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Application Duplicate

The document is an application form for issuing a duplicate certificate from Amrita School of Engineering, detailing necessary information such as the degree, payment details, and circumstances of loss. It outlines the required documents and instructions for submission, including an affidavit and a demand draft for the applicable fees. The fees for duplicate certificates are Rs.500 for a Grade Sheet and Rs.1000 for a Degree Certificate, and once paid, they are non-refundable.

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0 views

Application Duplicate

The document is an application form for issuing a duplicate certificate from Amrita School of Engineering, detailing necessary information such as the degree, payment details, and circumstances of loss. It outlines the required documents and instructions for submission, including an affidavit and a demand draft for the applicable fees. The fees for duplicate certificates are Rs.500 for a Grade Sheet and Rs.1000 for a Degree Certificate, and once paid, they are non-refundable.

Uploaded by

tamiloppo321
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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DUPL - 1

OFFICE OF THE DEPUTY CONTROLLER OF EXAMINATIONS


AMRITA SCHOOL OF ENGINEERING, COIMBATORE – 641 112
APPLICATION FOR ISSUE OF DUPLICATE CERTIFICATE
Certificate for which applied for * : Details of payment made
Degree & Branch :
Demand Draft No.:
College through which D. D. Date :
Studied / Studying : Bank :
Amount paid Rs. :
1. Name of the Student :

2. Register Number :

3. Sex :

4. (a) If applying for duplicate Statement of Grades/


Marks, fill in the Month and Year of Exam for
Which statement is required. :
(b) If applying for duplicate degree certificate,
Fill the :
i. Month and Year in which qualified for the
degree :
ii. Date of convocation in which the degree
was conferred :
(c) If applying for duplicate provisional
certificate / consolidated statement of grades /
marks fill in the Month & Year of last
appearance in which qualified for the degree. :
5. Circumstances under which the certificate was lost :
6. Whether the prescribed affidavit has been enclosed
with the application :
7. Address to which the certificate is to be sent :

8. E-mail ID & Phone Number :

Place :
Date : Signature of the Candidate
FOR OFFICE USE ONLY
Certificate issued on : Prepared by :
Folio No. : Examined by :

Date on which the D.D. was


sent to Finance Section : Deputy Controller of Examinations
* Write as Degree Certificate / Statement of Grades / Marks
Provisional Certificate / Consolidated Statement of Grades / Marks.
(for instructions see over leaf)
P.T.O.
INSTRUCTIONS

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

2. Application should be made only by the candidate in the prescribed format and should
be sent to the Controller of Examinations directly. Application received on behalf of the
candidate will not be accepted.

3. The following documents should be enclosed along with the application.


(a) an affidavit giving the circumstances under which the original certificate was lost.
The affidavit should be duly executed before the Notary Public on a Non-judicial
Rs.50/- stamp paper.
(b) Self – addressed, stamped envelope (for Registered Post).
(c) Xerox copy of the grades / marks statement / certificate for which duplicate is
required (if available)
(d) The demand draft.
(e) For those who apply for Degree Certificate.
(i) FIR – Original
(ii) The candidate has to provide the full address of the company / organization where
he/she works/worked when he/she lost the certificate.

4. Application should be completed in all respect. Failure to furnish correct details may cause
delay in the issue of the certificate.

5. The fee for the issue of duplicate Grade Sheet Rs.500/- and for Degree Certificate
Rs.1000/-.

6. The fee should be paid in the form of demand draft in favour of “AMRITA VISHWA
VIDYAPEETHAM” Payable at Coimbatore.

7. Fees once paid will not be refunded nor adjusted for any other certificate under any
circumstances.

8. Duplicate Certificate is to be surrendered to the University immediately if the Original


Certificate is recovered.

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