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Government of Telangana

Department of Backward Classes

Student Application cum Verification Report for

Post-Matric Scholarship Renewal 2023-24

1. Application No: 2023 1058 1090 2. Application Date: 20-11-2023 3. Caste / Sub Caste: BC-D / Yadava(Sl.No.-33)
4. Student Name : PANCHITHA ANIL 5. Gender : Male
6. Father / Mother Name :PANCHITHA BAPAIAH
7. Address & Mobile No : 4-71/A ,Buggaram , Sirikonda ,JAGTIAL & xxxxxx6108
8. SSC HT No : 1807100329 9. Pass Year -Pass Type : 2018-Regular 10. Date of Birth: 12-07-2000
11.Family Annual Income (in Rs.): 90000 12. UID(aadhar) : xxxxxxxx3417
13. Income Certificate Details: ,
,
14.College Details : INSTITUTE OF AERONAUTICAL ENGINEERING DUNDIGAL DUNDIGAL( M)MEDCHAL DIST.(14045) ,
Dundigal Gandimaisamma,Medchal Malkajgiri , Private College ,JNTU HYDERABAD
15. Course Name /Course Year /Duration of Course : B.TECH-CSE (DATA SCIENCE) / IV Yr / 4Yrs
16. College Admission No / Admission Date(of this year): 21955A6701 / 01-08-2023 17. Distance (in Kms.) : 220
18. Scholarship Type : Day Scholar 19. DAH Name : -
I.Declaration
I hereby certify that that above information furnished is true. I have not availed any other scholarship for this purpose from any other
sources. I shall abide by the terms and conditions of the sanction of the scholarship. If any discrepancies are found later, I hereby abide for refund
of the scholarship amounts claimedand also am liable for action by the Department. .

Signature of the Student

Date :

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