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ANNEXURE I

ACCOMMODATION INFORMATION FORM

I Date of Birth (dd/mm/yyyy) , aged

S/o/D/o R/o being admitted in

Programme Programme Code with Reg. No. .

Here in, I undertake that I am a day scholar and (tick only 1 option):

I am staying with my parents.

I am staying with my legal guardian (attach ID proof of legal guardian with II).

I am staying in PG/ Rented accommodation (attach Annexures III, IV and IV).

I hereby declare that:

• all the information either mentioned above or in enclosed documents (if any) are true and correct to the best of my knowledge and
nothing has been concealed therein.
• if any information is found to be false and incorrect than I will liable to be punished under Law in Force and any benefits received
by me will be liable to be ceased.
• in case of change in type of stay, I will resubmit this undertaking again before shifting along with other required documents.


Signature of the Candidate Date:


Signature of the Parent/Legal Guardian Date:
(Should match with Admission Form)