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Caution Money Refund Form

This document is a student no dues and caution money refund form for a national institute of technology. It collects information from the student such as name, contact details, course/branch, semester attended, address, scholar number, department/project guide if applicable, hostel if applicable, library, accounts, exams, and sports/NCC details. It documents any dues owed and refunds of stipends/fellowships. Signatures are required from the head of department, warden if applicable, admission section to certify caution money refund, accounts section to verify and process the refund, and notes provide instructions on filling and processing the form.

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MohitChetwani
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109 views

Caution Money Refund Form

This document is a student no dues and caution money refund form for a national institute of technology. It collects information from the student such as name, contact details, course/branch, semester attended, address, scholar number, department/project guide if applicable, hostel if applicable, library, accounts, exams, and sports/NCC details. It documents any dues owed and refunds of stipends/fellowships. Signatures are required from the head of department, warden if applicable, admission section to certify caution money refund, accounts section to verify and process the refund, and notes provide instructions on filling and processing the form.

Uploaded by

MohitChetwani
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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Maulana Azad

NATIONAL INSTITUTE OF TECHNOLOGY


BHOPAL-462 051

STUDENT NO DUES
cum
CAUTION MONEY REFUND
FORM
Student
Name

Contact No.

2
3

Course
Branch
Semester
(Last attended)

Address
of
correspondence

Sl No
1

Scholar No.

Department/ Sections
Project Guide
( In case of PG & PhD Student)
Concerned Department

Concerned Hostel
(In case of Hosteller)
Library

Accounts Section

Controller of Exams

Games & Sports

NCC
( for UG Students only)

Date of leaving
S B A/c No
&
Bank Name/Place
Dues position

Declaration
I hereby declare that there is nothing dues against me
in the Institute except above. Even if, any due is reported
against me I shall be liable to pay within a week from the date
of intimation. Further, I have refunded the Stipend /
Fellowship
Rs.
_________________
vide
TR
No____________ dated ___________ as I am unable to
complete the said Course.
Date:

Signature of Student

State Bank of India.


IFS Code:
Sign of HoD/ HoS/Warden

For the use of Admission Section


Certified that the caution money deposited
by the Scholar may be refunded after
recovery of dues (if any). Final Semester
Mark sheet has been given to the student.

Checked by

OS

AR/ DR

Caution Money Amount

For the use of Accounts Section


Checked & found correct and Permissible for
Refund of Caution Money of Rupees ____________.

Recovery (if any)


Net Refund

Checked By
Note
1
2
3

Payment Voucher is put up for Approval.

Verified by

AR/DR

It is mandatory to fill all the requisite information in the format.


Original shall be sent to Accounts Section for onward processing and a copy shall be retained by Academic Section
If any alteration needed in the format must be brought to the notice of Benny Abraham for necessary action.

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