APPLICATION FORM FOR
Migration Certificate –
Passport size
1. Course Completion 2. Discontinuation of Studies photograph
3. Duplicate
TO BE FILLED BY THE OFFICE OF THE DIRECTORATE OF DISTANCE EDUCATION
Mode of Payment :
Application Form No.: Date:
Fee Receipt No. :
Amount :
Category of Application: Name of Authorized Staff:
(Normal/Urgent/Super Urgent)
Signature:
TO BE FILLED BY THE STUDENT
Name of the student in
capital letter (as per the : Father’s Name :
University Record)
Roll Number : Enrolment Number :
Name of the Program of
: Specialisation :
study
Date of Submission of
Year of Passing : :
Application
Detail of Enclosure Self Attested (Mandatory) :
1. No dues certificate, if not submitted yet
2. Original Receipt of Fees Paid as per University norms
3. Xerox of Final Year Pass Mark Sheet
4. Xerox of High School & Intermediate Marksheet
5. Migration Certificate issued from previous Board / Institution in Original.
6. Copy of permission letter from Registrar Office for discontinuation of studies
7. Cutting of advertisement, News paper in Original for duplicate Migration Certificate
8. Copy of FIR for duplicate Migration Certificate
What is your preferred Personally: Mobile Number -
method of receiving the
Migration Certificate ? Through Post / Courier: Email ID -
Address for mailing the Migration Certificate-Course Full Postal Address :
Completion only, through Registered post/Courier in India, by
paying the required postal charges. Receipt of the payment has
to be submitted.
Note: The University will not be responsible for any loss, damage, or delay in receiving the Migration Certificate while the document is
in transit. The Migration Certificate will not be resent to the student if it is returned to the University for any reason. The student
must collect it from the Office of the Directorate of Distance Education.
DECLARATION BY THE STUDENT
I solemnly declare that the information provided above is true and correct in all aspects. I have not concealed any
information. I understand that if any of the information provided here is found to be incorrect or untrue, I shall be held
responsible for the actions taken by the University.
Date: ………………………. Signature of Student: ……………..…………
VERIFICATION BY THE Director, Directorate of Distance Education
This is to certify that the particulars mentioned by the candidate in the Form have been checked and verified & found
correct by the undersigned.
Date: ………………………. Stamp & Signature of Directorate of Distance Education: …………..…………
Contd. Page no. (2) (overleaf)
(1)
FOR OFFICE OF THE CONTROLLER OF EXAMINATION USE ONLY
Date and time of Receipt of the Application:
Migration Certificate Issued on Dated :
Serial No. :
Authorised Signatory
(2)
