K. K.

Wagh Institute of Engineering Education & Research, Nashik

DROUGHT-HIT RELIEF FORM (Applicable for SPPU Students Onl v)

' Universitv PRN Student Name

Course Admission (Branch) Email ID Mobile

Are you eligible for EBC

Caste Category Admission Seat Type
scheme & applied for it?
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'
Exam Form Fees for Oct. 2023 Exam Form Fees for May 2024
Rs............ Rs............
Bank Name IFSC Code Student Banck A"/c. Number

Bank Branch Code

District Taluka Revenue Circle

I, hereby declare that I am residing in the drought-hit affected taluka and my fathers' or mothers' annual family
income is not more than Rs. 8 lac in the financial yer 2022-23. Therefore, I am eligible for exam fees waiver
scheme in academic year 2023-24.
I, hereby declare that I have not claimed the exam fees under any Govemments' Tution Facility Schemes like
Freeship/ Scholarship/lr4inority etc. This scheme is not applicable for SC/ST/VJA.,IT/SBC category students, who
are beneficiary of 100% exam fees refund under Govemments' Educational Fees Facility Schemes.
Only Open, EWS & Institute Level admitted students are applicable under this scheme.
Last date to submit hardcopy with email in PDF format is 6, April 2024

Attach following documents and email pdf files separately to exam-engg@kkwagh.edu.in

L Bank pass-book front page (in PDF Format)

2. Family Annual Income Certificate (Fathers' or Mothers') (in PDF Format) of Financial Year 2022-23

Date:

Signature of Student Signature of Exam Section Principal