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Hsslive-Application For Plus Two Duplicate Certificate PDF

This document outlines the application for a duplicate higher secondary certificate or score sheet from the Directorate of General Education in Kerala. The application requests information such as the applicant's name and address, examination details, circumstances for why a duplicate is needed, and details of any fees paid. Supporting documents like an affidavit or remnants of a damaged original must be included. If the original is lost, an affidavit sworn before a notary or military officer is required stating the certificate has been lost and will not be misused if recovered. The principal of the applicant's former higher secondary school must also certify the application details are correct.

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EOS SATAN
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1K views

Hsslive-Application For Plus Two Duplicate Certificate PDF

This document outlines the application for a duplicate higher secondary certificate or score sheet from the Directorate of General Education in Kerala. The application requests information such as the applicant's name and address, examination details, circumstances for why a duplicate is needed, and details of any fees paid. Supporting documents like an affidavit or remnants of a damaged original must be included. If the original is lost, an affidavit sworn before a notary or military officer is required stating the certificate has been lost and will not be misused if recovered. The principal of the applicant's former higher secondary school must also certify the application details are correct.

Uploaded by

EOS SATAN
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Annexure - 30

GOVERNMENT OF KERALA
DIRECTORATE OF GENERAL EDUCATION (HIGHER SECONDARY)
APPLICATION FOR DUPLICATE CERTIFICATE/SCORE SHEET
1. Name of the applicant with complete address :
(in block letters) with PIN code
2. Name of parent / guardian :
3. Date of birth :
4. Particulars of examination
Name of the examination Register Nos. Year & Month Examination centre Remarks

5. Circumstances under which duplicate certificate is


applied for:
6. a. Whether the affidavit in the prescribed format attested by
designated authority attached?*
b. If the original Certificate is damaged, give details
and enclose its remnants?**
c. Whether applied for Duplicate / Triplicate
certificate before? If. Yes, give details.
7. Particulars of fees remitted.***
No. & date of
Amount remitted Name of treasury Head of account Remarks
Chalan

Place:
Date : Signature of the applicant

CERTIFICATE OF THE PRINCIPAL OF THE HIGHER SECONDARY SCHOOL IN WHICH THE


CANDIDATE ATTENDED THE EXAMINATION

Certified that to the best of my knowledge and belief, the original certificate/score sheet
issued to Sri/Smt ………………………………………………….. was irrecoverably lost/damaged. I
have carefully verified the particulars furnished above, by the candidate and found the same correct. I
recommend that a duplicate/triplicate certificate / score sheet may be issued to the applicant.
Principal :
Name of school :
Place: Address :
Date : Revenue dist. :
(Office seal)

* If the original certificate/mark list is irrecoverably lost, declaration of the candidate, in Stamped Paper worth Rs.100/
(one hundred only), attested by a notary under the seal or by the Officer Commanding, in the case of Jawan or by an
authorised officer of the Indian embassy in the case of applicants in foreign countries detailing the circumstances under
which it was lost should be produced.
** Affidavit not necessary in case of damaged certificates/score sheet if remnants of the damaged certificate are produce
along with the application.
***Fee shall be remitted by way of DD in the case of equivalency candidates.
FORMAT OF THE AFFIDAVIT

I, ..……………………………………………………………………………………...
………………………………………… (name and address) do hereby solemnly affirm &
state as follows:

I completed my higher secondary course in the Year …………………… and


appeared for the higher secondary examination ………………… (Month & Year) with
register number …………………………………

A certificate/score sheet was issued to me with register number ………………. The


same was irrecoverably lost …………...……………………………………………(Give
details).

I made all my efforts to get the above certificate/score sheet. Now I am convinced that
the certificate/score sheet is irrecoverably lost. I need a duplicate copy of the certificate/score
sheet. I am swearing this affidavit for getting a duplicate of the higher secondary
certificate/score sheet and submit that I am highly needed of the duplicate of the same as
early as possible.

If at any time, the lost certificate/score sheet is recovered, it will be surrendered to the
concerned authority and I shall not misuse the above certificate for any other purpose.

The above facts are true.

Dated ……….…………………….. (Month & Year)

Deponent

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