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STATEMENTSTATEMENT SHOWING THE STUDENT INFORMATION UNDER

EXEMPTION/REIMBURSEMENT OF EXAMINATION FEES TO THE STUDENTSFROM SCARCITY AFFECTED VILLAGES FOR THE YEAR 2OI3.I4

Name of the College -

Address of the College -

Ph. No. of the College (with STD Code) -

Fax No. of the College (with STD Code) -

Email id of the College *

Name of the Nationalised Bank -

Branch Name -

Address of the Bank -

A/c. No. of the Bank -

IFSC Code of the Bank -

MICR Code -

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B.C.A., B.C.S., L.L.B., M.A., M.Com., M.Sc., M.Ed., M.P.Ed, M.C.A., M.C.S., L. L. M.q{{ E5,'w k5r;IT *Tr.5^ a vqrq s.f,{ qsi ril qr qqldr *ar vqr. I Year, II Year, III Yearo

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Viltage Taluka District CourseName

ExamYear

BankAlc.No.

Nameof theBank

IFSCCodeoftheBank

ParentsAnnualIncomefor2012-13

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