DEPARTMENT OF TECHNICAL EDUCATION. APPLICATION FOR DUPLICATE
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West; Bengal Board of Secondary Education. 7721 Park Street ... (in block Letters
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SIGNATURE OF STUDENT. Please sign clearly within this box and not on the lines. VERIFIED. Faculty Representative - Admis
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UNIVERSITY OF CALICUT. Application for Duplicate Marklist/ Grade Card. Name
of the Candidate. : (in block letters). Mobile Number. : Name of the ...
UNIVERSITY OF CALICUT Application for Duplicate Marklist/ Grade Card Name of the Candidate (in block letters)
:
Mobile Number
:
Name of the Course/Programme
:
Details of course studied Year / Semester
Register number
Month & year of study
Mark/ Grade obtained
Centre of Examination
Remarks
1 2 3 4 5 6 7 8 9 10 Details of Duplicate Marklist/ Grade Card required Year / Semester
1 2 3 4 5 6 7 8 9 10
Register Number
Month & Mark/Grade year of study obtained
Centre of exam
Details of fee remitted : Chalan number
Amount
Date
Place of Remittance
Details of paper notification Date
Name of newspaper
Page number
If affidavit enclosed (Tick whichever is applicable) Yes
No
Address to which duplicate marklist/grade card is to be sent (In Capital Letters)
UNDERTAKING
: ........................................................ ........................................................ ........................................................ ........................................................ P I N...............................................
I undertake that if the original marklist is recovered, I will intimate the fact and surrender the same. Place: ........................ Date: .........................
Signature of the Applicant
Enclosures required 1. 2. 3. 4.
Newspaper containing the notification Affidavit Chalan receipt (original) Copy of lost marklist (if available)
Instructions 1. News paper notification should contain all the details like Register Number, Year of study, Name of course, Name of University, reason for loss etc. 2. Affidavit should be in stamp paper worth Rs. 100 (from First Class Judicial Magistrate) 3. Affidavit should be obtained only after the expiry of 15 days of paper notification. 4. Fee for duplicate marklist is Rs. 250 per marklist. Postal charge of Rs 50 also is to be remitted. 5. Fee for duplicate certificate is: upto 5 years of passing the exam
:
Rs. 300/-
upto 10 years of passing the exam :
Rs. 400/-
After 10 years of passing the exam :
Rs. 500/-
(To apply for duplicate certificate, download and use the application for degree certificate.)
