debit authority letter for post-matric fee …aith.ac.in/crm/news_image/20190807071740352.pdfdebit...
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Debit Authority Letter for Post-Matric fee reimbursement
Provided by Social Welfare Department (Mandate to debit the Account)
Name of the Bank, Syndicate Bank Syndicate Bank, Rama Dental College, Kanpur.
Customer Name: ..........................................................................
Customer Account Number: ........................................................
The Branch Head, Syndicate Bank, Sharda Nagar / RDC, Kanpur
Dear Sir,
I irrevocably authorize Syndicate Bank, Sharda Nagar /Rama Dental College, Kanpur to debit my SB Account No: ...................................................................... By /- only (......................................................................................... only) provided by the State Government as reimbursement of fee under Scheduled Caste/scheduled Tribe post matric fee reimbursement scheme provided by Samaj Kalyan Department & remit this amount (20____-____) to Director, Dr. Ambedker Institute of Technology for Handicapped, U.P. Kanpur.
(Name of the institution) Account No 86982150000025 maintained at Syndicate Bank, …………………………………………………………..………………, Kanpur (Name of the Bank & Branch).
(in case the beneficiary account is with some other bank)
RTGS/NEFT (IFSC) CODE of the beneficiary Bank……………………………………………….…………….
Name of the Bank & Branch: …………………………………………………………………………………………….., Kanpur
I/We request you to make the above remittance. It is being understood that the remittance is to be sent at my/our risk and my/our responsibility and on the distinct understanding that no liability whatsoever is to attach to the Bank for any loss or damage arising or resulting from delay in transmission, delivery or non delivery of the message or for any mistake. I/We also hereby undertake to refund to bank any over remittance, which is made by mistake in beneficiary’s account. I/We also understand that remittance would be made as per RBI, RTGS/NEFT Scheme.
Signature of the Customer
Name :…………………………………………………..
Date :…………………………………………………..
Place :…………………………………………………..
Branch/Year/Category :…………………………………………………..
l= 2019&20
n”keksRrj Nk=o`fRr ,oa “kqYd izfriwfrZ vkuykbu vkosnu i= ds lkFk fuEufyf[kr layXud vfuok;Z :Ik ls
dqy 2 izfr;ksa esa tek fd;k tkuk gSA
1. Photo copy of High School & Intermediate mark sheet and Certificate with Board
Verification (UP Board/CBSE/ICSE/others).
2. Photo copy of Income Certificate, Caste Certificate, Domicile Certificate with Verification
by Board of Revenue website (www.bor.up.nic.in) and (http://edistrict.up.nic.in).
3. Search/Track Student Record, Status of application 2018-19 Certificate from
SWD website.
4. Father’s employer’s Certificate/Pension Receipt/pay slip/gram pradhan income
certificate/ Ration Card with khatauni (for farmers).
5. Photo copy of Aadhar card of student, Father and Mother.
6. Photo copy of Bank A/c Passbook (Only Syndicate Bank,Sharda Nagar/RDC
lakhanpur).
7. Photo copy of Last year passing mark sheet or internet result copy verified by
HODs.
8. If old students are filling online fresh application form SWD then affidavit is
required regarding reason.
9. Photo copy of fee receipt of session 2019 - 20(not applicable of SC / ST / Zero Fee
students)
10. Self-attest all the enclosures.
11. UPSEE Counseling Letter (Photocopy) compulsory.
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1 & ikB~;dze dk uke B.Tech. gh Hkjs vU; ikB~;dze flysDV u djs rFkk ,ykWVesaV ysVj ij
iznf”kZr czkap gh flysDV djsaA
2 & vk/kkj ua0 dh txg vU; dksbZ vkbZ0Mh0 ugh Hkjs rFkk vk/kkj ua0 dks vkosnu i= ij fn;s x;s
cSad ds ek/e; ls [kkrs dks fy ad djkuk Hkh vfuOkk;Z gSA
3 & fo”ofo|ky;@cksMZ iath;u la[;k ds LFkku ij uoizosf”kr Nk= ,ykVesaV ysVj ij iznf”kZr
,Iyhds”ku ua0 Hkjs ,oa iqjkus Nk= ,0ds0Vh0;w0 }kjk izkIr bujksyesaV ua0 gh vfuok;Z :i ls HkjsA
4 & vkuykbu vkosnu i= Hkjh x;h lHkh izfof’V;ksa dh tkap HkyhHkkafr ewyizek.k i=ksa ls dj ys =qfV
gksus dh n”kk esa lEiw.kZ nkf;Ro Nk=@Nk=k dk gksxkA
5 & uku fjQ.Mscy vfuok;Z okf’kZd “kqYd &
I/II Lateral Entry = 72,800/- II/III/IV B.Tech. = 67500/=
6 & ,l0lh0@,l0Vh0 ds Nk=@Nk=kvksa dks 100 :i;s ds ukuT;wMhf”k;yh LVkEiisij ij vuqca/k
i= rS;kj dj tek djkuk vfuok;Z gS rFkk ,d ?kks’k.kk i= ¼lHkh tkfr oxksZ ds fy;s½ Hkh tek
fd;k tkuk gSA ftldk izk:i dkyst dh osclkbV ij miyC/k gSA
www.scholarship.up.nic.in
12. PAN Card of Father.
I/II Lateral Entry (PH) = 57,800/-
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laLFkk/;{k
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tuin--------------------------------------------dk fuoklh gWw] fuEufyf[kr c;ku djrk gWw&
1 & ;g fd eS xzke -----------------eqgYyk]--------------------------------rglhy---------------------------ftyk--------------------------mRrj izns”k
dk ewy fuoklh gWwA ¼vk;@tkfr izek.k i= l{ke izkf/kdkjh }kjk iznRr layXu gS½
2 & ;g fd eS mRrj izns”k jkT; eas fofufnZ’V vuqlwfpr tkfr@vuwlwfpr tutkfr dk gWwA ¼rglhynkj
}kjk iznRr tkfr izek.k i= layXu gS½
3 & ;g fd esjs ekrk firk fof/kd vfHkHkkod dh leLr Jksrks ls okf’kZd vk; :I;s nks yk[k ;k blls
de gSA ¼rglhynkj }kjk iznRr vk; izek.k i= layXu gS½
4 & ;g fd lEizfr eS--------------------------------“kSf{kd laLFkku ds ---------------------------------ikB~;dze esa------------- o’kZ esa
laLFkkxr Nk= ds :i eas v/;;ujr~ gWwA laLFkk ----------------------------fo”ofo|ky;@cksMZ ls ekU;rkizkIr gSA
5 & ;g fd eSus mDr fo”ofo|ky;@cksMZ esa iath;u gsrq vkosnu dj fn;k gSA iath;u izek.k i= izkIRk
gksus ij laLFkk dks lle; miyC/k djk nwaxkA
6 & ;g fd eSus fiNyh ijh{kk -------------o’kZ esa mRrh.kZ dh gSA xSi ds laca/k esa vyx ls ?kks’k.kk i=
vkSfpR; lfgr izLrqr gSA
7 & ;g fd eq>s dksbZ nwljh Nk=o`fRr ugh fey jgh gSA
8 & ;g fd esjk cpr [kkrk la[;k ------------------------------------------cSad --------------------------------------ds -------------------------“kk[kk
esa [kqyk gqvk gSA
9 & ;g fd mDr laLFkk }kjk eq>s fu%”kqYd@l”kqYd izos”k fn;k x;k gSA
mDr ?kks’k.kk i= esa fcUnq la[;k 1 ls 9 rd esa of.kZr lHkh rF; lgh ,oa esjh iw.kZ tkudkjh es gSA blesa
dksbZ Hkh rF; fNik;k ugh x;k gSA
fnukad %
Nk=@Nk=k ds gLrk{kj----------------------
uke------------------------------------------------------------
firk@ifr dk uke--------------------------------
irk------------------------------------------------------------
uksV& lekt dY;k.k foHkkx }kjk l= 20 & gsrq ;g O;oLFkk fu/kkZfjr dh x;h gS fd Nk=@Nk=k }kjk
vkosnu i= esa =`fViw.kZ@viw.kZ@xyr izfof’V;ka Hkjus ij iw.kZ mRrjnkf;Ro Nk=@Nk=k dk gh gksxk ,oa
vkosnu i= fujLr gks tk;sxk rFkk Nk=o`fRr ,oa “kqYd izfriw.kZ vuqeU; ugh gksxhA lkFk gh Nk=o`fRr ,oa
“kqYd izfriwfrZ dsoy “kklu ds ikl ctV dh miyC/krk ij gh ns; gksxkA
firk@ifr ds gLrk{kj %--------------------------------------------------------------
firk@ifr dk uke %---------------------------------------------------------------------
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