JAWAHARLAL NEHRU TECHNOLOGICAL UNIVERSITY KAKINADA KAKINADA-533003, ANDHRA PRADESH, INDIA. VISION Code College NAME OF THE CANDIDATE (IN BLOCK LETTERS AS PER $.$.C) FATHER’S NAME (INBLOCK LETTERS) UGIP.G. PROGRAMME AND BRANCH Branch MONTH & YEAR OF PASSING EXAM (To be filled by the candidate, who Completed the Course) PERMANENT ADDRESS FEE PARTICULARS: (Rs. 200/-) Online Payment Reference No, (DU Number): Date: NOTE: 1. The fee shall be paid online at www.jntukexams.net > Apply for Certificates. The receipt of the payment shall be submitted along with the application, 2, For TATKAL Provisional Certificate, Rs. 3,000/- shall be paid online at www.intukexams.net --> Apply for Certificates, 3. Photocopy of SSC Certificate should be enclosed. 4, The filled in application along with online payment receipt sahil be sent to the Director of Evaluation, INT University, Kakinada — 533 003, 5. Corrections in the individual Marks memos will not be entertained after issuing PC&CMM. Undertaking: I verified and agree with the grades in all the grade sheets and will not claim for any further changes! modifications in future. Date: SIGNATURE OF THE CANDIDATE, For College Office Use Certificate of Identification T certify that Mr. / Mrs. / Miss. Slo! Dio _is a Bonafied Student of this College College Code: during to with H.T.No, and he/she secured, ligible credits out of 180 /141/132 credits and obtained CGPA. He’She is eligible to obtain Provisional Certificate as per the regulation under which he’she is admitted, Date: Signature of the Principal With Office Seal