Central University of Punjab
City Campus, Mansa Road, Bathinda- 151 001
Student Contingency Claim / Adjustment Form

1. Name _______________________________________________________________

2. Department _______________________________________________________________

3. Subject/Class ____________________________________________________________

4. Session/Admission Date ________________________________________________________

5. Sanctioned Amount & Date _____________________________________________________

Details of Contingencies (Attach Extra Sheet, if required)

Sr. No Particulars Cash memo / Bill/Ticket No. Date Amount Remarks
01
02
03
04
05
06
07
08
09
10
11
Total

Certified that the amount has been utilized for the purpose it was sanctioned/authorised.

Date……………………. Signature of Research Scholar
Name
__________________________________________________________________________________________

Certified that the contingency amount has been utilized for the purpose it was sanctioned/authorised. The details are verified & the amount claimed, may be reimbursed.

Recommendation of supervisor Coordinator of Centre

……………………………………………………………………………………………………………………………………………………………………………

Dean

Registrar

Vice Chancellor