APPLICATION FOR REVIEW

To
Application No: 0023629
The Controller of Examinations
University of Calcutta
87/1 College Street
Kolkata - 700 073.

Sir,
I would like to apply for re-examination of 2 Papers for which I am furnishing my particulars as hereunder.
and remitting Rupees Two Hundred Ten only (Rs. 210 /-) herewith.

a) Name (In Block letters) : Debayan Das

b) Contact Address : 59/60 Bagmari Road,B.R.S-3,Bl-20, Fl-7, Kol-54,700054

c) Mobile No. : 9836238290

d) Name of the Examination and Year : B.COM. SEMESTER - V (GENERAL) Examination, 2023 (Under CBCS)

e) Roll No. : 211316-22-0018

(Photocopy of Admit card shall have to be attached)

f) Registration No. : : 316-1111-0226-21

(Photocopy of Regn. certificate shall have to be attached)

g) Subjects and papers sought for re-examination of answer script under the relevant
Regulations of the University.
CC5.1CG, DSE5.2AG

DECLARATION

I declare that the above statements made by me are true to the best of my knowledge and belief and if any of
the statements is found to be false, my application shall liable to be rejected by the University without any
intimation to me .

Date : 13/05/2024 ..........................................................

N.B.
Full Signature of the Examinee

1. Last date of submission of form to the college by the student - 15/05/2024

Countersigned by the Principal .........................................................................., College

Enclosed: Please Tick( )
i) Photocopy of Admit Card
ii) Photocopy of Registration Certificate
iii) Photocopy of Gradesheet

RECEIPT COPY FOR STUDENT

Received an amount of Rs.210.00 from Received application form from Debayan Das having Registration No. 316-1111-0226-21 and Roll
No. 211316-22-0018 for re-examination B.COM. SEMESTER - V (GENERAL) Examination, 2023 (Under CBCS)

Date (Signature of dealing person with college seal)