JOINT ENTRANCE EXAMINATION (MAIN)

JANUARY JEE(MAIN) 2020Confirmation Page

Application No. 200310000048 -DO NOT SEND THIS PAGE TO BOARD.

CANDIDATE IS REQUESTED TO RETAIN THE PRINTOUT OF ACKNOWLEDGEMENT PAGE FOR FUTURE REFERENCE.

Personal DetailsCandidate's Name AQUEEL AHMAD Date of Birth 01-01-2000

Mother's Name ASMAT PERVEEN Category General

Father's Name TUFAIL AHMAD KHAN Gender Male

If you are a PwD Candidate, do you havebenchmark disability (40% or more /“Severe” where percentage is not defined)?

No Nationality Indian

Place of Residence Rural State Code of Eligibility UTTAR PRADESH

Are You Diabetic? NO Mode of Preparation Self Study

Apply ForApply For B.E./B.Tech. Only Question Paper Medium English

Exam City 1st UTTAR PRADESH - AGRA Exam City 2nd UTTAR PRADESH - ALLAHABAD

Exam City 3rd UTTAR PRADESH - BAREILLY Exam City 4th UTTAR PRADESH - MEERUT

Education DetailsQualification

PassStatus

Qualifying Exam Place ofSchooling

Type ofSchool/College

SchoolBoard

Year ofPassing/Appearing

ResultMode

Marks Detail RollNumber

School/College Name &Address

School/CollegePincode

10th orequivalent

Passed 10th or Equivalent City Government

ALIGARHMUSLIMUNIVERSITY,ALIGARH

2017 Percentage

Obtained Marks: 780Total Marks: 800Percentage: 97.5

123456 AMU 202001

12th orequivalent

Appearing

The finalexamination of the10+2 system,conducted by anyrecognizedcentral/ stateBoard, such asCentral Board ofSecondaryEducation, NewDelhi; Council forthe Indian SchoolCertificateExaminations,New Delhi; etc.

City Government

ALIGARHMUSLIMUNIVERSITY,ALIGARH

2020 NA NA NA AMU 202001

Additional DetailsAre you a Twin No

Contact DetailsAddress 54 BAZBAHADUR Locality KOTE

City/Town/Village AZAMGARH District AZAMGARH

State UTTAR PRADESH Pin Code 276001

Email Address aqu********@gmail.com Mobile Number (+91) 886****505

Land Line No. withSTD code or anyother Contact No.

--

Parents Income DetailsQualification Occupation Annual Income

Father's/Guardian's: GRADUATE GOVERNMENT SERVICE RS. 600001-700000

Mother's: MATRICULATE OTHERS (INCLUDING HOUSE WIFE) UPTO 100000

Fee Payment DetailsPayment Mode: Transaction ID: 20190902111212800110168025885671

219

Exam Fee: 650 /- Date of Transaction: 2019-09-02 13:42:30.0

Fee Submitted On: 02/09/2019

DECLARATION

I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief. I have read and understood the Boardprocedures. I shall abide by the terms and conditions thereon.

Images Uploaded by Candidate

Photograph Signature

List of Document UploadedPhotograph,Signature

Date of Printing : 02/09/2019 01:45:37 PM