A w n Nar G 9 A .

oa167APP}ENDIX 16
CUDDAPAH DIST.
3 eoscssiw, 99%S 2dasäsioo RULE 99,CHAPTER III

s o a t FORM OFTRANSFER CERTIFICATE

1. Bbbsgsi aoug 3 9 3 Z.P. HIGH SCHNAL
Transfer Cortifticate No. AG o5-ds
UPPALUR 516 G80
Muddanur (M) Kadapa Dt
Name of the School (Place and Distriet)

Highest Class in the School

Fomporary Recognition accorded in Ro

No: 6415/e3/2001 Dt : 23-11-2001 of
If Non-Government, Class upto which Recognized
No. and Dale of Recognition Orders
ho B.J.D. Cuddapaha
2. / Doo
Name of the Pupil
PALLA S RiyinyA
4.
Name of the Parent or-Guardian
oS, Soeso5 & soSSs»
SP Napyhomam
Nationality. Religion & Cast ndian= H n d hatalta

Whether the candidate belongs to Scheduled Caste

or Scheduled Tribes or Vimuktha Jathis or Other
socially and cducationally backward classes
specified in the Andhra Pradesh Educational Rules
or is he a converted from the Scheduled Caste or
the Scheduled Tribe ?If so the particulars thereof.
BaCkd Bc-624
6.

9-&1982
Date of Birth (in words) as entered in the
Admission Register ha y e) O
7. ) ore a60 3yY DsSS
Class in which the pupil was reading at the
time of leaving (in words)
) 1) GSD rs
First Language
2) aroos P
Second Language
,
3) 1) S°) S°E»y (¢En Da ? )
Coùrse offered (i.e. whether Academic or

8. 1) Srsrá
Bifurcated and the subject offered under the
bifurcated course)
2) á
Aca
3) 5 5 » ss°) rá
Mother Tongue Medium of Instruction Optional
-
-

Date of Adaiien or Promotion to the Class

(The
year to be entered in words) June 994

Mskeen intyoy)
 -2

10. 0 r o °0>8 os
Class and year in which the puril was first
admitted in the school 21 o6 -1993
vomdtm
Whether qualified for promotion to a higher class.
12. /osg oToas 39oSSes
Whether the pupil has paid all the fees due to the
School
13. ) a / s a s DSw o8ay årod

Whether the pupil was in receipt of any

Scholarship. (Nature of the Scholarship to be
specified)
14.
ossSs6 eg/sg 36 sôg
OAs ? Jess3».
Whether the pupil has undergone medical
inspection during the year first or repeat (to be
specified) No -
15. /as 5), KoQo D e
)
ii)
16. 3g P6TO` S o r Sa8
22-04-1995
Date on which the pupil actually left the school.
17. /2rs9 soOI sO/s s/öo

Date on which application for Transfer Certificate

was made on behalf of the pupil by kis/her Parent
15-A0-20055
orGeerdien.
18. »ds s83s Sa
Date of the Transfer Certificate
15-10-20nS
19. 5
Conduct
20. a / 9 SEKO DdOs533

Attendance in the class of leaving

21. T e $IB33 BSKoe 3 v » $ops
Total number of working days

22. S g g v $oaSKo
Signature of the Head of the School.
HEAD MA$TER s J
Z.P. HIGH SCHOCOL
UPPALUR S16 80
Muddanur (M) Kodapa Dt.

Note In case the pupil is leaving the State of Andhra Pradesh this Certificate will not be valid without the
counter Signature of Inspecting Officer concerned.

(As per G.0.Ms.No.40 Edu (Ser-V) date: 7-5-2002.)