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Scholarship Application Form
ST&SC and MBC Welfare Department
Academic Year 2025-26 STSC92601019625005
Government of Odisha
Basic Information
Department Scheme Academic Year Application Type
ST&SC and MBC Welfare Post Matric Scholarship 2025-26 Renew in Same Course
Department
Unique Ref. No. (CAF Barcode)
24H0114180
Applicant Details
Applicant Name Category Applicant Gender
Subham Naik SC Male
Religion Date of Birth OTR No.
Hindu 19 Oct 2008 (17 Year) 24010016490271
Aadhaar No.
XXXXXXXX4772
Bank account is seeded with Aadhaar when applied by student.
Bank Name : CANARA BANK | Sync Date : 14 Aug 2021
Mobile No. Alternative Mobile No. e-Mail Id
7605925161 8598058355 naiksubham12345@[Link]
Father's Name Father Educational Status Father Occupational Status
Goutam Naik Literate Agriculture
Mother's Name Mother Educational Status Mother Occupational Status
Sabhagyamalini Naik Literate House Wife
Guardian Name Individual/ Family Information
VIEW
-- Beneficiary of NFSA
Address Information
District Block/ULB GP/Ward
Angul Anugul Bantala
Village Pin Code Address
Bantala 759129 AT- BANTALA, PO-BANTALA, DIST-ANGUL,
PIN-759129
Educational Qualification Details
For : Matric-Annual
Passing Total Secured Percentage Marksheet/
Course Board Roll No. Year Mark/CGPA Marks/CGPA (%) Certificate
X BSE, 082AE0172 2024 600 385 64.17 Uploaded
Odisha
Institute / Course Information (Current Education Information)
Institute Type
Govt.
Institute District Block/ULB
Government Higher Secondary School, Angul Angul Anugul Mpl
Nature of Course Course Branch/Stream/Trade
General Plus 2 Arts
Course Year (Current Year of Study) Admission/Registration No. Admission/Readmission Date
2nd Year IA24148 06 Sep 2025
Enrollment No. Enrollment Date
IA24-148 23 Jul 2024
Any Exam Conducted during current academic year? : No
Residential Status
Whether
Day Scholar
APAAR ID (Automated Permanent Academic Account Registry ID) Information
Do you have APAAR ID ? Reason
No APAAR ID Generation in Progress
Eligibility Information
Income Certificate No. Family Income (in Rs.) To Whom the Certificate Issued
E-INC/2024/1021937 60000.00 GOUTAM NAIK
Issuing Authority Issue Date Income Certificate
Revenue Officers not below the rank of 15 Jun 2024 Uploaded
Tahasildar / Additional Tahasildar
Matriculation Certificate No. Issuing Authority Matriculation Certificate
124109659 BSE, Odisha (Annual) Uploaded
Caste Certificate issuance year Caste Certificate No. Token No
Certificate issued on/after 1st Feb 2020 E-SCO/2021/106236 69740475
To Whom the Certificate Issued Issuing Authority Issue Date
SUBHAM NAIK Revenue Officers not below the rank of 16 May 2021
Tahasildar / Additional Tahasildar
Applicant Father Applicant Mother Issuing District
GOUTAM NAIK SABHAGYAMALINI NAIK ANUGUL
Tribe Name Category
Pan SCO
Institute Declaration Certificate
NA
Bank Information
Account Holder Name IFSC Code Account No.
SUBHAM NAIK CNRB0018075 110003315249
Whether account number tagged /seeded with
the Aadhaar number?
Yes
Bank Name Branch Name
CANARA BANK ANGUL
Passbook front page
Uploaded
Student Declaration
1. I have read and understood the conditions of award of Scholarship.
2. I am aware that my application is liable to be rejected, if it is found at any stage, that Aadhaar number provided by me is wrong or Aadhaar number is
of someone’s else.
3. I am aware that if more than one application is found, all my applications are liable to be rejected.
4. I am aware that for any wrong entry or mis-match of the Bank-account details, the State Government will not be responsible for mis-credit and I will
be held responsible for diversion of public money on this ground.
Date ........................
Place ........................
Full Signature of Applicant