Applicatio Form

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Application Print E-Receipt Print
GOVERNMENT OF MAHARASHTRA
340136
State Common Entrance Test Cell
Online application for Admissions to First Year of Three Year Degree Course in Law
leading to LL.B. (3Yrs.) (Regular-Full Time-Course) 2020-2021
Registration Number : 8917425
Full Name of the Candidate : SHUBHAM

PRADIPRAO TEKALE
Social Category : OBC
Have you completed your Graduation Degree : YES

Examination from the state of Maharashtra ? OR
Are you Appearing for Graduation Examination
from the State of Maharashtra ?
Have you completed your Post Graduation Degree : NO

Examination from the state of Maharashtra ? OR
Are you Appearing for Post-Graduation
Examination from the State of Maharashtra ?
Have you completed Post Graduation Degree : NO

Examination from the University which is Out Side
Maharashtra State?
OR
Are you Appearing for Post-Graduation Degree
Examination from the University which is Out Side
Maharashtra State?
Are you a domicile of Maharashtra ? : YES
Are you born in Maharashtra? : YES
Is your Father or Mother is domiciled in the State of : YES

Maharashtra ?
Is your Father or Mother is an employee of the : YES

Government of India or Government of India
Undertaking who is posted and reported to duty in
Maharashtra State before the last date for
submitting the Application Form for CAP : ?
Is your Father or Mother is an employee of the : YES

Government of Maharashtra or Government of
Maharashtra Undertaking : ?
2/5
Have you passed Graduation & or Post Graduation : NO
Examination qualifying Examination from a
recognized institution from a disputed Maharashtra-
Karnataka Border Area and your Mother tongue is
Marathi ?
Do you belong to Maharashtra State Candidature / : YES
Outside Maharashtra State Candidature / Jammu
and Kashmir Migrant Candidature : ?
if Yes, please select the type : Maharashtra State

Candidature
Are you a person with benchmark disability of 40% : NO

and above ?
Type of Disability : -
Sub Type of Disability : -
Do you need compensatory time at the time of : -

examination?
Are you suffering from cerebral palsy and your : -

writing speed is affected
If Yes, Do you need compensatory time at the time : -

of examination?
Whether your dominant (Writing) hand is affected : -
If Yes, Do you need compensatory time at the time : -

of examination?
Do you intend to use the services of a scribe ?. : -
Religion to which you belong : Hindu
Do you belong to Religious Minority Community : NO

Belonging to Maharashtra State ?
Do you belong to Linguistic Minority Community : NO

belonging to the State of Maharashtra ?
Do you have Caste Certificate from the State of : YES

Maharashtra ?
Do you have Valid Non-Creamy Layer Certificate : YES

valid up to 31st March 2021
Do you have "Caste Validity Certificate" issued by : YES

the Scrutiny Committee of the Social Welfare
Department ?
Do you have "Tribe Validity Certificate" issued by : -

the Scrutiny Committee of Tribal Department
Have you passed the prescribed basic qualification : NO

i.e. SSC/10th Std./ Secondary Schooling Certificate
Examination, in a single sitting examination, without
having basic qualification(i.e.1 to 9th std. of
schooling) : ?
Following which mode have you Completed your : Regular mode

SSC /10th Std. Examination ?
Following which mode have you Completed your : Regular mode

HSC /12th Std. or Equivalent Examination ?
3/5
Have you Passed your SSC /HSC/Pre- University : NO
Examination before the Year 1975 ?
"Have you Completed Graduation Degree : Distance Mode/Open

Examination through Regular Mode/ Distance Mode/Correspondence
Mode/Correspondence Mode ? OR Are you Mode
Appearing for Graduation Degree Examination
through Regular Mode/ Distance
Mode/Correspondence Mode ?"
Have you Completed Post-Graduation Degree : NA

Examination through Regular Mode/ Distance
Mode/Correspondence Mode ? OR Are you
Appearing for Post-Graduation Degree
Examination through Regular Mode/ Distance
Mode/Correspondence Mode ?
Citizen of (Country) : India
Centre of Examination Preference 1 : Buldhana
Centre of Examination Preference 2 : Nagpur
Centre of Examination Preference 3 : Akola
Application Fee / Intimation charges
Payment In : ONLINE
Amount : 600.00
Payment Status : PAID
Reference ID : SSBI8733581124
Transaction Date : 23-04-2020
Personal Details
Date of Birth : 25-02-1996
Age completed as on 01.08.2020 : 24
Gender : MALE
Marital Status : Unmarried
Father's Name : PRADIPRAO TEKALE
Mother's Name : VIMAL
Spouse's Name : -
Address for Correspondence
Address 1 : SARASWATI NAGAR
Address 2 : CIRCULAR ROAD
Address 3 : BULDANA
District : BULDANA
State : MAHARASHTRA
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Pincode : 443001
Permanent address
Address 1 : SARASWATI NAGAR
Address 2 : CIRCULAR ROAD
Address 3 : BULDANA
District : BULDANA
State : MAHARASHTRA
Pincode : 443001
Contact Details
Mobile No : +91 8208361360
Alternative Number : +91 9422883477

(Mobile No/Landline No)
Email ID : mr.tekalesp@gmail.com
Educational Qualification(as on 01.07.2020)
Exam Degree/Subject/Stream/Discipline Appearing Date of Aggregate Maximum % of Class /

Passed / Passed Passing marks marks Marks Grade
obtained
10th / SSC - - 13-06- 502 550 91.27 First

2012 Class
12th / HSC SCIENCE - 02-06- 421 650 64.77 Second

2014 Class
Graduation Arts Passed 22-06- 901 1800 50.06 Second

2019 Class
Declaration:
I SHUBHAM PRADIPRAO TEKALE have read all the rules of admission and on understanding these rules, I have
filled this On Line Application form for admission to First Year of Three Year Degree Course in Law leading to LL.B.
(3Yrs.) (Regular-Full Time-Course) 2020-2021. The information given by me in this Application is true to the best of
my knowledge and belief. If at latter 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
subjected to legal and / or penal action as per the provision of the law. I further declare that I will bring with me my
valid Original Photo ID (Aadhar Card, Pan Card, Driving Licence, Latest College Identity Card (2020-2021)) and
Change of Name Document in original in case of Married/Adopted candidates at the time of CET Examination. I have
downloaded and read the Information Brochure and understand that I fulfil the eligibility criteria including details of
Category, Candidature Type, Educational qualification details mentioned in the Brochure and I have filled in the
Information for which I have the proper documentation. If it proved to be otherwise at any stage, my admission will be
cancelled by the authority admitting me.
5/5
Date: 23-04-2020 Signature of Candidate

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1/5

Application Print E-Receipt Print

Registration Number : 8917425

Full Name of the Candidate : SHUBHAM

Social Category : OBC

Have you completed your Graduation Degree : YES

Have you completed your Post Graduation Degree : NO

Have you completed Post Graduation Degree : NO

Are you a domicile of Maharashtra ? : YES

Are you born in Maharashtra? : YES

Is your Father or Mother is domiciled in the State of : YES

Is your Father or Mother is an employee of the : YES

Is your Father or Mother is an employee of the : YES

if Yes, please select the type : Maharashtra State

Are you a person with benchmark disability of 40% : NO

Sub Type of Disability : -

Do you need compensatory time at the time of : -

Are you suffering from cerebral palsy and your : -

If Yes, Do you need compensatory time at the time : -

Whether your dominant (Writing) hand is affected : -

If Yes, Do you need compensatory time at the time : -

Do you intend to use the services of a scribe ?. : -

Religion to which you belong : Hindu

Do you belong to Religious Minority Community : NO

Do you belong to Linguistic Minority Community : NO

Do you have Caste Certificate from the State of : YES

Do you have Valid Non-Creamy Layer Certificate : YES

Do you have "Caste Validity Certificate" issued by : YES

Do you have "Tribe Validity Certificate" issued by : -

Have you passed the prescribed basic qualification : NO

Following which mode have you Completed your : Regular mode

Following which mode have you Completed your : Regular mode

"Have you Completed Graduation Degree : Distance Mode/Open

Have you Completed Post-Graduation Degree : NA

Citizen of (Country) : India

Centre of Examination Preference 1 : Buldhana

Centre of Examination Preference 2 : Nagpur

Centre of Examination Preference 3 : Akola

Application Fee / Intimation charges

Payment Status : PAID

Transaction Date : 23-04-2020

Date of Birth : 25-02-1996

Age completed as on 01.08.2020 : 24

Marital Status : Unmarried

Father's Name : PRADIPRAO TEKALE

Mother's Name : VIMAL

Address for Correspondence

Address 1 : SARASWATI NAGAR

Address 2 : CIRCULAR ROAD

Address 1 : SARASWATI NAGAR

Address 2 : CIRCULAR ROAD

Mobile No : +91 8208361360

Alternative Number : +91 9422883477

Educational Qualification(as on 01.07.2020)

Exam Degree/Subject/Stream/Discipline Appearing Date of Aggregate Maximum % of Class /

10th / SSC - - 13-06- 502 550 91.27 First

12th / HSC SCIENCE - 02-06- 421 650 64.77 Second

Graduation Arts Passed 22-06- 901 1800 50.06 Second