Affidavit on Rs.

100/-
non judicial stamp paper

Affidavit
For paying the fee in installments (for semester courses)

Session: _____________________
I deponent stated on oath as under.

Student’s Name: ______________________________________________________________

Father’s Name: _______________________________________________________________

Course/Branch: _______________________________________________________________

No. of installments in a year: ____________________________________________________

Installment Details (Odd semester 2019-2020)

1st Installment: On or before 3rd July Rs. ______________

(Minimum 50% of semester fee)

2nd Installment: On or before 3rd October Rs._______________

 Declaration
I _____________________________________ S/o. ___________________________________

Abide to pay the fee as per above said installments on the following conditions. In case I fail to do as said
about ITM GOI may not forward my exam form for the odd semester 2019-2020. I shall not be allowed
to fill the form incase my complete semester fees (academic + Hostel + Bus and any other) is not paid
before the last date of filling exam form.

❖ Rs. 50/- will be charged per day in case the student is not submitting 50% of the semester fees on
the due date of 1st fee installment (maximum Rs.4000/-.

❖ Rs. 25/- will be charged per day if the student fails to submit the remaining 50% of the semester
fees in the due date of 2nd fee installment (maximum Rs. 3000/-)

❖ The student under no circumstances will request for any extension of due dates of installment and
exemption of fees or fine for both registration and fee payment

Father/Guardian Student

HOD Dean Academics

Date:
 Undertaking
I hereby declare that:

i) I shall attend all the classes as per time table after registration failing which I will
bear all the consequences as levied on me by ITM GOI authority.
ii) I shall be regular, attentive and serious towards my studies during the entire degree
program.
iii) Under no circumstances my attendance in theory and practical classes (separately)
shall fall below 75% as per requirement of ITM GOI, in case my attendance falls
below the requisite attendance, I shall comply with the decision taken by ITM GOI
authorities and may even be debarred from appearing in semester exam of RGPV,
Bhopal. I may also be deprived of the opportunity to avail campus placement if I fail
to have requisite attendance.
iv) I shall obey the rules and regulations as laid down by ITM GOI from time to time and
shall maintain proper discipline.
v) In the situation when I am unable to attend the classes due to illness, I shall inform
the ITM GOI authorities within three days and shall submit the medical certificate
within seven days, from a registered practitioner duly endorsed by the ITM GOI
doctor.
Name of Student Father’s Name
Roll No. Program& Semester
School/Department Permanent
Email ID Father’s Email ID
Contact No. Father’s Contact No.
I hereby solemnly declare that the information given above is true & correct to best of my
knowledge and belief.
1. Students are advice to get registered for odd semester (except first semester students) on
date July 03, 2019, so that all academic co-curricular, and extra-curricular activities can
be executed well on time.
2. It is also informed that all students have to register on registration date July 03, 2019,
irrespective of the status of their fee payment.
3. If any student fails to register up to July 03, 2019, he/she will be liable to pay Rs. 200/- as
late registration fee till July 11, 2019. All registrations after July 11, 2019 are liable to
pay Rs. 5000/- as late registration fee. After July 21, 2019 the students have to register
again by paying Rs. 10,000/- as re-registration charge.
4. The late registration fees will be waived off if the student has 80% attendance in the
respective session (July-Dec.2019).
5. Students interested in paying fees in installment are required to fill the fee Affidavit,
format and other details regarding the Affidavit are available with the mentors.

(Signature of Student) (Signature of Parent)

Name & Signature of Mentor HOD Dean Academics

Date:
 Guidelines for Fee Submission
Attention to : B. Tech III, V and BE VII Sem. Students
Session: July – Dec. 2019

In view of the installment payment of Fees being introduced from the academic
session 2019 - 2020. The following guidelines must be followed.
• All students paying Fees through installment have to submit the affidavit on
the date of registration failing which he/she will not be entertained for
installment Fee payment.
• This facility is available on for the students whose parent’s income is below
Rs. 2.5 Lacs per annum. Therefore the student has to submit an income
certificate of the parent so as to avail installment Fee payment.
• Student whose parent’s income is above the prescribed limit of Rs. 2.5 Lacs
can avail the facility of installment Fee payment only once (any one
semester) throughout the degree program.
• No fine will be charged if the student pays the installments on the due dates.
However failing to do so will attract the following fine.
o On the due date of I installment 50% percent of the full semester fees
has to be paid else a fine of Rs. 50/- per day would be charged till
submission of 50% per day would be charged till submission of 50%
semester fees.
o On the due date of II installment remaining 50% percent of the full
semester fees has to be paid else a fine of Rs. 25/- per day would be
charged till submission of complete semester fees.