Beruflich Dokumente
Kultur Dokumente
Center Code
: DDE/RVU/SA/_________
Name
: ___________________________________
Address
: ___________________________________
Address
___________________________________________________
Name
: ___________________________________
: ___________________________________
___________________________________________________
City : ____________________
Pincode : ________________
Pincode : ________________
3. Tel No.
(With STD Code:
5. Name of the
Examination:
Passed
State : __________________
4. Email :
Diploma
B.Tech
M.Tech
8. Final Exam
Roll Number :
7. Year of
Passing :
6. Stream :
9. Enrollment No. :
Migration
Certificate
11. Academic Details (Enclose Xerox and attested copies of the Marks card of all semesters) :
Course
Stream
Semester
Semester Total
Semester Grade
DD Date
DD Amount(Rs.)
Bank Name
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UNDERTAKING FORM
(By the student)
To,
The Director
Directorate of Distance Education
J.R.N. Rajasthan Vidyapeeth University
Photo
Sir/Madam,
Date : ________________
Enrolment No.___________
YES / NO
Fees Received
Certificates verified
Despatched on
References
________________________________
Date :
INSTRUCTIONS
Following documents must be forwarded along with the application :
a. Certified true copy of 10th or equivalent in case of Diploma students and 10+2 or equivalent in case of B.Tech students and
Degree pass certificate of M.Tech students. (Duly Notarized)
b. Copy of Fi nal pass certificate obtained from the University.(Duly Notarized)
c. Xerox copy of the Marks Sheet of all semesters. (Duly Notarized)
d. Original School Living Certificate in case of Diploma Student & Original Migration from Old University in case of Degree Student.
Note : Along with all relevant documents & DD the application form should be submitted to the study center only.
DD should be in the Name of J.R.N Rajasthan Vidyapeeth University, Payable at Udaipur.
FEES
S. No.
1.
2.
3.
4.
5.
6.
Description
Consolidated Marksheet
Provisional Certificate
Original Degree Certificate
Duplicate Degree Certificate
Duplicate Mark Sheet
Migration Certificate
:
:
:
:
:
:
New Fees
Rs. 200/Rs. 100/Rs. 200/Rs. 500/Rs. 200/
Rs. 150/-
FIR No.
2. I say that in spite of diligent search I am unable to trace the originals of the aforesaid certificates and hence they are taken as lost. If
traced, I will produce them before the University.
3. I say that I have not misused the same and I shall not misuse the same if recovered.
4. I say that for the purpose of _______________________________________________________________________________
I need the certified duplicates of the said certificates.
5. It is therefore necessary that on the strength of this affidavit certified duplicates are issued to me by the University.
6. All this is true.
NOTARY PUBLIC
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