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Provisional Certificate Request Form
Provisional Certificate Request Form
Name
Contact No.
Accountancy
Store Keeper
_________________________
_______________________
Dated
Students Signature
_____________
_____________
______________
_______________
Issue Date
Prepared By
Verified By
Registrar
Please Note:
Deposit an amount of Rs 500/- Fee at the On-Campus Accountancy
Attach copy of the fee deposit slip
No fax/telephonic request is entertained for the issuance of Provisional Certificate
Any delinquency in the clearance status causes a strict excuse against the request
Provisional Certificate on the prescribed script paper only