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Application Consolidated PDF

The document is an application form for students of Himachal Pradesh University to request a Consolidated/Provisional Marks Certificate. It requests information such as the applicant's name, father's name, examination passed, roll number, marks obtained, and address to send the certificate. The applicant must sign to confirm the details are correct and pay a fee of Rs. 500 for the first time, Rs. 1000 for the second time, or Rs. 1500 for the third or subsequent times. Once completed, it requires verification and signature from the Head of Department and Director of the university before being processed by the Examination Section.

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Dinesh Katoch
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354 views1 page

Application Consolidated PDF

The document is an application form for students of Himachal Pradesh University to request a Consolidated/Provisional Marks Certificate. It requests information such as the applicant's name, father's name, examination passed, roll number, marks obtained, and address to send the certificate. The applicant must sign to confirm the details are correct and pay a fee of Rs. 500 for the first time, Rs. 1000 for the second time, or Rs. 1500 for the third or subsequent times. Once completed, it requires verification and signature from the Head of Department and Director of the university before being processed by the Examination Section.

Uploaded by

Dinesh Katoch
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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HIMACHAL PRADESH UNIVERSITY

GYANPATH, SUMMER HILL, SHIMLA-171005


Application form for the supply of Consolidated/Provisional Marks Certificate for all Undergraduate/Post
Graduate/Professional Courses [(Rs. 500/- (Ist Time)/Rs. 1000/- (IInd Time)/Rs. 1500/- (Third Time) for details and fee
updates visit www.hpuniv.nic.in & www.hpuniv.in]
Roll No. ____________________

To

The Controller of Examinations,


Himachal Pradesh University,
Shimla-171005
Dear Sir,

I have passed ______________________ examination from the Himachal Pradesh University in the
month of _________________________ year. I request you to kindly supply Consolidated/Provisonal Marks
Certificate. I am remitting Rs. _______________ for ___________time (Ist time: 500/-, IInd time:1000/-,
IIIrd time: 1500/-) through IPO’S/Bank Draft in favour of “FINANCE OFFICER, HIMACHAL PRADESH
UNIVERSITY, SHIMLA-5.

(Signature of Candidate)
Dated____________
Particulars of the Candidate

Name of the candidate______________________________________________________________________

Father’s Name ____________________________________________________________________________

Examination Passed _______________________ Month ___________________ Year___________________

Examination Roll No. ______________ Marks obtained __________________ Division________________

Examination Centre (Last Appeared)__________________________________________________________

Title of course Pass Marks Obtained when passed (Use separate sheet for Title of Course)

1._______________________________ 5._______________________________
2._______________________________ 6._______________________________
3._______________________________ 7._______________________________
4._______________________________ 8._______________________________

Address for dispatch of certificate ______________________________________________________________

__________________________________________________________________________________________

Declaration: I solemnly declare that the above particulars filled in by me are correct and that in case of any discrepancy/incomplete
form or without proper fee found therein, I shall be responsible for the consequences under Law.

(Signature of the Candidate)

Particulars given above are verified that there is no objection to be issued of the desired certificate.

Head of Deptt.
Director of ICDEOL
(office seal) H.P. University, Shimla

Dated ____________________
(For office use)
Consolidated Marks card bearing Sr. No. ________________________________ dated ___________________

Section Officer(Examinations) Dealing Assistant

Notes: The application is to be attested by the Director of ICDEOL in case of ICDEOL students.

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