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West Bengal Minorities' Development and Finance Corporation: Application For WB Pre Matric Scholarship 2019-20

This document is an application for a West Bengal pre-matric scholarship submitted by MD Samim Aktar. It provides basic information about the student such as name, date of birth, family income, address, academic details, and bank account information. It also includes a declaration of family income signed by the student's parent/guardian stating their annual income is 48,000 rupees and agreeing to refund the scholarship if the information is found to be false. The student is instructed to submit this computer-generated application form along with a photocopy of their bank passbook to their educational institution.

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md ziaul haque
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74 views

West Bengal Minorities' Development and Finance Corporation: Application For WB Pre Matric Scholarship 2019-20

This document is an application for a West Bengal pre-matric scholarship submitted by MD Samim Aktar. It provides basic information about the student such as name, date of birth, family income, address, academic details, and bank account information. It also includes a declaration of family income signed by the student's parent/guardian stating their annual income is 48,000 rupees and agreeing to refund the scholarship if the information is found to be false. The student is instructed to submit this computer-generated application form along with a photocopy of their bank passbook to their educational institution.

Uploaded by

md ziaul haque
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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West Bengal Minorities' Development and Finance Corporation

A statutory Corporation under Minority Affairs & Madrasha Education Department,


Government of West Bengal
"Amber", DD/27E,Salt Lake City Sector-I, Kolkata-700064, Toll free No:-18001202130

APPLICATION FOR WB PRE MATRIC SCHOLARSHIP 2019-20


Application ID: SSP2019010100232875 Application Date: 03-08-2019
BASIC INFORMATION
Student's Name: MD SAMIM AKTAR Father's Name: MD MOMINUL HOQUE
Date of Birth: 23-12-2005 Mother's Name: JAHANARA BEGAM
Gender: Male Annual Family Income: 48000
Marital Status: Unmarried Guardian's / Husband's Name: MD MOMINUL HOQUE
E-mail Id: Religion: Muslim
Mobile No: 9641586647

ADDRESS INFORMATION
Permanent Address Present Address
Domicile State: WEST BENGAL State: WEST BENGAL
Domicile District: NORTH 24 PARGANAS District:NORTH 24 PARGANAS
Block/Municipality:Deganga Block/ Municipality:
Permanent Address: KUMARPUR Present Address: KUMARPUR
Post Office: SOHAI KUMAR PUR Post Office: SOHAI KUMAR PUR
Police Station: DEGANGA Police Station: DEGANGA
Pin: 743423 Pin: 743423

ACADEMIC INFORMATION
Previous Academic Information Present Academic Information
Previous Institute Name: kumarpur parasmani Institution Name: KUMARPUR PARASHMANI SHIKSHABITAN
siksha bitan Current Class / Course Name : IX
Previous Class / Course Name: VIII Current year of Study :
Previous Year of Study: VIII Are you a Hosteller: No
Name of the Board of Name of the Board / Council / University : West Bengal Board of
last Exam Passed: West Bengal Board of Secondary Education
Secondary Education Course Duration : 1 Year
Year of Passing Last Exam: 2018
% of Marks Obtained
in Last Examination: 79.08
BANK ACCOUNT DETAILS
Bank:UNITED BANK OF INDIA
Branch:SOHAIHAT
IFSC: UTBI0SOHD94
Savings bank account no.: 1168010272704

Declaration:I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief.

___________________
Signature of Student
DECLARATION OF INCOME
(To be given by the parents/ guardians)

Certified that the gross annual income from all sources in respect of my family is Rs.48000 . I further undertake that in the
event of the particulars given in the declaration being found false, I shall refund the whole amount of the Scholarship paid to
the said Scholarship holder MD SAMIM AKTAR and the Government's decision in this regard shall be final and binding on me.

__________________________
Signature of the parents/ guardian

Instruction
Student is to submit this ***computer-generated filled-in application form (duly signed) to the educational institution along with
following supporting document:
1. Photocopy of the bank-passbook where the details of bank a/c number,IFSC are mentioned clearly.

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