6/18/2019 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 : SAAR1920-0128987 BE/BTECH 2019-20 Application ID : EN19118965 Version :1
Personal Details
Candidate's Name MANAV NIKHIL SHAH

Gender Male

Orphan NO

Economically Weaker Section(EWS) NO

Date of Birth 16/09/2001

Candidature Type Maharashtra State Candidate - Type A

Home University Mumbai University

Caste-Category OPEN

PWD Type N.A.

Defence Type N.A.

Applied For Tution Fee Waiver Scheme(TFWS) Seats No

Religious Minority / Linguistic Minority N.A / Linguistic Minority - Gujarathi
District from which Candidate has Passed SSC Thane
District from which Candidates passing HSC or
Thane
equivalent examination
UID Number XXXXXXXX0308
I, the holder of UID(Aadhaar Number) [XXXXXXXX0308 ], 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 Central Board of Secondary Education, Delhi
HSC Passing Year 2019 HSC Seat Number 4661286
HSC Passing Status Passed
Qualification Marks Obtained Marks Out of Percentage
HSC Physics Marks 83 100 83.00
HSC Mathematics Marks 75 100 75.00
HSC Chemistry Marks 92 100 92.00
HSC English Marks 85 100 85.00
HSC Aggregate Marks 428 500 85.6

SSC Board Council for Indian School Certificate Examinations, New Delhi
SSC Passing Year 2015 SSC Seat Number 6598691
Qualification Marks Obtained Marks Out of Percentage
SSC Mathematics Marks 98 100 98
SSC English Marks 83 100 83.00
SSC Science Marks 94 100 94.00
SSC Aggregate Marks 651 700 93
MHT-CET 2019-20 Details
MHT-CET 2019-20 Roll No. 103036270011 MHT-CET 2019-20 Registration No. 110139510
Physics Percentile 95.6049894 Chemistry Percentile 93.2632266
Mathematics Percentile 95.4237669 Biology Percentile -
PCM Percentile 95.7282939 PCB Percentile -
JEE (Main) 2019 Paper-1
JEE Roll No MR20304747 JEE Physics 32.7489336
JEE Chemistry 59.5946784 JEE Maths 73.9115320

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).
Note: List of Documents Required at the time of Document Verification and Confirmation at SETU Suvidha Kendra (Do not attach Xerox Copies)

admissionengg2019.mahacet.org.in/fe2019/index.php/CandidateController/paf?succ=1&id=MTE4OTY1 1/2
6/18/2019 State Common Entrance Test Cell, Maharashtra State, Mumbai

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 Score Card of JEE (Main) 2019 Paper-1
2 Domicile Certificate of Candidate indicating that he/she is Domiciled in the State of Maharashtra
3 Indian Passport in the name of the Candidate, issued by Government Of India.
4 Statement of marks obtained at 10th/SSC or its Equivalent Examination
5 School Leaving Certificate after passing Qualifying Examination.
6 Statement of marks obtained at 12th/HSC or its Equivalent Examination.
7 Proforma O [For Linguistic Minority Community Student`s Self Declaration].

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 : 18-06-2019

Signature of the Candidate

Place :
(MANAV NIKHIL SHAH)

Last modified by : EN19118965 Printed By : EN19118965

Last modified on : 18-06-2019 05:18:40 PM Printed On : 18-06-2019 05:18:40 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.

Copyright 2019-2020 All rights reserved. Best viewed at 1024 X 768 resolution. Browser support Mozilla Firefox 2.0 & above , I.E. 7 &
above.(M1..)

admissionengg2019.mahacet.org.in/fe2019/index.php/CandidateController/paf?succ=1&id=MTE4OTY1 2/2