West Bengal Board of Secondary Education

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Form No: WBBSE/01

West Bengal Board of Secondary Education


77/2, Park Street, Kolkata-700016

FORM OF APPLICATION FOR DUPLICATE (REGISTRATION CERTIFICATE /ADMIT CARD / MARK


SHEET /PASS CERTIFICATE )

Application form with prescribed fees are to be OFFICE USE ONLY(NOT FOR APPLICANT)
Submitted to Regional Offices Kolkata / Burdwan Candidates’ Name:…………………..……………………………………………….
/ Midnapore/North Bengal. For the records of the (In Block letter)
Examination from 1974 onwards forms are Father’s Name:………………………………………………………………………….
required to be submitted to the respective Roll No / Registration No…………………………………….. Year…………..
Regional Office i.e. North Bengal, Burdwan and
Date of Birth:……………………………………….. Subject……………………….
Midnapore. Payment should be made in cash
through the prescribed challan, at the cash Division…………………………………………………Index No:…………………..
counter. Please see instruction at overleaf. Part No:…………………………………………………Cert. No:…………………..
As per D/R Verified

In case of loss / theft of original pass certificate, Police General Diary No……………………..………………Date …………………/ enclosed copy of
the concerned Police Station with Signature & Seal of the Police Station. SUBMISSION OF THE ATTESTED PHOTOCOPY OF VOTER ID
CARD / AADHAAR CARD (in case of minor) is required with this form. Producing that card is mandatory in time of delivery.

To
The Deputy Secretary (Records)
Sir / Madam,
I beg to apply for a duplicate Certificate/Marks Sheet/Admit Card/Registration Certificate in my favour.
The particulars are given below:
Sri/ Smt…………………………………………………………………………………Son/Ward/Daughter of …………………………………………..
………………………………………………Residing at…………………………………………………….P.O………………………………………………….
P.S……………………………….…………Dist……………………………….………………Pin………………….Mobile No…………………………….
Registered for appearing/appeared at/Passed the…………………………………………………..……………Examination held in
the month of …………………………..of the Year……………….………Bearing Registration no…………………………………………..of

The year……….……Roll…………………………………No………………………Year…………………….from………………………………………
……………………………………………………………………………….school as a Regular / Private/ External candidate in the
……………………………….division. Nationality ………………………………………………………

Cash Challan No ………………………………………………….Date…………………………………..

Yours Faithfully
I,…………………………………………………….………..………S/o/D/o
…………………………………………………………………………. declare
Full signature of the Candidate(in English)
that the above information is true to my knowledge and In blue colour ink
in case of any false representation of fact, penal action
as per law may be taken against me.
Verified and countersigned

Signature of the Head of the Institution/


[ **for External/Private candidate only ] **Gazetted Officer with seal

Index No. of the School


FOR THE ISSUE OF DUPLICATE CERTIFICATE / MARK SHEET /
ADMIT CARD / REGISTRATION CERTIFICATE

INSTRUCTIONS:-

1. The documents shall not be delivered by post. It should be collected by the candidate or his/her
authorised person against Board’s cash challan, obtained on payment of prescribed fees.
2. In case of a regular candidate of a school the application should be forwarded by the Head of the
Institution from which the candidate was enrolled and for CC, compartmental, Private of External
candidate, the application may be forwarded by (I) The Headmaster or Headmistress of a
recognized high school, (II) The Principal of a recognized college, (III) a Gazetted Officer of the
Central or State Government.
3. Application for the issue of any of the documents is to be properly countersigned and sent to the
Deputy Secretary(Records) along with the requisite fee and following details:
a) Full name of the candidate and his/her present address in full in block letter
b) The name, month and year of the Examination.
c) The name of the Institution from which he/she was sent up for the Examination concerned.
d) Correct Roll, Number and Registration No. of the candidate with Year of Examination.
e) For Duplicate certificate, either damaged portion of the certificate or General Diary No. and
date with seal duly signed by the I.C. / O.C. of P.S. concerned should be attached with the
application.

THE BOARD SHALL NOT BE HELD RESPONSIBLE FOR NOT ISSUING ANY
DUPLICATE DOCUMENT IN CASE OF THE ABSENCE OF THE DETAILS
STATED ABOVE.

4. The documents will be made available for delivery after 15 clear working days from the date of
receipt of the application and fees. The Board, however, reserves the right not to issue any
duplicate document in case it is deemed fit.

5. Receiving Hours at office cash counter(Application & Fees) 11:00 A.M. to 4:00 P.M. on weekdays

6. USE SEPARATE APPLICATION FORM FOR EACH DOCUMENT

7. Revised Rate of Fees:


i. Duplicate Certificate 300/-
ii. Duplicate Mark Sheet 300/-
iii. Duplicate Admit Card 300/-
iv. Duplicate Registration Certificate 300/-

NB: i) The Board shall not however be responsible for the delay in preparing the duplicate
document due to unavoidable circumstances.

ii) Complaints for non-receipt of the documents will not be entertained after a period of 3
months from the date of submission.

iii) If Not Received within one month from the date of submission the aggrieved incumbent
may write to the Secretary, WBBSE at website wbbse.wb.gov.in

By order

Secretary

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