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Government of Telangana

Department of Social Welfare

Student Application cum Verification Report for

Post-Matric Scholarship Renewal 2023-24

1. Application No: 2023 1130 3675 2. Application Date: 26-11-2023 3. Caste / Sub Caste: SC / Madiga
4. Student Name : VUTUKURI GOPICHAND 5. Gender : Male
6. Father / Mother Name :VUTUKURI LAXMAIAH
7. Address & Mobile No : 6-4-148/1 VENUGOPALA NAGAR ,Khammam (Urban) , Khammam ,KHAMMAM & xxxxxx9190
8. SSC HT No : 1831100491 9. Pass Year -Pass Type : 2018-Regular 10. Date of Birth: 04-12-2001
11.Family Annual Income (in Rs.): 99000 12. UID(aadhar) : xxxxxxxx1155
13. Income Certificate Details: ,
,
14.College Details : CBIT GANDIPET RAJENDRANAGAR , Gandipet,Ranga Reddy , Private College ,OSMANIA UNIVERSITY
15. Course Name /Course Year /Duration of Course : BE (EEE) / IV Yr / 4Yrs
16. College Admission No / Admission Date(of this year): 160120734032 / 01-06-2023 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 :

1 of 1 11/26/2023, 10:48 AM