Date:

From,
____________________
____________________
____________________
____________________
____________________

To,
The Controller of Examinations
JSS Science and Technology University,
Mysuru-570 006

Respected Sir,
Sub: Requisition for Provisional Grade card

With reference to the aforementioned subject, I request you to kindly

provide the provisional grade card for the details mentioned below.
Name
USN
Mobile number Email ID
Department
Exam
Month and year of
Examination
Reason for applying

Thanking you,
Yours faithfully

(Signature)
 Date:
From,
____________________
____________________
____________________
____________________
____________________

To,
The Controller of Examinations
JSS Science and Technology University,
Mysuru-570 006

Respected Sir,
Sub: Requisition for CGPA to Percentage Conversion Certificate
With reference to the aforementioned subject, I request you to kindly
provide CGPA to Percentage conversion certificate for the details mentioned
below.
Name
USN
Mobile number Email ID
Department
CGPA obtained
Reason for applying

Thanking you,
Yours faithfully

(Signature)
 Date:
From,
____________________
____________________
____________________
____________________
____________________

To,
The Controller of Examinations
JSS Science and Technology University,
Mysuru-570 006

Respected Sir,
Sub: Requisition for Document attestation
With reference to the aforementioned subject, I request you to kindly attest the
following documents for the details mentioned below.
Name
USN
Mobile number Email ID
Department
Reason for applying
Documents attached 1.
2.

Thanking you,
Yours faithfully

(Signature)

Encl as above.
 Date:
From,
____________________
____________________
____________________
____________________
____________________

To,
The Controller of Examinations
JSS Science and Technology University,
Mysuru-570 006

Respected Sir,
Sub: Requisition for Fee Refund
With reference to the aforementioned subject, I request you to kindly refund
the fees for the details mentioned below.
Name
USN
Mobile number Email ID
Department
Refund Rs. /-
Voucher no.
(Voucher Available in
Examination section)

Thanking you,
Yours faithfully

(Signature)

Enclosure: 1. Reason for FEE refund

2. Voucher
 Date:
From,

To,
The Controller of Examinations
JSS Science and Technology University,
Mysuru-570 006

Respected Sir,
Sub: Requisition for Medium of Instruction
With reference to the aforementioned subject, I request you to kindly
provide the Medium of Instruction Certificate for the details mentioned below.

Name
USN

Mobile Number Email ID

Department

Reason for applying

Enclosed: Photocopies of all grade cards.

Thanking you,
Yours faithfully

(Signature)
 Date:
From,

To,
The Controller of Examinations
JSS Science and Technology University,
Mysuru-570 006

Respected Sir,
Sub: Requisition for Backlog Certificate/Summary
With reference to the aforementioned subject, I request you to kindly
provide the Backlog Certificate/Summary for the details mentioned below.

Name
USN

Mobile Number Email ID

Department

Reason for applying

Enclosed: Photocopies of all grade cards.

Thanking you,
Yours faithfully

(Signature)