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Teerthanker Mahaveer University: Application Form For Migration Certificate

Migration form.

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Sreehari Ravindran
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270 views

Teerthanker Mahaveer University: Application Form For Migration Certificate

Migration form.

Uploaded by

Sreehari Ravindran
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

TEERTHANKER MAHAVEER UNIVERSITY

(Established under Govt. of U. P. Act No. 30, 2008)


Delhi Road, Moradabad (U.P.)

APPLICATION FORM FOR MIGRATION CERTIFICATE


(For migration of students from Teerthanker Mahaveer University to other Universities/Institutions)
Please paste
i. All particulars should be filled in by the candidate himself/herself. your latest
ii. No person is entitled to apply or to receive the migration certificate on behalf of another person. passport
iii. A DD/University Fee Receipt for non refundable migration fee of Rs.1,000/- must be attached. size colour
iv. Attested photocopy of the certificate of last examination passed/failed must be attached. photograph
and sign it
v. A self addressed duly stamped envelope should be attached. across
vi. The office shall not be responsible for any delay if the form is found incomplete.
A. APPLICANT’S DETAILS
1. Name: (In capitals)

2. Father’s Name: (In capitals)

3. Mother’s Name: (In capitals)

4. University Registration No.: 5. Present Enrollment No.:

6. Particulars of Last Examination of Teerthanker Mahaveer University in which passed/appeared:


Name of Last Exam......................................... Session/Year…...........................Roll No.............................
Result.............................Name of College/Department…………………………………………………………………………
7. Name of College/Department, if still on rolls………………………………….……………………………………………………
Session/Year….........................................................Roll No………………………….…………….............................
8. Whether any unfair means case against the applicant is under consideration with this University? If
so, give the following particulars :-
Name of Examination …………………………………… Session/Year…………………………Roll No………………..………...
9. Whether disqualified by this University at any point of time? if so, give the following particulars :-
College/Department …………………………………...Examination in which disqualified…………………………………..
Session/Year…………………………Roll No…………….………………Period for which disqualified………………………..
10. Name of University/Institution/College where the applicant has joined/intends to join:
.……………………………………………………………………………………………………………………………………………………………
Programme/Course………………………………Year/Session………………Class……………….Roll No. ……………………
11. Postal Address to which the migration certificate should be sent (In capitals): ......................................
...................................................................................................................................................................
...................................................................................................................................................................

I solemnly declare that: -


(i) The particulars filled in by me are correct and nothing has been concealed;
(ii) I did not appear in any other examination thereafter from this University;
(iii) In case of compartment/re-appear, I will not appear in the compartment/re-appear subjects of
the last examination from Teerthanker Mahaveer University; and
(iv) I shall be responsible for the consequences, if the above statements are found incorrect.

Dated: …………………………………
Place: …………………………………. Signature of the Applicant
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B. FEE PARTICULARS
Fee Remitted Rs…………………………… For Use of Accounts Dept. Only
Bank Draft/University Receipt No……………………………… Received Rs..............vide Univ. Receipt No.
................................. Dated........................
Date ………………………………
ACCOUNTS OFFICER

CERTIFICATE – I
(The Certificate is required when the applicant had left the college/department without appearing in the University
Examination or whose name has been struck off from the college/department rolls)
Forwarded with the remarks that I have no objection to the issue of Migration Certificate to the
applicant and nothing is due against him/her.

Dated………………………………. Director/Principal/Head
(with seal)
Note: The Director/Principal/Head of Department may please forward it after obtaining ‘No dues
Certificate’ from the applicant.
CERTIFICATE – II
(CERTIFICATE FOR ISSUANCE OF MIGRATION CERTIFICATE PERSONALLY)
Certified that the applicant Mr./Ms. …………………………………………………………… has last been a student of
Programme/Course………………………………Year/Session………………Class……………….Roll No. …………………………
at College/Department…………………………………………………. and is personally known to me and he/she is
the same candidate who has applied for the issue of migration certificate. He/She has signed in my
presence. The Migration Certificate may be issued to the candidate on my responsibility.

Dated………………………………. Director/Principal/Head
(with seal)
CERTIFICATE – III
(AFFIDAVIT ON A STAMP PAPER SWORN BEFORE A FIRST CLASS MAGISTRATE)
(For applicants who have lost the original migration certificate and require duplicate one)
I, ……………………………………. son/daughter of Sh….……………………………… r/o………………………………………………..
solemnly affirm and declare that Migration Certificate No………………………………Dated……………………issued
to me by Teerthanker Mahaveer University, Moradabad has been lost and that I did not join any other
University/Institution on the basis of the same.
Signature of the deponent………………………………….
Name of the deponent……………………………………….
Address………………………………………………………………
Signature (1st Class Magistrate)
(Seal of the Court)
FOR OFFICF USE
Migration application form checked and particulars verified vide ‘Register of Students’.

Dated:…………………………. Dealing Clerk / Assistant

Migration Certificate No....................... dated.......................... issued after Registrar’s approval dated


……………………………. on page no………………………….. of ‘Register of Students’.

ASSTT. REGISTRAR

Received Migration Certificate


Full signature and name of the candidate
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