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Government of Telangana
Department of Tribal Welfare
Student Application cum Verification Report for
Post-Matric Scholarship Fresh 2024-25
1. Application No: 2024 1308 7230 2. Application Date: 19-02-2025 3. Caste / Sub Caste: ST / Lambadis(Sl.No-29)
4. Student Name : AMBOTH JYOTHSNA 5. Gender : Female
6. Father / Mother Name : AMBOTH RAVINDER
7. Address & Mobile No : 5-121 RAJYALAXMINAGAR PHASE 2 GURRAMGUDA ,Balapur , Nadergul ,RANGA REDDY & xxxxxx9180
8. SSC HT No : 2422117992 9. Pass Year -Pass Type : 2024-Regular 10. Date of Birth: 25-05-2008
11.Family Annual Income (in Rs.): 186000 12. UID(aadhar) : xxxxxxxx7827
13. Income Certificate Details: IC022441131835 , ,
14.College Details : BADRUKA JR COLL FOR GIRLS DOMALGUDA , Musheerabad,Hyderabad , Private College ,BOARD OF
INTERMEDIATE EDUCATION
15. Course Name /Course Year /Duration of Course : INTER (MEC) / I Yr / 2Yrs
16. College Admission No / Admission Date(of this year): 54 / 01-07-2024 17. Distance (in Kms.) : 19
18. Scholarship Type : Day Scholar 19. DAH Name : -
20. Bank Name / IFSC Code: -SANTOSH NAGAR COLON /UBIN0805483 21. Bank A/c No : 054812010001704
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 :
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