ASSAM UNIVERSITY, SILCHAR
(A Central University established in 1994)
APPLICATION FOR DUPLICATE REGISTRATION / MIGRATION CERTIFICATE
1. Name of the Candidate in full : __________________________________________________________________
(in block capital letters only)
2. Father’s Name in full : __________________________________________________________________
(in block capital letters only)
3. Mother’s Name in full : __________________________________________________________________
(in block capital letters only)
4. Sex : ________________________ 5. Date of Birth : ___________________
6. Permanent Address : __________________________________________________________________
with Pin Code
___________________________________________________________________
___________________________________________________________________
7. Name of the College / PG Deptt where
studied at the time of Registration : __________________________________________________________________
8. (a) Name of the Exam last appeared
under Assam University, Silchar :___________________________________________________________________
(copy of Mark sheet to be enclosed)
(b) Roll No. and Year of Exam :___________________________________________________________________
9. Reason : __________________________________________________________________
10. Mode of Payment of Fees DD / Cash : Receipt No________________________ dtd__________________
DECLARATION
I do hereby declare that the Registration / Migration Certificate No___________________________ of __________________ issued to me by Assam University has been lost/damaged for which I have lodged an FIR with the ________________________________ Police Station vide FIR No_________ dtd.__________________. Further, I have not registered myself with any other University or with the same University for different course at the same time. I also declare that I shall submit the Duplicate Registration / Migration Certificate to the competent authority if the original certificate is found at a later stage. I have made an Affidavit and loss of document is published in the _______________________ newspaper. Copies of FIR, Affidavit & paper cutting are enclosed.
I do hereby also declare that the above statements made by me are true and correct to the best of my knowledge and belief. In case any portion of above statement is found to be incorrect at a later stage, I shall be liable for disciplinary action as per rule.
Date :________________________
Place:________________________ (Signature of the applicant)
The particulars stated above have been verified & found correct. Duplicate Registration/Migration certificate may be issued.
Memo No. ________________________________ Signature of the Principal /HOD of PG Deptt
Date :________________________________ with seal
APPLICATION FOR DUPLICATE REGISTRATION / MIGRATION CERTIFICATE CCCC
Recommendation of the Principal / HOD of PG Deptt. where studied at the time of issue of Duplicate Registration / Migration Certificate
DOWNLOADED FORM
OFFICE NOTES & ORDERS
(1) Police Report, (2) Court Affidavit,
(3) Paper cutting & (4) Fees received. Registration / Migration records verified
and found correct / incorrect.
Documents verified.
Duplicate Certificate may be prepared
Dealing Asstt.
Section Officer
Assistant Registrar (E)
Deputy Registrar (E)
-2-
INSTRUCTIONS
1. Application for Duplicate Registration / Migration Certificate must be submitted along with the (1) Police Report, (2) Paper cutting, (3) Affidavit and copy of mark sheet of the last examination passed / appeared under Assam University, Silchar.
2. The application to be forwarded by the Principal Head PG Deptt only after careful verification and with memo number, date and office seal.
3. No Duplicate Migration Certificate will be issued except loss of the same due to natural calamities, riots etc. Moreover, no Duplicate Migration Certificate will be issued after one year from the date of issue of original certificate.
4. Fees may be paid in Cash OR through Demand Draft in favour of Finance Officer, Assam University, Silchar payable at State Bank of India, Silchar (7061) or UCO Bank, AU Branch (2005).
5. Duplicate Registration / Migration Certificate fee is Rs. 300/- ( This is subject to change)
BIP/DUP/12