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bachalakurin.cs.22Dr B R Ambedkar National Institute of Technology, Jalandhar - 144008
Registration Form (B.Tech)
(Students are advised to retain a copy of this registration form.)
Registration/Roll No. : 22103037 Branch : CS Batch : 2022 Sem. : 5th
Name of the Student : BACHALAKURI NIKIL (In Hindi) : _____________________________
Father's Name : Sh. BACHALAKURI ANAND
Mother's Name : Smt. BACHALAKURI RUPA
Address : 30-24-20/4,BODE PUDI VARI VEEDHI DURGA AGRAHARAM Vijayawada (Distt.
Krishna) Andhra Pradesh - 520002
Mobile No. : 7730063899 Email : [email protected] Current CGPA :
_________________________________________________________________________________________________________
Date of Registration : 11-Jul-2024 (without Late Fee)
Details of the Courses to be registered in the current semester:
Course Code Course Title L T P Credits Teacher Remarks/
Consent (if Pre-requisite
applicable)
CSCI-301 Minor Project 0 0 02 0
CSPC-301 Theory of Computation 3 1 0 4
CSPC-303 Operating Systems 3 0 0 3
CSPC-305 Software Engineering 3 0 0 3
CSPC-307 Information Security System 3 0 0 3
CSPC-309 Probability Theory for Data Analytics 3 1 0 4
CSPC-323 Operating Systems Laboratory 0 0 2 1
CSPC-325 Software Engineering Laboratory 0 0 2 1
CSPC-327 Information Security Laboratory 0 0 2 1
CSPE-331 Advanced Programming Concepts Using Java (Departmental 3 0 0 3
Elective-I)
CSPE-333 Natural Language Processing (Departmental Elective-I) 3 0 0 3
CSPE-335 Web Technologies (Departmental Elective-I) 3 0 0 3
CSPE-351 Advanced Programming Concepts Using Java Laboratory 0 0 2 1
(Departmental Elective-I)
CSPE-353 Natural Language Processing Lab (Departmental Elective-I) 0 0 2 1
CSPE-355 Web Technology Laboratory (Departmental Elective-I) 0 0 2 1
Total :
Total Number of Courses Registered : Total Credits : for Audit courses
Total Credits : for Credit courses
Registration in the Departments is subject to payment of all the dues mentioned below:
1. No Dues from Library : ________________________ 2. No Dues from Previous Semester Hostel
: __________________
3. Payment of Mess Advance : ________________________ (To be verified from respective hostel)
Semester Fee Details
Name of the Bank/Funding Agency DD/Transaction No. Date Amount
HDFC 113370298805 11-Jul-2024 00:08:29 25500.00
(To be verified by the concerned Department)
1. I cleared all Institute, Hostel and Library dues and fines (if any) of the previous semesters.
2. I paid all required advance payments of Institute and Hostel dues (for hostellers) for the current semester, and not been debarred from registering on
any specific ground.
Registration Form generated from NITJ Online Registration Portal on Dated 06-Aug-2024 15:08:53
3. I certify that all the information given above are correct and true to the best of my knowledge and belief and nothing has been concealed therien. If any
wrong information is found on my part, I shall be liable to face the disciplinary action.
(Signature of Student)
Recommended/Not Recommended for Registration (Please Tick)
(Signature of HOD)
Registration Form generated from NITJ Online Registration Portal on Dated 06-Aug-2024 15:08:53
Dr B R Ambedkar Dr B R Ambedkar
National Institute of Technology National Institute of Technology
Jalandhar - 144008 Jalandhar - 144008
Fee e-Receipt (Institute Copy) Fee e-Receipt (Student Copy)
Student's Details Student's Details
Roll No. : 22103037 Roll No. : 22103037
Student's Name : BACHALAKURI NIKIL Student's Name : BACHALAKURI NIKIL
Course : B.Tech Course : B.Tech
Branch : CS Branch : CS
Semester : 5th Semester : 5th
Batch : 2022 Batch : 2022
Father's Name : BACHALAKURI ANAND Father's Name : BACHALAKURI ANAND
Fee Type : Hosteler Fee Type : Hosteler
Category : SC Category : SC
PH Status : No PH Status : No
Annual Income : Less than Rs. 1 Lac Annual Income : Less than Rs. 1 Lac
Mobile No. : 7730063899 Mobile No. : 7730063899
Email ID : [email protected] Email ID : [email protected]
Fee Details Fee Details
Amount : Rs. 25500.00/- Amount : Rs. 25500.00/-
Transaction ID : 113370298805 Transaction ID : 113370298805
Transaction Date : 11-Jul-2024 00:08:29 Transaction Date : 11-Jul-2024 00:08:29
Payment Status : SUCCESS Payment Status : SUCCESS
Student's Signature Student's Signature
Payment Amount : 25000.0 Receipt No : NA
Payment Date : 09-01-2024 Qfix Reference Number : YULQT2GIGBYQ6OU
Payment Channel : Credit Card Mode Of Payment : CREDIT CARD
Transaction ID : 202437493254016
Description : Fees Payment by Applicant ID : AY19-25/337599907228
Application Details
Mobile Number : 7730063899
Name : BACHALAKURI NIKIL
Father's Name : BACHALAKURI ANAND
Email ID : [email protected]
Roll No. Or Registration Number : 22103037
Date of Birth : 2003-10-28
Course : BTECH
Department : CSE
Semester Number : 4
Hostel Name : Mega Hostel Boys F
Caution Money : 0
Late Fee Fine_ If Any : 0
No Dues_ If Any : NA
Total Fees : 25000
Remarks_ If Any : NA
Thanks for your payment.
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To
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Sir/Madam,
Hostel Clerk
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Blood Group: B+
03
Warden Hostel No.
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Roll No.: 22103037
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The Warden Hostel MBHF
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Date of Joining: ...................
03
Permanent Address: 520002
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Received the following items:
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Advance deposited Rs .................
which the authority may deem fit.
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Countersign of the parent (s) with date:
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Mothers Name: BACHALAKURI RUPA
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E-mail ID.: [email protected]
Fathers Name: BACHALAKURI ANAND
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Branch: Computer Science and Engineering
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Local guardians address: Vijayawada 520002
Name of the Student: BACHALAKURI NIKIL
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Room Mate Name : Nikhil ( Roll No : 22106073)
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Unique Code: 7c51e8cbc6e1c2f66610207494e51cdb
Hostel Allotment Form generated on Dated 06-Aug-2024 15:15:50
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(with contact no.): _______________________________
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(For office use only)
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Dr. B. R. Ambedkar National Institute of Technology, Jalandhar
5. Bulbs holder/ Tube Fittings .............................. 6. Any other
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(Fill the details in capital letters)
Room Mate Branch : Instrumentation and Control Engineering
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G T Road Bye Pass, Jalandhar-144008, Punjab (India)
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Mobile No. : (S) 7730063899 (F) 7730063899 (M) 9646759461 (Bro./ Sis.) 7382283919
It is requested that I may be allotted room no 516 in the Hostel MBHF , I have carefully
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Signature of Applicant
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Photo
furniture, fixtures and fittings in my room. In case of violation, I may be imposed any penalty/fine
that I will abide by the rules and regulation of the hostel. Further, I shall also be responsible for
gone through the instructions received vide email dated 6/7/2024 as per Annexure B and certify
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1. Bed ...................... 2. Study Table ...................... 3. Study Chair ................... 4 Fan....................
Dr B R AMBEDKAR NATIONAL INSTITUTE OF TECHNOLOGY JALANDHAR
________________________________________________________________________________
________________________________________________________________________________
Room Allotted .....................
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I declare that:
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disciplinary action.
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Date: _________________
Place:_________________
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kind of protest in this regard.
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appropriate disciplinary action
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3 3 3
will not leave the station in any case.
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mental problem, act of indiscipline, etc.
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Hostel Allotment Form generated on Dated 06-Aug-2024 15:15:50
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- I am not suffering from any prolonged physical and mental illness.
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UNDERTAKING BY THE HOSTEL INMATES
Name & Signature of the StudentName & Signature of the Parent/Guardian
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with the infrastructure provided to me, I will vacate the hostel and will not involve in any
resources in the hostel and I have no objection for the same. In case I am not comfortable
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- I understand that due to limited hostel facility, the inmates have to share the available
- I will inform my parents / guardians, if required, in case of any exigency such as depression,
- I declare that without prior approval from concerned HOD/ Chief Warden/ Hostel Warden, I
- I also understand that if I am found in violation of any hostel rules, I will be liable for
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declaration below or not following protocols after onboarding at the institute, I will be liable for
in the Institute hostels. I understand that if I am found to have given wrong information in the
(home address) 520002 have gone through and understood the guidelines and protocols for staying
I, BACHALAKURI NIKIL, son/daughter of Mr./Ms BACHALAKURI ANAND, resident of
___________
Annexure-U1
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Date: _________________
Place:_________________
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Hostel Allotment Form generated on Dated 06-Aug-2024 15:15:50
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(home address) 520002 hereby submit an undertaking that
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would be liable for punishment for any violation on this account.
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Name & Signature of the StudentName & Signature of the Parent/Guardian
my hostel seat will stand automatically cancelled without assigning any reasons.
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MOTOR DRIVEN VEHICLES IN THE INSTITUTE CAMPUS
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UNDERTAKING BY THE STUDENT FOR NOT OWNING AND/OR USING
registering the vehicle at the Institute main gate and the hostel office, if required and I
during my stay in the Institute. If in case, I am found to violate the above undertaking
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- Any visitor in my reference bringing a vehicle would follow the guidelines for
- I will not own or make use of motor driven vehicle for commuting inside the campus
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I, BACHALAKURI NIKIL, son/daughter of Mr./Ms BACHALAKURI ANAND, resident of
Annexure-U2
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Hostel Clerk
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1
Course : B. Tech
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Roll No.: 22103037
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Mobile No.: ________
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Name: BACHALAKURI NIKIL
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4. No Dues from Previous Hostel
1. Institute Fee Receipt (Hosteler)
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Student(s) Signature with date: ______
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Email ID: [email protected]
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2. Mess Advance Fee Receipt (July - Dec 2024)
Department: Computer Science and Engineering
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Date and Time of arrival: _______________(Date)
_______________ (Time)
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Hostel Allotment Form generated on Dated 06-Aug-2024 15:15:50
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3. Undertakings by student/parent (Annexure - U1 & U2)
(for office use only)
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I am submitting the following documents to the hostel office:
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: _____ (Yes / No)
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(To be filled by the Student)
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5. Single Room Undertaking (optional for single accommodation)
DOCUMENT CHECKLIST
Signature of Hostel Supervisor 1Signature of Hostel Supervisor 2
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: _____ (Yes / No)
: _____ (Yes / No)
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: _____ (Yes / No)
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3
: _____ (Yes / No)
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___________________________________________________________________________
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73 73 73 73 73 73 73 73 3 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 1 06 10 10 1 06 1 06 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
To
73 73 73 73 73 73 73 73 73 07 07 07
3 73 73 3 3 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 6 07 60 60 6 07 6 07 60 60 60 60 60 60
Sir/Madam,
Hostel Clerk
73 73 73 73 73 73 73 73 73 3 73 73 3 3 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 1 06 10 10 10 10 10 10 10 10 10 10 10
Blood Group: A+
Warden Hostel No.
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
Roll No.: 22106073
73 73 73 73 73 73 73 73 07
3 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
Fathers Name: tilak raj
Mothers Name: kamlesh
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
The Warden Hostel MBHF
60 60 60 60 60 60 60 60 6 60 60 60 60 60 60 60 60 60 60 60
Date of Joining: ...................
07
Name of the Student: Nikhil
73 73 73 73 73 73 73 73 3 73 73 73 73 73 73 73 73 73 73
Received the following items:
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
Advance deposited Rs .................
which the authority may deem fit.
Permanent Address: pathankot
Local guardians address: 145001
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
E-mail ID.: [email protected]
60 60 60 60 60 60 60 60 60 6 07 60 60 6 07 6 07 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 3 73 73 3 3 73 73 73 73 73
Countersign of the parent (s) with date:
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10
10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
Unique Code: bc08ce0d3f3a2384d7fa01f5b6665ec5
Branch: Instrumentation and Control Engineering
Hostel Allotment Form generated on Dated 06-Aug-2024 13:23:03
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
(with contact no.): _______________________________
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
(For office use only)
Room Mate Branch : Computer Science and Engineering
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
Dr. B. R. Ambedkar National Institute of Technology, Jalandhar
5. Bulbs holder/ Tube Fittings .............................. 6. Any other
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
(Fill the details in capital letters)
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 Room Mate Name : BACHALAKURI NIKIL ( Roll No : 22103037)
60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
G T Road Bye Pass, Jalandhar-144008, Punjab (India)
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 6 0
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
Mobile No. : (S) 6239221217 (F) 9888817335 (M) 9646034856 (Bro./ Sis.) 7696875092
It is requested that I may be allotted room no 516 in the Hostel MBHF , I have carefully
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
Signature of Applicant
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
Photo
furniture, fixtures and fittings in my room. In case of violation, I may be imposed any penalty/fine
that I will abide by the rules and regulation of the hostel. Further, I shall also be responsible for
gone through the instructions received vide email dated 6/7/2024 as per Annexure B and certify
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
1. Bed ...................... 2. Study Table ...................... 3. Study Chair ................... 4 Fan....................
Dr B R AMBEDKAR NATIONAL INSTITUTE OF TECHNOLOGY JALANDHAR
________________________________________________________________________________
________________________________________________________________________________
Room Allotted .....................
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 1 06
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 0
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 6 07 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 3 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 1 06 10 10 1 06 1 06 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 07 60 60 07 07 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 3 73 73 3 3 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 6 07 60 60 6 07 6 07 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 3 73 73 3 3 73 73 73 73 73
I declare that:
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 1 06 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 07 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 3 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
Date: _________________
Place:_________________
60 60 60 60 60 60 60 60 6 60 60 60 60 60 60 60 60 60 60 60
kind of protest in this regard.
73 73 73 73 73 73 73 73 07
3 73 73 73 73 73 73 73 73 73 73
appropriate disciplinary action
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
6 6 6
will not leave the station in any case.
60 60 60 60 60 60 60 60 60 07 60 60 07 07 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 3 73 73 3 3 73 73 73 73 73
mental problem, act of indiscipline, etc.
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
Hostel Allotment Form generated on Dated 06-Aug-2024 13:23:03
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
- I am not suffering from any prolonged physical and mental illness.
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
UNDERTAKING BY THE HOSTEL INMATES
Name & Signature of the StudentName & Signature of the Parent/Guardian
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 6 0
following protocols after onboarding at the institute, I will be liable for disciplinary action.
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
with the infrastructure provided to me, I will vacate the hostel and will not involve in any
resources in the hostel and I have no objection for the same. In case I am not comfortable
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
- I understand that due to limited hostel facility, the inmates have to share the available
- I will inform my parents / guardians, if required, in case of any exigency such as depression,
- I declare that without prior approval from concerned HOD/ Chief Warden/ Hostel Warden, I
- I also understand that if I am found in violation of any hostel rules, I will be liable for
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
understand that if I am found to have given wrong information in the declaration below or not
through and understood the guidelines and protocols for staying in the Institute hostels. I
I, Nikhil, son/daughter of Mr./Ms tilak raj, resident of (home address) pathankot have gone
___________
Annexure-U1
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 1 06
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 0
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 6 07 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 3 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 1 06 10 10 1 06 1 06 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 07 60 60 07 07 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 3 73 73 3 3 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 6 07 60 60 6 07 6 07 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 3 73 73 3 3 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 1 06 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 07 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 3 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 607 60 60 60 60 60 60 60
submit an undertaking that 60 60 60 60
Date: _________________
Place:_________________
73 73 73 73 73 73 73 73 3 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 6 07 60 60 6 07 6 07 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 3 73 73 3 3 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
Hostel Allotment Form generated on Dated 06-Aug-2024 13:23:03
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
would be liable for punishment for any violation on this account.
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
Name & Signature of the StudentName & Signature of the Parent/Guardian
my hostel seat will stand automatically cancelled without assigning any reasons.
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
MOTOR DRIVEN VEHICLES IN THE INSTITUTE CAMPUS
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 6 0
UNDERTAKING BY THE STUDENT FOR NOT OWNING AND/OR USING
registering the vehicle at the Institute main gate and the hostel office, if required and I
during my stay in the Institute. If in case, I am found to violate the above undertaking
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
- Any visitor in my reference bringing a vehicle would follow the guidelines for
- I will not own or make use of motor driven vehicle for commuting inside the campus
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
I, Nikhil, son/daughter of Mr./Ms tilak raj, resident of (home address) pathankot hereby
Annexure-U2
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 1 06
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 0
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 6 07 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 3 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 1 06 10 10 1 06 106 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 07 60 60 07 07 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 3 73 73 3 3 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 6 07 60 60 6 07 6 07 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 3 73 73 3 3 73 73 73 73 73
Hostel Clerk
Name: Nikhil
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
1
Course : B. Tech
10 10 10 10 10 10 10 10 06 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
Roll No.: 22106073
73 73 73 73 73 73 73 73 07
3 73 73 73 73 73 73 73 73 73 73
Mobile No.: ________
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 607 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 3 73 73 73 73 73 73 73 73 73 73
Email ID: [email protected]
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
4. No Dues from Previous Hostel
1. Institute Fee Receipt (Hosteler)
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 6 07 60 60 6 07 6 07 60 60 60 60 60 60
Student(s) Signature with date: ______
73 73 73 73 73 73 73 73 73 3 73 73 3 3 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
2. Mess Advance Fee Receipt (July - Dec 2024)
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
Date and Time of arrival: _______________(Date)
_______________ (Time)
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
Department: Instrumentation and Control Engineering
Hostel Allotment Form generated on Dated 06-Aug-2024 13:23:03
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
3. Undertakings by student/parent (Annexure - U1 & U2)
(for office use only)
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
I am submitting the following documents to the hostel office:
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
: _____ (Yes / No)
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
(To be filled by the Student)
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
5. Single Room Undertaking (optional for single accommodation)
DOCUMENT CHECKLIST
Signature of Hostel Supervisor 1Signature of Hostel Supervisor 2
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
: _____ (Yes / No)
: _____ (Yes / No)
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
: _____ (Yes / No)
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
6
: _____ (Yes / No)
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 0
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
___________________________________________________________________________
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 1 06
60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 0
73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73 73
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
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