To The …………………………. Dibrugarh University, Dibrugarh, Assam.

Subject Sir,

: Authority to collect Provisional Pass Certificate.

I do hereby authorise Sri …………………………………………………………………… …………………….. whose signature is attested below to collect my Provisional Pass Certificate of the B.E. Examination, 2011, (Passed from the Jorhat Engineering College, Jorhat, Assam) on behalf of me.

Signature attested

_________________________ Signature of Authorised Person.

(Mujtaba Mobin Bora)

(Mujtaba Mobin Bora)

Place : Dibrugarh Date :

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