FEES SCHEDULE:

SPACE FOR ORIGINAL CASH RECEIPT/DD

ALIGARH MUSLIM UNIVERSITY
Application Office of the
Fee (Rs.) Controller of Examinations
Deg./Dip./Certificate 10/- (Degree Unit)
Please paste here original Cash Receipt For Rs. 10/- ALIGARH (U.P .)-202002 INDIA
issued from Cash Section, Finance Office, AMU, Aligarh
OR APPLICATION
Please pin/Staple demand draft for the said amount payable to
the Finance Officer, AMU, ALIGARH (U.P .) (No other mode DEGREE/DIPLOMA/CERTIFICATE
of Payment is valid). (Not V alid for Duplicates)
Appl. Regn. No. …………………...… dated …………………….
D.D. No …………………..………………… Date …….………...
For Rs. 10/- only issued by (Name of Bank) ……………..………. DDC No. …………………………….. dated …………………….
Place ………………………..…. (ENTRIES TO BE MADE BY THE
Sent to AFO (Cash) vide No. XM/DC/(Deg)./………………..…...
Dated ………………………… CANDIDATE IN CAPITAL LETTERS)
Cash Receipt No. …………. Dated …………. for Rs……..
1. Personal Particulars of the Candidate: 3. Particulars of Exam. for which the document is required for :
(Please ensure that your name in the MARKSHEET is (a) Name of Exam ………………………………………..
correctly spelled as per the HS/SSC or equivalent exam. Annual/Suppl. ..………………..……………….……..
before applying for issue of Certt/Dip./Degree) (b) Held in (year) ………….,.. (Month) ……...………….
(c) Faculty Roll No. ………………………….……...…...
(a) Name: Exam. Roll No. ……………………………………….
Enrolment No. ………………………………………..
(d) Status (Regular/Ex/Private)…………………..….……
Date Month Y ear Division ………………………………………….…...
(b) Date of Birth (Attach a clear photocopy of the final year mark
sheet, in case of cl. XII, also attach cl. XI mark sheet.
(Pl. attach a photocopy of Class X/SSC Exam. Certificate or In case of MBBS/BDS/BUMS, also attach an attested
marksheet in support of DOB)
photocopy of internship completion certificate)
(c) Parent’s Name (IN CAPITAL LETTERS)
(i) Father: Mr. …………………………………..……………. (e) In case of M. Phil./Ph.D.:
(ii) Mother: Mrs. ……………………………………..………. (i) M. Phil. or Ph.D. (Pl. specify) ……………………
(d) Last Hall & Hostel ………………………………………....... (ii) Subject ……………. Date of Regn. ……………..
(e) Full Home/Permanent Address (in Capital Letters)……...…... (Please also attach a Photocopy of the Notification for
……………………………………………………..……….… M. Phil./Ph.D./M.D./M.S.)
4. Have you taken Migration Certificate ?
…….................................. PIN (Write Y es/No) …………...
Mob. No. …………… Tel. No. ……..…..E-mail ……….… If yes, Migration Cert. No. …………. dated…….…...….
(f) Full Address for Correspondence/mailing the degree /diploma (Dealing Asstt., Degree Unit, to verify)
/certificate (in Capital Letters): ……………………………..... 5. Have you taken provisional certificate ? (Write Y es/No)
…………………………….………………….………………. If Y es, please attach a photocopy of the provisional
Certificate
………………………..…PIN
Mob. No. ……………Tel. No…….….… E-mail……….…....
(g) Sex: Male: Female:
2. How do you wish to receive the document?
(a) Personally? (Write Yes/No) ………………….….
(b) By registered Post? (Write Yes/No) …………..………….
(If yes, give mailing address in column 1 (f) clearly and
enclose postage stamps & self addressed slips as mentioned Date. ……………… Signature of the Candidate
overleaf) (Not in Capital Letters)
(c) Through a permanent employee of AMU Place. ……………... P .T.O
(Write Yes /No) …………….…..
(If Yes, pl. give an authority letter, duly attested by the Head
of Deptt./office, as per proforma given overleaf.
ATTENTION PLEASE ACKNOWLEDGEMENT
(This slip must be produced at the Degree counter for receiving the document)
TO BE
FILLED
IN
BY THE
CANDI-
DA TE
{ RECEIVED from
an application for issue of original degree/dip./cert. of. ….............…………..……………………………………………...
Exam passed in the year ……………. With Roll No. ………………………. Enrolment No. ………………………………
Application Regn. No. ………………….…… Dated ………………..………….
IMPORTANT: Appl. from received without checking. If found Dealing Assistant
incomplete on scrutiny later on, it will be rejected. (Degree Unit) P .T.O.
 [2]
CLEARANCE CERTIFICATES
(Not required for Private candidates and those who have taken Migration Certificate/Provisional Certificate)
1. Clearance from the Provost/Principal/A.F.O. (Students): 2. Clearance from the Maulana Azad Library:
The particulars mentioned by the Candidate overleaf are The account of the candidate is clear
true. His/her account is clear.

Seal Signature Seal Dy. / Asstt. Librarian

(Hand written, not stamped)
Date …………. Name ………………………... Date ……………….. Name ………………………

3. Clearance from the Seminar Lib./Book Bank/College Lib. 4. Clearance from the DFO/AFO (Advance):
(in case of M. Phil./Ph.D. Scholars only)
The account of the Candidate is clear.
The account of the candidate is clear.
Seal Signature of the
Authorized Officer Seal Signature of the AFO/DFO
Date …………… Name ……………………….. Date ………….. Name ………………………….
Conditions/Instructions to the Candidates
1. Each information/verification/document, etc. sought from the candidate, as shown overleaf and above, is an essential
requirement for issue of the degree/diploma/certificate and must therefore be furnished/enclosed.
2. For mode of delivery of the degree/diploma/certificate, please fill in column 2 overleaf carefully and completely. No
Change will ordinarily be accepted.
3. The degree/diploma/certificate must be collected within three months from the date of application.

PROFORMA FOR AUTHORITY LETTER

(To be type written on a separate sheet and given to the authorized person)
I hereby authorize the following permanent AMU employee, whose particulars are given below, to receive my
degree/dip/cert……………………………….. exam of ………………..… The acknowledgement of the application
registered under no ………………………….dated ……………………….is enclosed.

PARTICULARS OF THE AUTHORISED PERSON: ATTESTATION BY HEAD OF THE DEPTT./OFFICE:

The authorized signatory is a permanent AMU employee
working in this Deptt./office He/She has signed before me:
1. Signature ………………………………………................ 1. Signature …………………………………………………..…...
2. Name of full ……………………………………………... 2. Name in full ……………………………………..……………..
3. Designation ……………………………………………… 3. Designation ……………………………………..……………...
4. Department/office ……………………………………….. 4. Department/office ……………………………………..……….
Date ……………………… SEAL ……………………... Date …………………..….. SEAL ………………..…..…….....

CHECK LIST: (Please tick P the boxes or write ‘NA’ if not applicable)

1. Cash Receipt is pasted/DD is attached 5. Postage stamps worth Rs. 42/- with 3 self
addressed slips of 5x3 cms size enclosed.
2. The candidate has signed at the end of the form OR
An authority letter on a separate sheet, as per
3. Clearance certificates Nos. 1,2,3 (also 4 in case above proforma, has been given to the autho-
of M.Phil./Ph.D.) signed and rubber stamped. rised person
OR
4. An attested photocopy of the exam. for which The candidate will collect the document personally.
the Degree/diploma/Cert. is required and applied for is
enclosed. (in case of class XII cert. both class XI and 6. An attested photocopy of H.S./SSC (Class X)
class XII mark sheets are enclosed). Certificate/marksheet is enclosed.

IMPORTANT The Degree/Diploma/Certificate will be handed over only either to the candidate or his/her authorized
representative holding a permanent position in AMU, on production of documentary proof of identity,
or will be sent by registered post to the address mentioned in the relevant column, (if three self
addressed slips of size 5x3 cms with postage stamps worth Rs. 42/- kept in a small envelope, are
submitted alongwith the application form ).