Visvesvaraya Technological University

“Jnana Sangama”, Belagavi - 590 018, Karnataka State

Name of the Candidate :

Gender : Male Female
University Seat number (USN) : Course & Branch:

Name of the college last studied :

Whether completed the course or :

discontinued.

Qualifying Examination Passed : Month & Year of Admission:

orDiscontinued (Month & Year)
Enclosures
: 1. Attested Photocopy of Degree certificate/ Provisional Degree Certificate (PDC) / Copies of all
semester Grade cards.
2. Academic record of student recommended by the college for issuing Migration certificate as per
Annexure - I
YES NO

(Payment to be made (in INR) through online payment (Refer - www.vtu.ac.in/online -fee- payments/- )

Amount: Tans ID: Date:

(Enclose Receipt of online payment made)

[Rs. 1500/- if admitted to the University in INDIA: Rs.5000 - if admitted to the FOREIGN University]

Candidate Address for Communication :

with Contact Number, Email id

Address of the University/ College (New College) where :

the candidate has taken admission.

Date: Signature of the candidate

(TO B E , FILLED IN BY THE COLLEGE/UNIVERSITY WHEHE THE CANDIDATE HAS GOT
ADMITTED/ PURSUING THE COURSE)

Forwarded to the Registrar (Evaluation), VTU, Belagavi-590018, Karnataka for necessary action

This is to certify that Mr. /Ms. __has admitted / Pursuing course

in our College/University during the academic year from to

Date: Signature of the Principal/Director with seal

[Where the candidate has taken admission / got admitted / pursuing the course]

Please Note: Incomplete application any respect (Documents, Fee, etc) and if amount sent by DD will not be processed and no communication
will be made in this regard.
 Visvesvaraya Technological University
“Jnana Sangama”, Belagavi - 590 018, Karnataka State

Application for Migration Certificate-Affiliated Colleges

Name of the Candidate :
Gender : Male Female

University Seat number (USN) : Course & Branch:

Name of the college last studied :

Whether completed the course or :

discontinued.
Month & Year of Admission:
Qualifying Examination Passed :
orDiscontinued (Month & Year)

Enclosures:

1. Attested Photocopy of Degree certificate/ Provisional Degree Certificate (PDC) / Copies of all
semester Grade cards.
2. Academic record of student recommended by the college for issuing Migration certificate as per
Annexure - I
YES NO

(Payment to be made (in INR) through online payment (Refer - www.vtu.ac.in/online -fee- payments/- )

Amount: Tans ID: Date:

(Enclose Receipt of online payment made)

[Rs. 1500/- i f admitted to the University in INDIA: Rs.5000 - if admitted to the FOREIGN University]

Candidate Address for Communication : with

Contact Number, Email id

Address of the University/ College (New College) where : the

candidate has taken admission.

Date: Signature of the candidate

(TO B E , FILLED IN BY THE COLLEGE/UNIVERSITY WHEHE THE CANDIDATE HAS GOT
ADMITTED / PURSUING THE COURSE)

Forwarded to the Registrar Evaluation, VTU, Belagavi for necessary action

This is to certify that Mr. /Ms. has admitted / Pursuing course

in our College/University during the academic year from to

Date: Signature of the Principal/Director with seal

[Where the candidate has taken admission / got admitted / pursuing the course]

Please Note: Incomplete application any respect (Documents, Fee, etc) and if amount sent by DD will not be processed and no
communication will be made in this regard.