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APPLICATION FOR REVALUATION Date: To The Controller of Examinations, Thro HOD, _________________ Sir, I request you to revalue my answer

script/s for the following subject/s relating to the Examinations held in________ (Month) _______ (year). 1. 2. 3. 4. University Registration No:: Full Name VTU ID No Branch :: :: ::

Sl. No.

Sub Code

Subject

Sem .

Marks Secured

1 2 3 4 5 6 7 8 9 10

11 12 13 14 15

I enclose DD. NO::________________ DD Amount_____________ Date_____________

at 750/- for Revaluation per subject.

Forwarded to COE.

Signature of the HOD

Signature of the Candidate

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