DECLARATION /UNDERTAKING FROM THE STUDENT

I, Mr. SHREY BHATNAGAR (542300) S/O Jitendra Bhatnagar,Computer Science and Engineering programme,
Dept. of B.Tech. student of SRMIST, Kattankulathur –603203, Tamil Nadu permanent resident of Phone No:
Father +91 8958657029 Mother 9917987382 Guardian (Give permanent home address with telephone no.), do
hereby undertake on this the 25 (Day),of August (Month)2021 (Year) and state the following:-

1. I am solely responsible for providing any incorrect information supplied in the application form for registration. I
understand that In case any information in this application is found to be false or incorrect at any time (during
or after completion of the course), this shall entail automatic cancellation of my admission, if granted,
cancellation of the degree if awarded, besides rendering me liable to such action as the University may deem
fit.
2. I will present all the original documents at the time of admission along with true attested copies of mark sheet,
transfer certificate, Aadhaar Card and other documents as required by the

3. I do undertake that if I am unable to present all the documents at the time of admission as stated at point
no.02, I will undertake to submit the same before the time duly prescribed by the authorities. Failing which I
accept the consequence including cancellation of admission.

4. I understand that, attendance is must as per University norms. I also understand, in case my attendance falls
short, for any reason, the competent authority of the Institute may take any

5. I, hereby declare that, I will neither join in any coercive agitation/strike for the purpose of forcing the authorities
of the Institute to solve any problem, nor I will participate in any activity which has a tendency to disturb the
peace and tranquility of life of the SRMIST campus and/or its Hostel premises.

6. I hereby declare that once I join the course, I will not be permitted to discontinue from the course after the time
given for such withdrawal. In case of discontinuation due to unavoidable reasons, I agree to pay the remaining
tuition fee for the entire duration of the course.
 7. I hereby declare that I will not post any defamatory remarks about the institution, problems faced by me or
fellow students or any other issues in the social media such as whatsapp, facebook, instagram, quora or any
other websites. If I post any such messages in social media detrimental to the interests of the institution, I
agree to any disciplinary action taken by the institution in this regard.

8. I hereby declare that I will not involve in any brawl, groupism, threatening fellow students with prohibited arms,
harassment of fellow students particularly girl students inside or outside the campus. I agree to any disciplinary
action taken against me by the institution in this regard.

9. I hereby declare that I will not consume or promote usage of liquor, drugs such as Ganja, Abin and other
Narcotic & Psychotropic substances inside or outside the campus. If I am found to be guilty of usage or
promotion of any of these mentioned above, I agree to any disciplinary action

10. I, hereby declare that, I will not indulge in, or tolerate ragging in any form and I accept to give an undertaking in
the prescribed format of UGC/AICTE as per directions given by the University. I undertake to face disciplinary
action and legal proceedings including expulsion from the

11. I, also declare that, I am not suffering from any serious/contagious ailment and/or any Psychiatric /
Psychological disorder.

12. I, hereby undertake to inform the Institute, about any changes in information submitted by me, in the
Application Form and any other documents, including change in addresses and phone nos., from time to time.

13. I hereby, promise to abide by the admissible rules and regulations concerning discipline, attendance etc. of the
institute and also to follow the code of conduct prescribed for the students of the Institute, as in force from time
to time and subsequent changes/modifications/amendment

a. I agree to pay towards the damage of the College property if any, caused by me.

b. I agree to abide by the proceedings and disciplinary actions taken by the committee constituted for the
purpose; if and when I violate the rules and regulations of the University.
I acknowledge that the Institute has the authority / for taking punitive actions again violation and / or non-
compliance of the same.
14. I, hereby, declare that, the entries made by me in the Application Form are complete and true to the best of my
knowledge and based on records.
15. I, further declare that, my admission may be cancelled, at any stage, if I am found ineligibleand / or the
information’s provided by me are found to be incorrect. I have read and understood each

Place: Signature of Student

Date:

DECLARATION BY PARENT/ GUARDIAN

I SHREY BHATNAGAR,(Father / Mother / Guardian) of Jitendra Bhatnagar joined for:Computer Science and
Engineering programme, Dept. of B.Tech. atSRM Engineering College, Ghazhiabad,SRMIST do hereby fully
endorse the above undertaking/declaration given by my ward and I will endeavor to ensure my ward to comply with
above stated undertaking in words and spirit.

Place: Signature of Father / Mother / Local

Date:
 SELF DECLARATION
To be submitted by Student at the time of joining the College/ University

1. I SHREY BHATNAGAR (542300) age : 17 yrs., student of B.Tech. / I Semester / SRM Engineering College,
Ghazhiabad (Department / Semester / College) will wear mask, maintain social distancing norms and follow all
government guidelines during this pandemic and also outside office hours /

2. I am aware that anyone – staff / student can be an asymptomatic carrier of COVID-19.

3. I am aware that I can be an asymptomatic carrier of COVID-19.

4. I was not in contact with any COVID-19 positive case.If I come in contact with a positive COVID case, I will
inform the concerned authorities immediately with all the details.

5. I am aware that the University / College / School / Organization is taking all the measures required to keep me
safe from COVID-19.

6. I am aware that in spite of following all precautions I may getinfected with COVID-19 and I will not hold the
College / University / School / Students / Staff responsible for it.

7. I will also follow all guidelines when I go out for my personal work.

8. I am aware that in spite of following all precautions I may getinfected with COVID-19 and I will not hold the
College / University / School / Students / Staff responsible for it.

9. If I suffer from fever / cold / cough / loss of smell or any other Influenza like (COVID-19) like symptom, I will
immediately report to Doctor / Hospital and also inform the College University/ School authorities.

10. I will follow all the rules and regulations stipulated from time to time by University / College / School and the
Government in this pandemic.

Signature :
Date :
Name :
Programme :

Mobile Number:
 ANNEXURE I
AFFIDAVIT BY THE STUDENT
1. I, Mr.SHREY BHATNAGAR (full name of student with admission/registration/ enrolment number) S/O Jitendra
Bhatnagar having been admitted to SRM IST Delhi NCR Campus, Ghaziabad, U.P., (Name of the Institution)
received a copy of the Regulations on Curbing the Menace of Ragging in Higher Educational Institutions, 2009,
(hereinafter called the “Regulations”) carefully read and fully understood the provisions contained in the said
Regulations.
2. I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging.
3. I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of the penal
and administrative action that is liable to be taken against me in case I am found guilty of or abetting ragging,
actively or passively, or being part of a conspiracy to promote ragging.

4. I hereby solemnly aver and undertake that

a. I will not indulge in any behaviour or act that maybe constituted as ragging under clause 3 of the
Regulations.

b. I will not participate in or abet or propagate through any act of commission or omission that may be
constituted as ragging under clause 3 of the Regulations.
5. I hereby affirm that, if found guilty of ragging, I am liable for punishment according to clause 9.1 of the
Regulations, without prejudice to any other criminal actions that may be taken against me under any penal law
or any law for the time being in force.

6. I hereby declare that I have not been expelled or debarred from admission in any institution in the country on
account of being found guilty of, abetting or being part of a conspiracy to promote, ragging; and further affirm
that, in case the declaration is found to be untrue, I am aware that my admission is liable to be cancelled.

Declared this 25 day of August month of 2021 year.

Signature of deponent
Name : SHREY BHATNAGAR

VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit is false
and nothing has been concealed or misstated therein. Verified at 884 on this the 25 (day) of August (month) ,
2021(year ) .

Signature of deponent
Name : SHREY BHATNAGAR

Solemnly affirmed and signed in my presence on this the 25(day) of August (month) , 2021(year ) after reading
the contents of this affidavit.

OATH COMMISSIONER
 ANNEXURE II
AFFIDAVIT BY PARENT/GUARDIAN
1. I, Jitendra Bhatnagar (full name of the parent/guardian) father/mother/guardian SHREY
BHATNAGAR(542300) ,(full name of student with admission/registration/enrolment number) having been
admitted toSRM IST Delhi NCR Campus, Ghaziabad, U.P.(name of the institute), have received a copy of
the UGC Regulations on Curbing the Menace of Ragging in Higher Educational Institutions, 2009,
(hereinafter called the “Regulations”) carefully read and fully understood the provisions contained in the
said Regulations.
I have, in particular, perused clause 3 of the Regulations and am aware as to what
2. I hereby solemnly aver and undertake that

a. My ward will not indulge in any behaviour or act that maybe constituted as ragging under clause 3 of
the Regulations.
b. My ward will not participate in or abet or propagate through any act of commission or omission that
may be constituted as ragging under clause 3 of the Regulations.

3. I hereby affirm that, if found guilty of ragging My ward is liable for punishment according to clause 9.1 of
the Regulations, without prejudice to any other criminal actions that may be taken against me under any
penal law or any law for the time being in force.

4. I hereby declare that My ward has not been expelled or debarred from admission in any institution in the
country on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging;
and further affirm that, in case the declaration is found to be untrue, I am aware that my admission is
liable to be cancelled.

Declared this 25 day of August month of 2021 year.

Signature of deponent
Address:

Telephone/ Mobile No.:

VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit is false
and nothing has been concealed or misstated therein.

Verified at 884 on this the 25 (day) of August (month) , 2021(year ) .

Signature of deponent

Solemnly affirmed and signed in my presence on this the 25(day) of August (month) , 2021(year ) after reading
the contents of this affidavit.

OATH COMMISSIONER