Application Form For Obtaining Original Certificate

Form No. Price Rs, 5
MANIPUR UNIVERSITY
Canchipur, Imphal
Original
Duplicate
Special
Application for obtaining Original Certificate
The application must be filled by the candidate in all respect
1. Name of student : . . . . . . . . . . . . . . . . . . . . . . . . .
(in block letter)
2. M.U. Registration No. : . . . . . . . . . . . . . . .Year . . . . . . . . . . . . . . . . . . . . .
3. Father’s/Husband’s name : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4. Home address Town/Village : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
P.S. : . . . . . . . . . . . . . . P.O. . . . . . . . . . . . . . . . . . . . . .
District : . . . . . . . . . . . . . . State .. . . . . . . . . . . . . . . . . . . .
5. Particulars of Certificate prayed:
Name of Exam. Arts/Sc./Com.
Roll No.
Year of
Exam.
Divn./
Class
Mark Sheet No.
Subject
Name of
College
6. Regular/Private . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7. Mode of payment Cash/IPO/Draft No. . . . . . . . . . . . . .. . date . . . . . . . .. . .. . . .
8. Whether the certificate is to be sent by post/to be delivered to authorized person/to be collected personally by the candidate.
9. Specimen signature and address of the applicant or the person authorized to collect the certificate.
Specimen signature
i) . . . . . . . . . . . . . . . . . Name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ii) . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
P.S. : . . . . . . . . . . . . . . P.O. . . . . . . .. . . . . . . . . . . . . . .
District : . . . . . . . . . . . . . State .. . . . . . . . . . . . . . . . . . . . .
The above particulars are true to the best of my knowledge and belief.
Date . . . . . . . . . . . . Signature of candidate
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
RECOMMENDATION OF THE PRINCIPAL /HEAD OF THE DEPARTMENT
(in case of private candidate Asstt. Controller of Exams, M.U.)
This is to certify that Shri/Km./Smt. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . .. . . . . . . a student of this College/University passed the . . . . . . . . . . . . . . . . Exam. . . . . . . . . . . . . . . . under Roll No. . . . . . . . . . . . and was placed in . . . . . . . . .
. . . . . . . . . . . . . He/She may be allowed to obtain his/her certificate from the University.
Office seal Signature of the Principal/
Head of Deptt. (in case of P.G. students)
With seal.
FOR OFFICE USE ONLY
Statement verified and found correct.
Scribe Asstt./Sr.Asstt. Section Officer Dy. Registrar
Certificate Section Certification Section S.O.(i/c) Certificate Section Asstt. Registrar
RULES
1.(a) Normal case:
The original certificate of all Examinations will be issued after 15 (fifteen) working days from the date of submission of application form.
(b) Urgent case:
The Certificate will be issued after 5 (five) working days on payment of urgent fee of Rs. 30/- (thirty) in addition to normal fee.
(c) Special case:
Double times of the normal fee of the concerned certificate.
2. The prescribed application form should be submitted to the certificate section (M.U.) along with the original mark sheet, original Registration Certificate & original Admit Card.
3. Attested photocopy of mark sheet/certificate of passing H.S.L.C./ Matriculation Examination.
4. M.U. Registration Certificate in original (if migrated, the Registration No. should be verified by the Registration and Migration section of the University) or attested photocopy of Migration certificate to be enclosed.
5. In case of private candidates, the prescribed form must be countersigned by the Asstt. Controller of Examinations, (M.U.)
6. In case of M.B.B.S. candidates Rules No. 2 above and attested photocopy of Internship completion certificate should be enclosed.
7. The application for Duplicate Certificate must accompany an affidavit sworn before a First Class Magistrate by him/her, police report & a copy of the insertion in the Newspaper for the losst of certificate to testify the loss of or damage of the Original Certificate.
8. Ph.D./MS/MD.
(a) In the case of Ph.D. : Original /Photocopy of Award of the Degree of Doctor of Philosophy & Original Registration Certificate of the University.
(b) In the case of MS/MD : Original Registration Certificate of the University and Original/ photocopy of Provisional Certificate issued by the Institution;
(c) In the case of PG Diploma:
(i) Anaesthesiology & - do –
(ii) Clinical Pathology.
9. No action will be taken unless the above rules are fulfilled and otherwise it will be summarily rejected without further communication. Incorrectness or inaccuracy of information submitted may lead to rejection of the application and in such case fee deposited should not refunded.
RATE OF FEES
ORIGINAL CERTIFICATE Normal Urgent Special case
1. P.U. Arts/Sc./Com. Rs. 30/- Rs. Rs. 60/-
2. B.A./B.Sc./B.Com. Rs. 50/- Rs. 80/- Rs. 100/-
3. M.A./M.Sc./M.Com./B.Lib. Rs. 70/- Rs. 100/- Rs. 140/-
4. L.L.B./B.T./B.Ed./M.B.B.S./
B.Sc.(Agri.)/P.G. Diploma/Diploma Rs. 70/- Rs. 100/- Rs. 140/-
5. M.S./M.D./M.Sc.(Agri.) Rs. 100/- Rs. 130/- Rs. 200/-
6. M.Phil/Ph.D. Rs. 100/- Rs. 130/- Rs. 200/-
DUPLICATE
CERTIFICATE Normal Urgent
1. P.U. Arts/Sc./Com. Rs. 60/- Rs. 60+30=Rs. 90/-
2. B.A./B.Sc./B.Com. Rs. 100/- Rs. 100+30=Rs. 130/-
3. M.A./M.Sc./M.Com./B.Lib. Rs. 140/- Rs. 140+30=Rs. 170/-
4. L.L.B./B.T./B.Ed./M.B.B.S./
B.Sc.(Agri.)/P.G. Diploma/Diploma Rs. 140/- Rs. 140+30=Rs. 170/-
5. M.S./M.D./M.Sc.(Agri.) Rs. 200/- Rs. 200+30=Rs. 230/-
6. M.Phil/Ph.D. Rs. 200/- Rs. 200+30=Rs. 230/-
Note: ALL ENQUIRES CONCERNING ISSUE/DESPATCH OF CERTIFICATE WILL BE ATTENDED TO FROM 2 P.M. TO 3.30 P.M. ON ALL WORKING DAYS.