Scribd
Upload
35 views

Sheet

Then I will be able to join the meeting and disadvantage of the day and the day of the day of the day of the day of my life and my love is very good ? you are always in love with a very happy birthday to you are always with my love

Uploaded by

mithunavelrajanps
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
35 views

Sheet

Then I will be able to join the meeting and disadvantage of the day and the day of the day of the day of the day of my life and my love is very good ? you are always in love with a very happy birthday to you are always with my love

Uploaded by

mithunavelrajanps
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

SRI KRISHNA ARTS AND SCIENCE COLLEGE

COIMBATORE - 641 008

APPLICATION FOR ISSUE OF DUPLICATE CERTIFICATE

1. Duplicate of which Certificate* required :

2. Name of the Candidate :

3. Register Number :

4. Programme of study :

5. Branch :

6. Period of study :

7. (a) If applying for duplicate statement of


Marks fill in the month and year of exam.
for which mark statement was issued. :
(b) If applying for duplicate consolidated
Statement of marks fill in the Month &
Year of last appearance in which qualified
for the degree :

8. Circumstances under which the certificate


Was lost / destroyed :

9. Whether the prescribed affidavit has been


enclosed with the application or FIR copy :
to be enclosed

10. Fees paid :

Place:
Date: SIGNATURE OF THE CANDIDATE

FOR OFFICE USE ONLY


Certificate issued on Prepared by:

Folio No. Examine by:

CONTROLLER OF EXAMINATIONS PRINCIPAL


* Write as Statement of Marks/Consolidated Statement of Marks
(For instruction see over leaf)
INSTRUCTIONS

1. Duplicate certificate will be issued only when it is lost or destroyed irrevocably.

2. Application duly filled-in along with an affidavit detailing the circumstances


under which the original certificate was lost or destroyed.

3. The affidavit should be duly executed before the Notary Public.

4. Application shall be complete in every respect. Failure to furnish correct details


may cause delay in the issue of the certificate. The application shall be filled in
only by the candidate otherwise it will be rejected.

5. The fees should be paid through the college office.

6. Fees once paid shall neither be refunded nor adjusted against any other certificate
under any circumstances.
AFFIDAVIT TO BE FILLED FOR ISSUE OF DUPLICATE CERTIFICATE

AFFIDAVIT OF Thiru / Selvi _______________________________________________


1. I ________________________________________________________________________
son/daughter of _______________________________________ aged ________ years,
an old student /student of Sri Krishna Arts and Science College with Register
Number _____________ and residing at _______________________________________
__________________________________________________ do hereby solemnly and
sincerely state as follows.
2. My ____________________ statement of marks issued relating to the examinations
held during _____________________/ Consolidated statement of marks issued by the
college has irrevocably been lost / destroyed.
3. I fill this affidavit for the purpose of receiving duplicate certificate.
4. The duplicate certificate shall be returned to the college once my original
certificate(s) is/are recovered by chance.

5. The facts stated are true and correct to the best of my knowledge and if found false
by the college, I shall abide by the decision of the college.

Solemnly affirmed.
Signature of the Candidate
At (place) ____________________________ (Before me)
This (date) _____________________ day of
The Signature affixed in my presence.
Place:
Date :
Notary Public
Address_________________________

_________________________________

_________________________________

Seal:
___________________________________________________________________________
*delete which is not applicable.

You might also like