College

H.T.No.
Code

APPLICATION FOR PROVISIONAL CERTIFICATE

JAWAHARLAL NEHRU TECHNOLOGICAL UNIVERSITY
KAKINADA – 533003, A.P.

NAM1E OF THE CANDIDATE

*(IN BLOCK LETTERS AS PER
S.S.C.)

FATHER’S NAME (IN BLOCK

LETTERS)

DEGRee / P.G.
COURSE AND BRANCH
BRANcH
MONTH & YEAR OF PASSING
EXAM
(To Be fillED BY tHe
cANDiDATe, wHO CoMPleteD
tHe CouRSe)

PERMANENT ADDRESS

AADHAAR CARD NuMBeR

PHOne

NuMBER e-

MAil ID
FEE PARTICULARS: (200/-) (3000/-)
ClicK On AMOunt (√)
BANK: E ReceiPt. No. DATe:

NOTE:
1. THe consoliDATeD DEMAND DRAft sHOulD Be DRAWn in fAVouR Of tHe REGISTRAR,
JNT UNIVERSITY, KAKINADA, PAYABle AT KAKinADA.
2. FoR TATKAL PROvisionAl CeRtificATe Rs. 3,000/- E-ReceiPt sHOulD Be DRAWn
in fAVouR Of tHe REGISTRAR, JNT UNIVERSITY, KAKINADA, PAYABle AT KAKInADA.
3. XEROx CoPY Of SSC CERtificATe sHOulD Be encloseD.
4. THe fillED in APPlicATion AlonG WitH E-ReceiPt. sHOulD Be sent to tHe DiRectoR
Of EvALuATion, JNT UniveRSItY, KAKinADA – 533 003.
5. CoRRections in tHe inDiviDuAl MARKS MEMOS Will not Be entERtAinED AFtER
issuinG PC&CMM.
UnDERtAKinG:-
I vERifiED AND AGRee witH tHe MARKS Of All MeMOS AND Will not clAIM foR ANY/fuRtHeR
cHANGes in futuRe.

DATe: SIGNATURE OF THE CANDIDATE

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
FoR CollEGe Office Use
CERtificATe of
IDentificATion

I cERtifY tHAT MR. / MRS. / Miss.

S/o / D/o of BonAfieD StuDent of tHis ColleGe is A
.
CollEGe CoDe: DuRinG to witH H.T.No.
AND He/sHe secuReD eliGiBle cReDits out of cREDits AND OBtAInED
PeRCentAGe of MARKS. He/SHe is elEGiBle to oBtAin PROvisionAL CERtificATe AS PER
tHe REGulATion unDER WHicH He/sHe is ADMitteD.

DATe: HEAD Of DEPARtMent PRINCIPAL

(VERifiED) WitH Office
SeAl
 JAWAHARLAL NEHRU TECHNOLOGICAL UNIVERSITY KAKINADA
University College of Engineering, Vizianagaram – 535 003, A.P.
CONSOLIDATED MARKS MEMO / CREDIT SHEET
NAMe : YEAR Of ADMission: CollEGe: BRANcH:

MontH & YEAR Of FinAl ExAM: CollEGe CoDe: HAll TicKET

No: I YEAR I SEMESTER I YEAR II SEMESTER
S.N CouRSE IM EM TM C S.N CouRSE IM EM TM C
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
TotAl TotAl
II YEAR I SEMESTER II YEAR II SEMESTER
S.N S.N
o CouRSE IM EM TM C o CouRSE IM EM TM C
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
TotAl TotAl
III YEAR I SEMESTER III YEAR II SEMESTER
S.N S.N
o CouRSe IM EM TM C o CouRSE IM EM TM C
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
TotAl TotAl
IV YEAR I SEMESTER IV YEAR II SEMESTER
S.N S.N
o CouRSE IM EM TM C o CouRSE IM EM TM C
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
TotAl TotAl
NuMBER Of CREDits REGisteRED: NuMBeR Of CReDits OBtAinED: % of MARKS:

SiGnAtURe of tHe CAnDiDAte HEAD Of DEPARtMent PRINCIPAL

(VeRifiED) WitH Office SEAl
To Date :
The Director of Evaluation
JNTUK, Kakinada – 533 003.

(Through the Principal of the College)

UNDERTAKING

I, _studied B.Tech. in
Name of the Student

during the academic years

Name of the College with College Code

and secured the required / credits for the award of the B.Tech.
Degree. Though I failed in one theory subject/ two theory subjects, I did not apply for
supplementary examinations and will not apply in future for any supplementary examination.
Hence, I request that my Consolidated Marks Memo and Provisional Certificate may kindly be
issued, at an early date.

Name of the Subject : 1.

With Code
2.

Signature of the Student

: Name of the Student

:
(In Capitals)

Hall Ticket Number :

Signature of the PRINCIPAL
(with seal)
 JAWAHARLAL NEHRU TECHNOLOGICAL UNIVERSITY
KAKINADA – 533003, A.P.

CONSOLIDATED MARKS MEMO / CREDIT SHEET

Name : Year of Admission: College:

Branch: Month & Year of Final Exam: College Code:

Hall Ticket No:

I Sem
S.no Course IM EM TM C
1
2
3
4
5
6
7
8

II Sem
S.no Course IM EM TM C
1
2
3
4
5
6
7
8

Number of Credits Registered: Number of Credits Obtained:

Percentage of Marks :

Signature of the Candidate Head of Department PRINCIPAL

(Verified) With Office Seal
 JAWAHARLAL NEHRU TECHNOLOGICAL UNIVERSITY
KAKINADA – 533003, A.P.
CONSOLIDATED MARKS MEMO / CREDIT SHEET

Name : Year of Admission: College:

Branch: Month & Year of Final Exam: College Code:

Hall Ticket No:

I YEAR I SEMESTER I YEAR II SEMESTER

S.No Course IM EM TM C S.No Course IM EM TM C
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
Total Total
II YEAR I SEMESTER II YEAR II SEMESTER
E T
S.No Course IM C S.No Course IM EM TM C
M M
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
Total Total
III YEAR I SEMESTER III YEAR II SEMESTER
S.No Course IM EM TM C S.No Course IM EM TM C
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
Total Total
Number of Credits Registered: Number of Credits Obtained: Percentage of Marks

Signature of the Candidate Head of Department PRINCIPAL

(Verified) With Office Seal