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(Main) 2023

Information Bulletin: Joint Entrance Examination

Annexure- 1B

DECLARATION BY THE CANDIDATE IN LIEU OF GEN-EWs CERTIFICATE

Name of the candidate: VZTE TH V


Address: NO 2. R6DDY NIKAyA
TMAiN ALTALA KCHNM LAYOUT
CARAKK| TANKJP NABAR EPuASE
BANGALDRE-78 kARNA7AKA
Application Number of JEE (Main)- 2023: 23 03104901 73

Mobile No: 4 4 84 3 6 3 5 Email:Sumilhzahv2laamil. con

Iunderstand that as per the new guideline from the Ministry of Personnel, Public
Grievances and Pensions, Gol, I am required to submit a GEN-EWS certificate issued on
or after 01 April 2022.

Since I have not been able to collect the said certificate on time, I may kindly be allowed to
write JEE (Main)- 2023 provisionally. I hereby declare that I will upload a fresh certificate
(issued on or after 01 April 2022) at the time of reporting after seat allocation.

I understand that inability to upload the same by the given date and time will lead to the
withdrawal of the GEN-Ews benefit. I also understand that, if qualified, my category will
be adjusted accordingly in the Common Rank List.

Sighature of Father/Mottrer

Name: Rs. VENkATARAVANA REDDY Date: 3//2/2r22

Signature of Applicant Date: 31/a/2aa2

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