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For downloaded applications, kindly remit Rs.50/- (Fifty only) through "Payment Gateway for students &others" provided in the Online Remittance System in the University website.

Application No.:(To be Filled by Office)

Application for obtaining Provisional / Extract Certificate

( For Degree / Diploma Examinations )

DETAILS OF PAYMENT(To be filled in by the candidate)Name and place of the BankD.D. Should be enclosed..Demand Draft No.: ..Date of Payment : ..Amount Rs.: ..

Candidates should read the instructions very carefully before fil ling in the columns. Any column leftblank will cause delay in issuing of certificate.

1. Name as registered in the University Records }

(In Block Letters) } ..

2. Sex : Male / Female

3.Date of Birth : ...

4.Name of the Degree course Passed : ..

5.Last Appearance Register Number : .

6. Month & Year of passing the Final Examination : .

7.College in which last studied : .

8.Branch /Optional Subject Studied : .

9. If applied for 2nd Provisional Certificate the period } CRI From. To ..Of C.R.I. to be mentioned here } At

10.Whether applied for convocation and received }the degree or not (in person or in Absentia) If received, } .state the date, month and year of convocation. }

10. Certificate for which applied for kindly tick[ ] } 1. Provnl Cert 2. Extract of ConvoThe column applicable } First.

Second

12. Address of the Candidate } .(In Block Letters) } .

} .

Date: Signature of the Candidate

Endorsement of the Institution

Recommended towards issue of (Strike out whichever is not applicable) First/Second Provincial/ Extract ofconvocation certificate as the candidate has passed / fulfill all the prescribed conditions as per the regulations ofthis University to receive the Certificate.

FOR OFFICE USE ONLYFor D.D. Endorsement

Date:Register P No:

Sl No:

Initial of the Asst.

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Seal:Date Signature of the Principal/ Dean

FOR OFFICE USE ONLY

i) Admission register P.No,.: ii)Certificate Issued Folio No.:iii) Certificate Printed Machine No.:iv) Signature:

Prepared by Read by Examined by :

CONTROLLER OF EXAMINATIONS.

DETAILS OF PASSING THE DEGREE / DIPLOMA EXAMINATION FOR WHICH THE CANDIDATE

HAS APPLIED FOR THE PROVISIONAL CERTIFICATE / CONVOCATION EXTRACT

This column should be filled in compulsorily by the candidate

Name of the Subject

With Code

Reg.No. Month & Year of

Passing

Name of the College /

Centre Code

Marks

Obtained

Place : .

Date : . Signature of the Candidate

INSTRUCTIONS

1. After conferment of a degree at a convocation. Provisional certificate will not be issued. But

only an EXTRACT from the convocation report will be issued based on the affidavit / Police

NOC produced by the candidate.

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The fee should be paid through "Payment Gateway for students & others" provided in theOnline Remittance System in the University website. Postal orders and Money orders willNOT be accepted.

2. A self addressed sufficiently stamped Registered cover should be enclosed for sending the

certificate by REGISTERED POST.

3. NOC of this University should be enclosed at the time of applying for IInd PPC for the CRI

transferred candidate of one recognised institution to another recognised institution.

4. A Xerox copy of H.S.C. mark sheet or equivalent certificate should be enclosed.