FORM – 2A
AFFIDAVIT
(For Duplicate Original Degree Certificate) (Printed on Rs.20/- Notary bond paper)
I,______________________________S/o/D/o _____________________________ aged_____ years ( Student’s Name) (Father’s Name)
Resident of ____________________________________________________________ ___________
(Residential Address)
____________________________________________________________________ do hereby solemnly affirm and status follows:
I have passed _________________ Degree from_______________________________________________
(College Name)
_______________________in the year of ___________with Hall Ticket No.________________________
That after noticing the certificate was lost in the travelling, I lodged a complaint on
______________________ in the _________________________________________________________
(Date ) (Name of Police Station) Police Station, for to trace out the certificate.
That the Police authorities of ____________________________________________ issued a certificate on ( Name of Police Station )
___________________ stating that the certificate tracing is in vain.
( Date)
I am unable to trace the said certificate and it is lost beyond recovery, in case it is traced out in future, I shall submit to the JNTUH authorities for its cancellation.
I am in need of a duplicate degree certificate for which purpose I am hereby making this declaration as required by the concerned authorities.
The facts stated above are true and correct to the best of my knowledge and belief.
DEPONENT Solemnly affirm and signed before me.
FIRST CLASS MAGISTRATE
