Law School Admission Council Transcript Request Form

LLM Credential Assembly Service

662 Penn Street, Box 8511
Newtown, PA 18940-8511 USA LLM.LSAC.org

APPLICANT: Please forward this form to the post-secondary institution listed below. It must accompany the
credentials they send to us on your behalf to the above address.
 Official academic records include (but are not limited to): transcript (official document with program details/grades/
marks/credits obtained), diploma, diploma supplement, etc.
 Original (native) language documents must be accompanied by complete, word-for-word English translations in
the same format as the original language documents.
 Academic records must be sent in a sealed institution envelope with a school stamp or school seal across the flap
directly to LSAC from the issuing institution. Academic records issued to students will not be accepted, nor will
academic records be returned to you under any circumstances.
Important: Please ensure that the correct Transcript Request Form is sent to each institution attended. This form
expedites the matching of your academic record to your LSAC file.

Full name: Samruddhi Gharote

Other name(s):
Address: Building No HIG C-3
Sundervan Society
Narendra Nagar
Nagpur, 440015 India
Date of birth: 12/15/1998
LSAC account number: L44093974

POSTSECONDARY INSTITUTION: The person whose name appears above is applying to one or more law
school programs. Please complete the information below and return this form, along with the applicant’s official
academic record in the original language from your institution and English translation (if necessary), to LSAC at
the address above. The information below may be used in the event we have to contact you regarding the
applicant’s academic record. If the transcript is an updated or corrected copy, please check the appropriate box.

Updated Copy Corrected Copy

*LSAC-44093974-T-1106606*
Name of institution: I.L.S. Law College
(please note any corrections)
Dates of attendance: 7/2016 - 4/2021
Certificate, degree or exams completed: B.A. LLB
Institution contact person:
Institution mailing address:

Phone number:
Fax number:
E-mail address: