STATE COUNCIL OF EDUCATIONAL RESEARCH & TRAINING BIHAR, MAHENDRU, PATNA

(APPLICATION FORM)
NATIONAL MEANS-CUM-MERIT SCHOLARSHIP SCHEME EXAMINATION
ACADEMIC YEAR 2022-23 PROJECT YEAR 2023-24
( For the Students Studying in Class VIII )

APPLICATION NO : 32222777

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Date of Examination : 18th December,2022
Name & Address of the Agency for STATE COUNCIL OF EDUCATIONAL RESEARCH & TRAINING,
conducting NMMSS Examination : BIHAR, MAHENDRU, PATNA-6
Name of the State/UT : BIHAR
Name of the School (where the candidate M. S. JAINAGAR, BLOCK-SONBARSA, DIST-SITAMARHI
is studying Class VIII) :

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Application Fee (in INR) : NIL
District Applying From : SITAMARHI
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Personal Details :
Name of Candidate : AMIT KUMAR
Father's Name : MANOHAR SAH
Mother's Name : SHANTA DEVI
Date of Birth : 24-04-2009 Gender : MALE
Area to which Candidate resides : RURAL
Caste Category : O.B.C. (Sub Cst. - E.B.C., State - BIHAR, Caste/Community - TELI)
Disability Status : NONE
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Studying in Class : CLASS VIII

Communication Details :
Address Line 1 : VILL- JAMUAHA, PO- BANARJHULA, PS- SONBARSA
Address Line 2 DIST- SITAMARHI
State/Union Territory : BIHAR PIN Code : 843317

Name and address of the School/Institution in which studying at Class VIII level :
School Name : M. S. JAINAGAR
Address : JAINAGAR
Post Office : BANARJHULA PIN Code : 843317
Block : SONBARSA
District : SITAMARHI
School Type : GOVERNMENT
Area in which the School is located : RURAL
Medium of Examination :
At the State Level : HINDI

Parental & Other Family Details :

Father's Education : NO FORMAL EDUCATION
Father's Occupation : FARMER, FISHERMEN AND RELATED WORKER
Mother's Education : NO FORMAL EDUCATION
Mother's Occupation : NOT EMPLOYED
No. of family members living in the house : 5 No of brothers : 3

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No of sisters : 0 At what no is the candidate among his/her brothers and sisters : 3
Parental annual income (in Rs.) : 50,001 to 1,00,000
Mobile Number : 8797652838 Telephone Number : 8797652838
Email Address : amitkumar240409@gmail.com

Document uploaded by the Candidate :

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Income Certificate Caste Category Certificate Disability Certificate
32222777_income.pdf 32222777_caste.pdf N.A.

Declaration by Candidate :
I hereby declare that all data reflecting in this application form are correct. I also declare that all the statements made including all documents uploaded
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in this application form are true, complete and correct to the best of my knowledge and belief and in the event of any information being found false/incorrect
my candidature is liable to be cancelled even after qualifying the State Level Examination.

Date : 2022-11-01 21:56:21 Uploaded Signature of the Candidate

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Certification by the Head of the Institution :

Certified that :
1. Master/Miss AMIT KUMAR is a regular student of this School/Institution and he/she has secured 79.67% marks in the class
VII annual examination, i.e., when he/she was promoted from Class VII to Class VIII. He/She has secured 239 marks out of 300 marks.
2. The particulars given by him/her in the application form have been verified and found in order.
3. Master/Miss AMIT KUMAR belongs to O.B.C. as per the records maintained by the Institution.
4. His/Her Aadhar Number is N.A.

Status : YOUR APPLICATION IS APPROVED

Date :- 2022-11-17 13:50:18