To
The Director
Directorate of Research & Development JNTUH, Kukatpally,
Hyderabad-500085
Dt. ………..
APPLICATION FORM TF NO DUES CERTIFICATE (All fields should be filled with in complete details)
I Mr./Mrs./Ms. ..………...……….……… (As per SSC Certificate) S/o/W/o/D/o. ..……….…… bearing H. T. No……….………
Ph.D. Scholar in the Dept. of……….………... under guide ship of Prof./Assoc. Prof. Sri./Smt.………...
I hereby declare that I have completed colloquium Ph.D/MS/M.Phil programme and paid all the fees required for the award of Degree.
If there are any dues to be paid by me at a later date I will do in single Payment.
My Office Address: ……….
.………
My Postal Address:……….
………..…
E Mail ID:………..
Mobile NO:………
DECLARATION
I hereby declare that all my original certificates are deposited at R&D cell, as per admission letter the information is true and correct to the best of my knowledge and nothing material has been concealed there from. If it is later on noticed to be false or untrue. I am liable for disciplinary action.
ENCLOSURES: Please Tick [ √ ] 1. Photo Copy of Admission letter issued by Director Admissions [ ] 2. Admission Fee Receipt [ ] 3. All Tuition Fee Paid Receipts [ ] 4. Photo copy of Colloquium Satisfactory Report [ ] 5. Photo copies of all Extension Orders (If Applicable) [ ] 6. Photo copy of S.S.C Certificate
Note: All Photo Copies should be self attested by the candidate:
Date: S I G N A T U R E O F S C H O L A R
