SPECIMEN APPLICATION FORM (30 cm x 20 cm) A separate application should be submitted in

respect of each subject applied for.

G.C.E. (A/L) EXAMINATION - 2019

APPLICATION FOR RE-SCRUTINY OF RESULTS
01. (i)
Reference No.
Subject No. & Subject to be re-scrutinized Index No.
(Official Use only)

(ii) Syllabus :- New Old (Put a ' ' in the relevent cage)
(iii) Grade obtained :- (iv) Medium :-

02. (i) Name of the candidate :- Rev./Mr./Mrs./Miss ...................................................................................................

(with initials)
(ii) Private address :-.............................................................................................................................................

(iii) N.I.C. No. :- (iv) Telephone No. :-

03. Are you a school candidate? Yes No

04. Name of the Examination Center :- ..................................................................................................................................

05. Information about the receipt of payment of Rs. 250/= (Rupees two hundred and fifty) :-
(i) Number of the receipt :- ................................... (ii) Date :- ......................................
(iii) Post Office/ Sub Post Office :- ........................................................................................................

06. Please paste firmly overleaf the receipt obtained from the post office for the payment of prescribed fee. Keep a photo
copy of the above receipt with you. Applications which do not carry the original receipt will be rejected.

07. Declaration by the candidate :-

I do certify that the above particulars furnished by me are correct. I am aware that this application could be
rejected in the event of furnishing incorrect information. I agree to be bound by the rules pertaining to Re-scrutiny
of results and to accept an upward or a downward revision of the Z-score or Grade as a result of re - scrutiny.

Date : - ................................... ......................................................

Signature of Candidate
08. Principal's certification for school candidates :-

I do certify that the above candidate is a pupil of my school and the Index Number, Name of the Examination
Center, Subject, Subject Number, Medium and the Grade obtained given here are correct according to the Results
Schedule and that the original receipt obtained for the payment of prescribed fee is pasted overleaf.

.............................................
Signature of Principal
Name & Address of School :-
Date :-
Official Stamp :-

Note:
1. Private candidates should complete the Sections from 01 to 07 only.
2. Please send your applications by registered post to the Commissioner General of Examinations, Evaluation (School
Exams) Branch, National Evaluation & Testing Service, Department of Examinations - Sri Lanka, P.O. Box 1503,
Colombo.
 GOVERNMENT NOTICE

DEPARTMENT OF EXAMINATIONS - SRI LANKA

G.C.E. (A/L) EXAMINATION - 2019 (New/ Old Syllabus)
RE-SCRUTINY OF RESULTS
The results of the above examination have already been dispatched to the principals and to the
private candidates.
Applications for re-scrutiny of results of the above examination, prepared by candidates according
to the specimen application form (30 cm x 20 cm) published with this announcement should be sent by
registered post to reach the Commissioner General of Examinations, Evaluation (School Exams) Branch,
National Evaluation & Testing Service, Department of Examinations - Sri Lanka, P.O. Box 1503, Colombo on
or before 17.01.2020 . Please indicate " Re-scrutiny of Results - G.C.E. (Advanced Level) Examination 2019
(New/ Old Syllabus)" on the top left corner of the envelope.
In re-scrutiny, the relevant answer scripts are fully examined by several members of the Re-scrutiny Board.
It is hereby emphasized that an upward or a downward revision of Z-score or Grade is possible as a result of
re-scrutiny.
Please adhere to the following instructions in preparing the application form :
1. S chool candidates should forward their applications through the principals of their respective schools
and the private candidates should send their applications directly to the above a ddress by registered
post.
2. Applications should be prepared strictly in accordance with the specimen application form.

3. The fee for the re-scrutiny per subject is Rs. 250/=. This amount should be paid to a Post Office/ Sub
Post Office and the receipt obtained should be pasted firmly on the reverse of the application. Please
note down the number of the said receipt and keep it along with the postal registration receipt of the
application. (It is advisable to keep a photocopy of the receipt of payment.)

4. Stamps, Cheques, Money Orders or Postal Orders will not be accepted.

5. A separate application should be sent in respect of each subject applied for.

6. T he Index Number, Name of the Examination Center, Subject Number and Subject, Syllabus, Grade
obtained and the Medium should be correctly entered as indicated in the Results Schedule. It is
the responsibility of the applicant to read the instructions carefully and fill the application accurately.
The Subject Number and the Subject should match exactly under section 01 (i), according to the
given subject list.
7. I ncomplete applications, those sent after closing date of applications (17.01.2020) and applications
without the prescribed fee will be rejected without any notice. Fees paid in respect of rejected
applications will not be refunded.

8. Private candidates are required to complete only the Sections from 01 to 07 of the application form.

9. C
andidates who have scored less than 30 marks for Subject No. 12 - Common General Test and as a
result have become ineligible for university entrance, can also forward re-scrutiny applications.

10. This advertisement, the specimen application form and the subject list are published in the web site
of the Department too. (www.doenets.lk)

N.B. Applications with incorrect information will be rejected.

Evaluation (School Exams) Branch, B. Sanath Pujitha,

National Evaluation and Testing Service, Commissioner General of Examinations
Department of Examinations - Sri Lanka,
P.O. Box 1503, Colombo.
27. 12.2019