APPLICATION FOR MIGRATION CERTIBICA’ to The Secretary, Maharashtra State Board of Technical Education, 49, Kherwadi, Bandra (East) Mumbai ~ 400051 Sub: To issue the Migration Certificate (To be filled by the Student) [ Undersigned kindly request you to issue me the Migrat Name of the Student Address of Student: _ Pincode_ Enrolment No, = Name of the {nstitute: eee Last Exani Passed: Documents required for Verification and Record L. Original & attested Xerox copy of Last Years / Semester Mark List. 2. Original & attested Xerox copy of College Leaving Certificate (Last Attended) 3. Original & attested Xerox copy of Provisional / Final Board Certificate. Yours Faithfully, Signature Name: For Office Use Only To Account Office Kindly accept the Amount of Rs. 300/- for the Migration Certificate. R012 Head Clerk / Superintendent ‘The above Amount is accepted as per the Receipt No. Cashier / Accountant Date: Signature3 Annexure - B SelfDeclaration for Self Attestation Applicant's | as | Phot | a I __. Son/ Daughter of _ aged , occupation __tesident of with UID No, a Hereby, declare that the copies attested by me are true copies of original documents, {am well aware of the fact that if the copies are found ‘0 be false, I shall be liable for prosecution and punishment under Indian Penal Code and / or any other law applicable thereto, Place: Applicant's Signature Date: Applicant’s Name: