INCOME DECLARATION FORM
INCOME DECLARATION FORM
Name of the Student SUNKARA SUBRAMANYAM
1.(i) Name of the FatherS.RAJA4.Business mention the trade/name
of businessNO
(ii) Whether EmployedNOIncome derived from the ventureNO
(iii) if employed, DesignationCOOLI5.(i) No. of Vehicles owned
by the Family NO
(iv) Salary per monthNO(ii) Whether used for personal/private
use onlyNO
2.(i) Name of the MotherS.VENKATA RATHNAMMA(iii) Mention type of
vehicles (two wheeler/ three wheeler/four wheeler)NO
(ii) Whether EmployedHOUSE WIFE(iv) Vehicle registered on whose
nameNO
(iii) if employed, DesignationNO6.(i) Type of House: Mention
whether RCC, thatched/Tiled roofedRCC HOUSE
(iv) Salary per monthNO(ii) Mention whether Indiramma
HouseNO
3.Agricultural holding of the parents mention extentNO(iii) Cost
of Construction of HouseNO
(i) In the name of the FatherNO(iv) Whether Constructed with
loan, if so amount and Bank BranchNO
(ii) In the name of the MotherNO(v) Any other type of
houseNO
(a)Crops Grown in landNO7.(i) Whether living in own house or
rented houseOWN HOUSE
(b)Whether Dry or Wet landNO(ii) if rented, mention rent
amountNO
(c)Annual Income from Agricultural LandNO8Telephone / Mobile
Number8520009276
9.Total Family income from all sources. RS :48,000/-
I hereby declare that the above information given is true &
correct. I will be held liable for any wrong information given
which shall include cancellation of scholarship, recovery of
amounts paid already if any besides criminal action.
Name & Signature of the Student
Name &Signature of the Parent :ePASS Application ID
(2013-14): 201304797338 Address:H.No.: 5/180 Kolimi StreetCourse:
DEGREE (BSC) Course Year: III Year Village &
Mandal:RajampetCollege: CGR DEGREE COLLEGE RAJAMPET City &
District: KadapaCollege District: Kadapa
Mobile No:_ 8520009276Mobile No:
