Requriments for ePass - Renewal of Post Matric Scholarships 2011-12

INCOME DECLARATION FORM

	Name of the Student:
1.	(i) Name of the Father
	(ii) Whether Employed
	(iii) if employed, Designation
	(iv) Salary per month
2.	(i) Name of the Mother
	(ii) Whether employed
	(iii) if employed, Designation
	(iv) Approx salary per month
3.	Agricultural holding of the parents mention extent
	(i) In the name of the Father
	(ii) In the name of the Mother
(a)	Crops Grown in land
(b)	Whether Dry or Wet land
©	Annual income from Agricultural Land
4.	Business mention the trade/name of business
	Income derived from the venture
5.	(i) No. of Vehicles owned by     the Family (ii)Whether used for       personal/private use only
	(iii) Mention type of vehicles(two wheeler/        three wheeler/four        wheeler)		Regd.No.
	(iv) Vehicle registered on       whose name
6.	(i)Type of House: Mention    whether RCC, thatched/   Tiled roofed
	(ii) Mention whether     Indiramma House
	(iii) Cost of Construction      of House
	(iv) whether constructed with loan, if so amount and Bank Branch
	(v) Any other type of house
7	(i) Whether living in own   house or rented house
	(ii) if rented, mention rent  amount
8.	Telephone/Mobile Number
9.	Total Family income from all sources

Name & Signature of the Student               Name & Signature of the Parent

 

ePASS Application ID of student:

Date:-                                                                            Date:

 Place:-                                                                   Place:-