Fee Code R0040 Website: http://forms.puchd.ac.

in

Panjab University, Chandigarh

Case No._____________________
Application for Inter-University Migration/copy
(For Office Use)
of entries from the Register of Students
(To be filled in by the applicant in his/her own hand)

A. Fee Remitted Rs.___________________________ Bank Draft/University Receipt

No._______________ Date __________________
B. Name: (In capitals)

Father’s Name: (In capitals)

Mother’s Name: (In capitals)

Registration No.

Institution where studying presently ________________________________________________

Class ________________ University to which Migration is sought __________________________
_______________________Reasons for Migration ______________________________________
______________________________________________________________________________
C.
Last examination of this University in which appeared/passed:
Examination _____________ Year/Session__________ Roll No. __________ Result__________
Institution/District (For Private Candidate ___________________________________________
______________________________________________________________________________
D. I solemnly declare that:
(i) All the particulars given by me are correct; (ii) I have passed Matriculation/Higher Seconday
Examination of Panjab University but I did not join any College affiliated to this University. (For
applicants who are not registered students).
Address
___________________________________
___________________________________ _____________________________
___________________________________ Signature of Applicant
CERTIFICATE NO. 1 AFFIDAVIT

(For applicant who are/were on rolls of affiliated For duplicate Migration Certificate please
College/Departments of Correspondence Studies attach an affidavit duly attested by Ist Class
and leaving the course without completing) Migistrate stating therein :-

I have no objection to the issue of University Migration That the Migration certificate earlier issued
Certificate to the Applicant to me has been lost and has not been used
by me to seek admission anywhere.

Signature of Principal/Chariman
Dept. of Correspondence Studies
Dated: ____________ Official Stamp
ATTESTATION (Regular Student /Private Candidates) Last Exam:____________
I certify that the applicant __________________________ son/daughter of Shri _______________
___________________ is the Same person who signed in my presence under the particulars on the
enclosed form.

Name, designation and address of the

attesting authority Signature of attesting authority
______________________________ Dated ______________________
______________________________ ____________________________
______________________________ Offical Stamp

1 of 2
 Website: http://forms.puchd.ac.in

Attesting Authorities:
(i) College/University : Principal of the College/Chairman of the Deptt.
Teaching Deptt. Concerned.
Candidates.
(ii) Private Candidate : A Gazetted officer, Principal of an affiliated College,
Chairman of the University, Teaching Deptt, a
fellow of University. University Officer not below
rank of Asstt. Registr!r

FOR OFFICE USE

Particulars verfied vide Gazette/According to Register of students ORDERS
Allowed /Not Allowed

Asstt. Suptd. A.R. (R & S)

(To be filled by the Candidate)
Address Address (For despatch of Certificate)
Name(In Capitals):_________________________ Name(In Capitals):_______________________
Address: _________________________________ Address: ______________________________
________________________________________ _____________________________________

2 of 2