODE IS CORRECT YES NO

(If inactive amount transfer will fail.If inactive ensure that it made active by the parent by contacting bank branch manager)

SIX STEP VALIDATION

DETAILS AGREE/DISAGREE REMARKS
IS ANY FAMILY MEMBER A GOVERNMENT EMPLOYEE/PENSIONER
IS ANY FAMILY MEMBER PAYING INCOME TAX
IS FOUR-WHEELER OWNED BY FAMILY MEMBER
IS LAND HOLDING BY THE FAMILY BEYOND PERMITTED LIMITS (i.e.,
25 ACREES OFDRYLAND OR 10 ACRES OF WETLAND OR 25 ACRES OF DRYLAND AND
WETLAND)
IS FAMILY OWNING PROPERTY(COMMERCIAL/RESIDENTIAL) IN URBAN
AREA BEYONDLIMIT (i.e., MORE THAN 1500 sq. FEET BUILTUP AREA)
FAMILY TOTAL INCOME PER YEAR
ADDRESS FOR COMMUNICATION
MUNCIPALITY / GRAM
WARD NUMBER
PANCHAYAT
DOOR NUMBER STREET/VILLAGE
COLONY PINCODE
Mandal District
ENTRY OF FAMILY MEMBERS DETAILS

RICE CARD AVAILBLE OR NOT RICE CARD NUMBER

NUMBER OF MEMBERS LIVING IN THE FAMILY

Details of other members of the family (other than student) based on the family size of the members entered as above, the details
have to be filled for all othermembers of the family
S.N Education Qualification
NAME Aadhar number Age Gender Relation Occupation Mobile
o (Highesteducation or
current pursuing)

Volunteer Signature Signature of the student/Parent/Guardian