(We request you to read the application carefully and send the application and the undertaking form

acknowledged by you on our official email id: info.msg@universalcollege.edu.in)

APPLICATION FORM REQUESTING PAYMENT OF FEES IN INSTALLMENT

From:
Shaikh Hashim Ali
Room no A1, plot no 21,
Road no 3, shivajinagar
Govandi 400043
Date: 23/06/2020

To,
The Principal
MSG-SGKM universal college ghatkopar (east)

Sub.: Requisition for payment of fees in instalment

Sir/Madam

I, the undersigned, wish to seek admission to TY-BSC (IT) class of your esteemed college. I would request you to

kindly approve of my request for payment of fees in instalments because we are not able to pay full fees at
one time. So I request you to accept my requisition letter for payment of fees in instalment

I have read the notice and the norms and conditions displayed by you on the notice board and agree to abide
by the same. In case if the payment is delayed because of any reason, I agree to abide by the decision and
action proposed by the college in the said notice.

I request you to approve of my request.

Yours faithfully

Shaikh Hashim Ali

Name and signature of the Student

I have read the norms, rules and regulations regarding payment of fees in instalment and agree to abide by
the norms and shall accept the decision of the college authorities if the fees are not paid within the scheduled
prescribed.
Kausar ali shaikh
Name and Signature of the parent.
 Undertaking

I, the undersigned Shaikh Hashim Ali , student of TY-BSC(IT) class for the academic year 20202021 , would like
to thank the college authorities for approving my request for payment of fees in instalment.

I agree to pay the instalments as per the schedule given below:

Instalment Date of payment Instalment Amount
I 15/07/20 7300/-
2 15/08/20 7300/-
3 15/09/20 3650/-
4 15/10/20 3650/-
5 15/11/20 3650/-
6 15/12/20 3650/-
7 15/01/21 3650/-
8 15/02/21 3650/-
I am aware and agree with the fine proposed by the college for the delay in payment which is as under:

“NACH Bounce Charges of Rs. 1000 for first offence and Rs. 2000 for second, Rs. 3000 for third and every
subsequent attempt. Late fee of Rs. 10/- per day from the date of the last instalment paid till the date of
payment for the first delay and Rs. 15/- per day for subsequent delays”.

I am also aware and agree that the college authorities can cancel my admission / debar me from appearing for
the examination if the total fee is not paid by February 28, 2021.

I am thankful to the college authorities for granting me the facility of payment of the fees in instalment and
will ensure that I do not misuse this facility. I promise to pay the fees within the schedule period prescribed
and specified above.

Shaikh Hashim Ali

Name and Signature of the Student

Kausar ali shaikh

Name and Signature of the Parent.