Edited Copy

Candidate's Details
Application Number : 502725
1 Course/s Applied for PGCET : M B A (only)FullTime

2 Name of the Candidate : DEVIKA S

3 Name of the Father : SRINIVASA A
4 Name of the Mother : VARALAKSHMI B L
5 Date of Birth : 26:12:1998
6 Gender : Female 7 Quota : Karnataka
8. Marital Status Single Spouse Name

9. Annual Income of the family from All Sources (If married include your spouse 15000
income also)
10 Category : Category-2A 10 a. Sub-Caste : BALAJIGA
Income RD Number (RD00-------) RD0038028127359
Caste RD Number starting with (RD0--------)

11 Religion : Hindu
12 Eligibility Clause Code: a
13 Qualifying Degree / Engineering Branch ? B.Com (3 Years Degree)

Study Information
Have You done BCA, BSc (I.T / Computer Science ) with Mathmatics at 10+2 level or at No
Graduate Level ? (for Lateral entry to 2nd Year MCA )
Qualifying Degree Status ? Appeard University Seat No : (USN) 161151584
Qualifying Degree College Name : ALVAS DEGREE Qualifying Degree University MANGALORE UNIVERSITY
COLLGE Name :
Total Number of Years of Study in Karnataka : 16
Particulars of Result Month of Passing Year of Passing Maximum Marks Secured Marks
Examination
1 Pass June 2017 1700 1221

2 Pass July 2018 1500 1091

3 Pass July 2019 1800 1345

14 Do You Claim Reservation Under Physically Disabled Quota ? No

15 Do You Claim Reservation Under Ex-Serviceman Quota ? No
16 Do You Claim Reservation Under 371(J) (Hyderabad Karnataka) Quota ? No
16 (a) 371(J) RD Number starting with (RD0--------)

M.Tech Program Details (Only for M.tech Candidates)

PGCET Appearing under :

PGCET Exam Appearing Course Name :

Have you Appeared for GATE during 2018 or 2019 ?

GATE Code :

GATE Score : 0

Do You Claim Seat under Sponsered Quota?

17. PGCET Examination Centre BANGALORE(BENGALURU)

Candidate's Postal Address for Communication

Address : MAHAL CHOWDADENAHALLI VILLAGE ,SARJAPURA POST ANEKAL
TALUK,ANEKAL,BANGALORE URBAN (BENGALURU),KARNATAKA-562125
Mobile No : 9741436206
Email : devikasrinivas6367@gmail.com

Declaration
 Edited Copy

I declare that the above information is true and correct to the best of my knowledge and belief. I have gone through the
relevant Government Orders, Admission Rules and all Notifications / Website Notification issued by competent Authorityfor
PGCET-2019 and understand the same.If any of the information furnished above is found to be false or incorrect, I shall
automatically forfeit my claim to be considered for a seat or the seat already been opted by me in a Professional College in
Karnataka. In such event, I will also liable for such civil and criminal action as the State Government / KEA may take against me
in this regard.

Signature of the Left Hand Thumb impression of Date:

Candidate the Candidate

Principal / Gazetted Officer Signature

Name:
Signature:

Seal:

PAYMENT STATUS
Appno : 502725 NAME OF THE CANDIDATE : DEVIKA S
APPLICATION FEES : 660 BANK NAME : Corporation Bank
BANK CHARGES : 10 BANK Ref NUMBER : 132120190601590983

Printed Date 31-08-2019 05-24-14