cow ., Guru Gobind Singh Indraprastha University Sector 16C, Dwarka, Delhi - 110078, FORM OF APPLIC; SERTIEICATE (To be filled in by the Applicant- Before filling in the form, see instructions on reverse) 1. Nene of Applicant 2 2. Father's Name : 3. University Barotment No: 4. Name of tie USS /astt + i College froes which the andiiate took the last : ‘examination oe + Programme’ Yearor Programme Year of Fartewtars of tne | Cotte ___. atiston Dorion Passing Rest 2 Pase/ Failed / Consolidated Provisional Absent Mark sheet, Certfiete {If Issued ) 6 Permanent Address: 7. Phone No : Mobile No. 8. Prescribed Fee Amount: Re Dated Contin No. Paid : 9 eof the Universigyto isch the. candidate ‘wants to migrate RECLARATION | solemnly affirm that the information furnished above is true and correct in all respects, have not concealed any Information. realise that if any iaformation furnished here is found to be incorrect / antrue, shall be lisble to setian by the University. Dated: ‘Sigaetare of Applicant Certified that the above entries made by are correct as per records and iie/shy has paid USS/Lastitution/College dues. Abe USS / Institution / College has no objectin for isaue of Migration Certificate to hiea/her by the University. Dated: ‘Sigiature of Dean / Director / Principal (With Seat) (Stamp of USS/Institution/Coll FOR OFFICE USE ONLY. Received the above Certitiente No. Dated.2 3. evox copes of Degree CertiateProvisonel Catficte and Consolidated Marksheetissust by the jinivecsity submitted should te duly attested and forwarded by Dean / Dita, Principai = USS ‘Affiliated Institution, lst eter ded by the applicant, long with this equest form, fmutleted on submission of an affidavit drawn up on a nonjudici! stamp paper of the valse of Re. 10/ to be duly notorozied ‘attested sworn before a I" Clase Magistrate on the following format, This may be noted that the suparession of facts and furnishing of wrong affidavit will tantamount to an offence and the applicant, i he/she does 50, shall doit at hisMier ee ‘isk and consequenges. The 5 Te ae Resident oF hereby ‘solemnly declare that. the e a Migration Certificate No, ‘dated issued to me by the Gum Gobind Singh indeaprastha University tenable me fo join University has been lost nd tha | didnot join any other University on the bass oF the same Wor hhave I submitted the ‘same for joining any other University”. Such students, who seek migratin from this Univesity without completing the course, will hes to give undertaking to the effect that helshesuncndershihher result, duly oust, Signed by the Dean / Director / -incipal / Head of the Department Ze delivery of the Migration Contfiate wil ordinarily be made in perton to the Candidate» to Riaher nominee duly authorized ia writing by the applicant with atation of the signature af the nominee, atthe University office during public dealing hours ofthe branch as specified and obtaining Ae gentile nominee has to Sul mit & copy of hisher any valid 1D such se Election Card, Adhar Card, PAN Cand, Driving License, I-Card isd hy Govt PSUleutonomons ‘organization etc, All public deating are made fron’ 9.30 A.M. 1o 1230 PM, on University working days and the GLlivery othe eniticate may be claimed nor:nally after 3 working dy From the date of deposit of sy aaa iOn counter O° Academic Conntnation and Students Support Brench Timings OAM 10 (2.30 PM and 2.00 P.M 133.00 Pw sil University working dye, Frat ee for Migration Con icte / Dupicate Migration Certifieate is Ra 200/- to be paid at Andian Buns, GGS Inidraprastha University, Sector 16Cy Dwarka: Neg Dethi-110078. The originat Feenits oF chollan ised by Indian Bank. ciS101), Dwarka ito be enclecad og, the application form for is. ve Migration Certficete,