Application No.:: For Office Use Only For D.D. Endorsement

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For downloaded applications, kindly remit Rs.

50/- (Fifty only) through "Payment Gateway for students & others" provided in the Online Remittance System in the University website. Application No.:
(To be Filled by Office) Application for obtaining Provisional / Extract Certificate ( For Degree / Diploma Examinations )

DETAILS OF PAYMENT
(To be filled in by the candidate) Name and place of the Bank D.D. Should be enclosed. . Demand Draft No.: .. Date of Payment : .. Amount Rs.: ..

FOR OFFICE USE ONLY For D.D. Endorsement

Date: Register P No: Sl No: Initial of the Asst.

Candidates should read the instructions very carefully before filling in the columns. Any column left blank will cause delay in issuing of certificate. 1. Name as registered in the University Records (In Block Letters) 2. Sex 3. Date of Birth 4. Name of the Degree course Passed 5. Last Appearance Register Number 6. Month & Year of passing the Final Examination 7. College in which last studied 8. Branch /Optional Subject Studied 9. If applied for 2nd Provisional Certificate the period Of C.R.I. to be mentioned here } } .. : Male / Female : ... : .. : . : . : . : . } CRI From. To .. } At

10.Whether applied for convocation and received the degree or not (in person or in Absentia) If received, state the date, month and year of convocation. 10. Certificate for which applied for kindly tick[ ] The column applicable

} } . } } } 1. Provnl Cert First. Second 2. Extract of Convo

12. Address of the Candidate (In Block Letters)

} . } . } .

Date:

Signature of the Candidate

Recommended towards issue of (Strike out whichever is not applicable) First/Second Provincial/ Extract of convocation certificate as the candidate has passed / fulfill all the prescribed conditions as per the regulations of this University to receive the Certificate.

Endorsement of the Institution

Seal: Date

Signature of the Principal/ Dean

i) Admission register P.No,.: iii) Certificate Printed Machine No.: iv) Signature:

FOR OFFICE USE ONLY ii)Certificate Issued Folio No.:

Prepared by

Read by

Examined by : CONTROLLER OF EXAMINATIONS.

DETAILS OF PASSING THE DEGREE / DIPLOMA EXAMINATION FOR WHICH THE CANDIDATE HAS APPLIED FOR THE PROVISIONAL CERTIFICATE / CONVOCATION EXTRACT

This column should be filled in compulsorily by the candidate

Name of the Subject With Code

Reg.No.

Month & Year of Passing

Name of the College / Centre Code

Marks Obtained

Place : . Date : . Signature of the Candidate

INSTRUCTIONS
1. After conferment of a degree at a convocation. Provisional certificate will not be issued. But only an EXTRACT from the convocation report will be issued based on the affidavit / Police NOC produced by the candidate.

The fee should be paid through "Payment Gateway for students & others" provided in the Online Remittance System in the University website. Postal orders and Money orders will NOT be accepted. 2. A self addressed sufficiently stamped Registered cover should be enclosed for sending the certificate by REGISTERED POST. 3. NOC of this University should be enclosed at the time of applying for IInd PPC for the CRI transferred candidate of one recognised institution to another recognised institution. 4. A Xerox copy of H.S.C. mark sheet or equivalent certificate should be enclosed.

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