6/19/2019 State Common Entrance Test Cell, Maharashtra State, Mumbai

State Common Entrance Test Cell, Maharashtra State, Mumbai

8th Floor, New Excelsior Building, A.K. Nayak Marg,Fort,Mumbai-400001.(M.S.)
Printable Application Form for Admission to First Year Under Graduate Technical Courses in
Engineering and Technology Admissions 2019-20 for the Year 2019 - 2020
SAAR Application Number : SAAR1920-0022773 BE/BTECH 2019-20 Application ID : EN19102400 Version :5
Personal Details
Candidate's Name DIVYANG KHARE

Gender Male

Orphan NO

Economically Weaker Section(EWS) NO

Date of Birth 16/01/2001

Candidature Type Maharashtra State Candidate - Type C

Home University Mumbai University

Caste-Category OPEN

PWD Type N.A.

DEF3 - (Active Service Non-Domiciled Personnel Defence

Defence Type
candidate - (Def-3))

Applied For Tution Fee Waiver Scheme(TFWS) Seats No

Religious Minority / Linguistic Minority N.A.
Whose Proforma A You are Submitting at SETU Father
District where Father / Mother of the Candidate is Posted
Mumbai City
in Maharashtra
UID Number XXXXXXXX7556
I, the holder of UID(Aadhaar Number) [XXXXXXXX7556 ], hereby give my consent to State CET Cell to obtain my Aadhaar number for authentication with UIDAI. State CET Cell has informed me that my
identity information would only be used for admission purpose and will be submitted to CIDR only for the purpose of authentication.

Payment Details
Payment Status Successful Application Fee Paid (Rs.) ₹ 800/-
Qualification Details
HSC Board Council for Indian School Certificate Examinations, New Delhi
HSC Passing Year 2018 HSC Seat Number 6108547
HSC Passing Status Passed
Qualification Marks Obtained Marks Out of Percentage
HSC Physics Marks 70 100 70.00
HSC Mathematics Marks 64 100 64.00
HSC Chemistry Marks 64 100 64.00
HSC English Marks 65 100 65.00
HSC Aggregate Marks 355 500 71

SSC Board Council for Indian School Certificate Examinations, New Delhi
SSC Passing Year 2016 SSC Seat Number 6108547
Qualification Marks Obtained Marks Out of Percentage
SSC Mathematics Marks 74 100 74
SSC English Marks 62 100 62.00
SSC Science Marks 62 100 62.00
SSC Aggregate Marks 456 600 76
MHT-CET 2019-20 Details
MHT-CET 2019-20 Roll No. 102004580007 MHT-CET 2019-20 Registration No. 110105102
Physics Percentile 21.2507073 Chemistry Percentile 76.7222967
Mathematics Percentile 64.8783703 Biology Percentile -
PCM Percentile 58.1298929 PCB Percentile -
JEE (Main) 2019 Paper-1
JEE Roll No MR16304794 JEE Physics 32.2767325
JEE Chemistry 47.6743346 JEE Maths 7.1801307
JEE Total Percentile 18.5502510

Note : Candidate shall carry printed copy of Application Form, Original documents and one set of Xerox copies of the required documents. SETU shall verify all documents
from Original and put SETU stamp with date & Signature on Xerox copies and return original and verified documents along with Receipt-cum-Acknowledgement of application
form. (Candidate shall submit SETU stamped & verified set of documents to SETU for re-verification after the allotment and then to the Institute at the time of reporting).

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6/19/2019 State Common Entrance Test Cell, Maharashtra State, Mumbai
Note: List of Documents Required at the time of Document Verification and Confirmation at SETU Suvidha Kendra (Do not attach Xerox Copies)
NOTE : Passed HSC or its equivalent examination with Physics and Mathematics as compulsory subjects along with one of the Chemistry or Bio-technology or Biology or
Technical or Vocational subjects, and obtained at least 50% marks(at least 45% marks, in case of Backward class categories and Persons with Disability candidates belonging
to Maharashtra State only) in the above subjects taken together.
Sr. No. Document Name
1 Certificate from the employer in the Proforma - A
2 Score Card of JEE (Main) 2019 Paper-1
3 Domicile Certificate of Defence service personnel (Father / Mother)
4 Defence Service Certificate Proforma - C
5 Certificate from the employer in the proforma - D
6 Certificate of the Indian Nationality of the candidate
7 Statement of marks obtained at 10th/SSC or its Equivalent Examination
8 School Leaving Certificate after passing Qualifying Examination.
9 Statement of marks obtained at 12th/HSC or its Equivalent Examination.

Declaration:
I have read all the rules of admission and on understanding these Rules, I have filled this Application Form for consideration of submission of Application Form at SETU for the
admission to First Year Under Graduate Technical Courses in Engineering and Technology Admissions 2019-20 for the academic Year 2019 - 2020. The information given by
me in this application is true to the best of my knowledge & belief. If at later stage, it is found that I have furnished wrong information and/or submitted false certificate(s), I am
aware that my admission stands cancelled and fees paid by me will be forfeited. Further I will be subject to legal and/or penal action as per the provisions of the law.

Date : 19-06-2019

Signature of the Candidate

Place :
(DIVYANG KHARE)

Last modified by : EN19102400 Printed By : EN19102400

Last modified on : 19-06-2019 04:38:50 PM Printed On : 19-06-2019 04:38:50 PM
Note: The Candidates are required to produce the documents in original for verification and Confirmation of Application Form at SETU. It is mandatory on the Candidates part
to produce all original documents in support of the claim made by the Candidate in the application form. Candidates are advised to keep the necessary documents ready at the
time of Documents verification stage as per the notified schedule.All SETUs shall remain open on all days including holidays and Sundays during the schedule.

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