DUP1

BHARATIARUNIVERSITY,COIMBATORE 641046.
APPLICATIONFORISSUEOFDUPLICATECERTIFICATE
1. DuplicateofwhichCertificate*required

2. NameoftheCandidate

3. RegisterNumber

4. Collegethroughwhichstudied/Studying

5. Degreeofstudy

6. Branch

7. PeriodofStudy

8. Sex

9. (a)Ifapplyingforduplicatestatementof
Marks,fillintheMonthandyearofexam.
Forwhichmarkstatementwasissued.

(b) Ifapplyingforduplicatedegreecerti
ficatefillinthe

i.MonthandYearinwhichquali
fiedforthedegree

iiNameinTamil

iiiDateofconvocationinwhich
thedegreewasconferred

Ifapplyingforduplicateprovisional
Certificate/consolidatedstatement
ofmarksfillintheMonth&Yearof
lastappearanceinwhichqualified
forthedegree

10. Circumstancesunderwhichthecertificate
Waslost/destroyed

11. Whethertheprescribedaffidavithasbeen
enclosedwiththeapplication.

12. Addresstowhichthecertificateistobesent

13. Feespaid

DD/ChallanNo.:

Bank:

Amount:Rs.

Place:
Date :
FOROFFICEUSEONLY
Certificateissuedon

Preparedby:

FolioNo.

Examineby:

Date:

SignatureoftheCandidate

DateonwhichtheD.D.was
SenttoFinanceOfficer
*WriteasDegreecertificate/Statementofmarks/
ProvisionalCertificate/Consolidatedstatementofmarks.
(forinstructionseeoverleaf)

ControllerofExaminations

INSTRUCTIONS
1. Duplicate certificate will be issued only when it is lost or destroyed irrevocably.
2. Application duly filled-in along with (a) an affidavit detailing the circumstances under
which the original certificate was lost or destroyed (b) self-addressed stamped cover(for
Registered Post) and (C) the demand draft should be sent directly to the Controller of
Examinations,Bharathiar University,Coimbatore 641 046. The affidavit should be duly
executed before the Notary Public / Principal of the College where he / she had studied.
3. Application shall be complete in every respect.Failure to furnish correct details may
cause delay in the issue of the certificate. The application shall be filled in only by the
candidate otherwise it will be rejected.
4. The fee for the issue of various certificates is as follows:
For First Time:
1. Statement of Marks
Rs.750/- per mark statement + Rs.25/- cost
of application
2. Provisional Certificate
Rs.750/- Plus Rs.25/- cost of application
3. Consolidated Statement of Marks
Rs.750/- Plus Rs.25/- cost of application
4. Degree Certificate
Rs.1500/- Plus Rs.25/- cost of application
5. Migration Certificate
Rs.750/- Plus Rs.25/- cost of application
6. Rank Certificate
Rs.750/- Plus Rs.25/- cost of application
For Second Time:
1. Statement of Marks
2. Provisional Certificate
3. Consolidated Statement of Marks
4. Degree Certificate
5. Migration Certificate
6. Rank Certificate

Rs.1500/- per mark statement + Rs.25/cost of application

Rs.1500/- Plus Rs.25/- cost of application
Rs.1500/- Plus Rs.25/- cost of application
Rs.3000/- Plus Rs.25/- cost of application
Rs.1500/- Plus Rs.25/- cost of application
Rs.1500/- Plus Rs.25/- cost of application

5. The fees should be paid in the form of Demand Draft in favour of the
REGISTRAR,BHARATHIAR UNIVERSITY payable at Coimbatore.
6. Fees once paid shall neither be refunded nor adjusted against any other certificate under
any circumstances.

AFFIDAVITTOBEFILEDFORISSUEOFDUPLICATECERTIFICATE

AffidavitofThru/Selvi
1.I.
son/daughterof..aged.....years,
anoldstudent/studentof.college
withregisternumber.andresidingat
street...
doherebysolemnlyandsincerelystateasfollows.
2.My*(I).(degree)statementofmarksissuedrelatingtothe
examinationsheldduring../(ii)Degreecertificateissuedatthe
convocation..
heldon../(iii)ProvisionalCertificate/Consolidatedstatementofmarks
issuedbytheBharathiarUniversity,Coimbatore46hasirrevocablybeenlost/destroyed.
3.Ifillthisaffidavitforthepurposeofreceivingduplicatecertificate.
4.TheduplicateCertificateshallbereturnedtotheUniversityoncemyoriginalcertificate/sis/are
recoveredbychance.
5.Thefactsstatedaretrueandcorrecttothebestofmyknowledgeandiffoundfalsebythe
University,IshallabidebythedecisionoftheUniversity.
Solemnlyaffirmed.
at(place)_______________________________________________________
this(date___________________________________dayofSignatureoftheCandidate
(month)________________________________________________________
andhis/hersignatureaffixedinmypresence.
Beforeme

Place:
Date:
NotaryPublic/Principal
Address____________________________________
___________________________________________
___________________________________________
OfficeSeal:
*deletewhichisnotapplicable.