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minority status  certificate and income deceleration Muslim minority affidavit for scholarship 

Annexure -I

DECLARATION OF FAMILY INCOME AND MINORITY STATUS


I    _________________________ (Father) of ___________ ___ _____________ (Name of Student) who is studying   in MASTER IN COMPUTER APPLICATION  second year (M.C.A.II )  hereby declare that my annual income from all sources is Rs  50,000 only  in word Rs. fifty  thousand only.


I also declare that I belong to Muslim  minority community declared as Minority Community by Government of Maharashtra, General Administrative Department Notification No. RAA/2005/89/C.R.19/2005, dtd 9th November, 2006.  

If at any stage, it is found that the information given by me is false/not true, all benefits given to the student under the scheme of ”Scholarship Scheme for pursuing Technical & Professional Studies to the students belonging to Minority Communities” could be withdrawn and legal action as deemed fit, may be taken against me or my ward.


Signature Student Signature

(student name )                                 ( father name  )


 Date : ……………………

Residential Address : addres_____________

____________________

______________________

_____________________



Verification


I hereby declare that the above information given is true & correct. If found false or incorrect, I am liable for legal action under sections 192, 193(1), and 200(A) of IPC.



 Signature

Place :-............................                                 (father name  )


Date : ……………………