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Application For Duplicate Grade Sheet

This document is an application form for obtaining a duplicate Statement of Grades or Consolidated Statement of Grades from Panimalar Engineering College. It outlines the required information, reasons for the request, and necessary payment details, including fees and enclosures needed for processing. The procedure emphasizes that the application must be complete and correct to avoid delays and that fees are non-refundable.

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KAMALESH S
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37 views2 pages

Application For Duplicate Grade Sheet

This document is an application form for obtaining a duplicate Statement of Grades or Consolidated Statement of Grades from Panimalar Engineering College. It outlines the required information, reasons for the request, and necessary payment details, including fees and enclosures needed for processing. The procedure emphasizes that the application must be complete and correct to avoid delays and that fees are non-refundable.

Uploaded by

KAMALESH S
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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PANIMALAR ENGINEEING COLLEGE

(An Autonomous Institution)


Office of the Controller of Examinations
APPLICATION FOR OBTAINING DUPLICATE FOR LOST/DAMAGED
STATEMENT OF GRADES/CONSOLIDATED STATEMENT OF GRADES

1. Name of the Applicant (Block letters) :


2. Father’s Name (Block Letters) :
3. Degree and Branch :
4. Register Number :
5. Gender :
6. Duplicate of which Grade sheet required : Statement of Grades/
Consolidated Statement of Grades
(i) If applying for Duplicate Statement of
Grades, furnish the month & year of exam
for which Statement of Grades is required : Month & Year :
(ii) If applying for Duplicate Consolidated
Statement of Grades, fill in the Month
and Year of last appearance in which
qualified for the degree : Month & Year :

7. Reason for applying duplicate grade sheet :


(Lost/Damaged)
8. Circumstances under which the grade sheet
was lost/damaged :
9. Address :

10. Mobile No & E-Mail Id :

11. LDR No. :


(Applicable only for lost Statement of Grades / Consolidated Statement of Grades)
I solemnly declare that the particulars filled in by me are correct and in case of any discrepancy found therein, I
shall be responsible for the consequences.

Place : Signature of the Candidate


Date :
Forwarded by

Signature of the Head of the Department

PAYMENT DETAILS

DD NO.: BANK NAME :

DD DATE: BRANCH :

DD AMOUNT: ₹ (IN WORDS) :

DUPLICATE STATEMENT OF GRADES/CONSOLIDATED STATEMENT OF GRADES RECEIVED

Date : Signature of the Candidate


PROCEDURE TO APPLY FOR DUPLICATE
STATEMENT OF GRADES / CONSOLIDATED STATEMENT OF GRADES
(Shall be applied only if original Statement of Grades / Consolidated Statement of
Grades were DAMAGED / LOST )

 The candidate shall submit the following to the Controller of Examinations for issuance of
Duplicate Statement of Grades / Consolidated Statement of Grades.
1. An application in prescribed format.
2. Demand Draft (DD) for issuance of Duplicate Statement of Grades / Consolidated
Statement of Grades.
o The prescribed fee is Rs. 300/- per Statement of Grades and Rs.1000/- for
Consolidated Statement of Grades. The fee may be paid in the form of a DD
drawn in favour of the “Controller of Examinations, Panimalar
Engineering College” payable at Chennai.
3. Lost Document Report (LDR) - (Required if the document was lost)
o Procedure to apply for LDR – Refer FAQ in the link provided
https://eservices.tnpolice.gov.in/CCTNSNICSDC/LostDocumentReport?8
o Mention the Type of Certificate while filling the LDR as given below:
- Semester 05 Grade Sheet (Or) Semester 05 and 07 Grades Sheets
- Semester 05 & 07 Grade Sheets and Consolidated Statement of Grades
4. The damaged Statement of Grades / Consolidated Statement of Grades if previous
Statement of Grades / Consolidated Statement of Grades were damaged.

 Application should be complete in every respect. Failure to furnish correct details may
cause delay in the issue of the certificate.
 Fee once paid will not be refunded or adjusted for any other certificate under any
circumstances.
 Duplicate Certificate is to be surrendered to the college immediately if the Original
Certificate is recovered later.

Tick the appropriate enclosures attached:

▢ 1. Application Form
▢ 2. Demand Draft
▢ 3. LDR
▢ 4. Damaged Grade Sheets

Signature of the candidate with date

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