Dr B R AMBEDKAR NATIONAL INSTITUTE OF TECHNOLOGY GT Road Bye Pass, Jalandhar-144011, Punjab (India) ‘Tol: 0481-2800301-02PBX Ext. 1201 Fax: 2690320 Ref. No.NITJ/Accounts/S 4! Dated: U+I1'19 NOTICE JOSAA refund for B.Tech 2019 Batch It is for the information of the All B Tech 2019 Batch students that Institute is going to refund the JOSAA balance amount to the concerned students. All concerned students are advised to ‘submit the request form {enclosed with this NOTICE) for the refund. Before submitting the request form please read carefully following points ror SC/ST/PH students (Only Day Scholar & Day Scholar with Bus facility) - only those students, who have opted Spot round at the time of admission/reporting and deposited Rs.30,000/(15,000/-+18,000/-) during admission process as per the guidelines of CSABIJOSAA For OPEN (GEN/OBC) Category students Only those students are eligible for refund, who have produced annual family income certificate at the time of reporting and availed the fee waiver benefits accordingly. ‘The concemed students are advised to submit the request form (Enclosed with this NOTICE) along with documents mentioned on the request form in the account branch (Student Welfare Section) of the Institute on or before 22 November, 2019 positively Please note after due date no request shall be entertained for above said refund Ns Asstt. aw (Accounts & Audit) wv CC to: 4 Al HOD(s)/(Chief Warden - With a request to make arrangement to place this NOTICE in the Department/Hostel notice board for information of students 2. HOD, IT/ Computer Centre With a request to make arrangement for placing this NOTICE to the Institute website for information of students.Dr B R AMBEDKAR NATIONAL INSTITUTE OF TECHNOLOGY GT Road Bye Pass, Jalandhar-144011, Punjab (India) ‘Tol: 0161-2690301-02PBX Ext. 1201 Fax: 2600320 REQUEST FORM FOR JOSSA-2019 REFUND To be filled by the student 1. Name of the Student a ee 2. Roll No ee 3. Branch’ Discipline ee 4, Gender (MALE FEMALE) __ ee 5. Category (SC/ST/PH/OP/OBC) ee 6. Father's Name : ee 7. Contact details, ‘Mobile No, ——______ 2 E-mail 1D —_____ 8 Hostler /Day Scholar/Bus Facility: (Please fil which is applicable) 9. Details of fee paid ‘Amount Paid to JOSAA + Fee Paid to Institute | Annual family income (Only for Refundable amount CSAB-2019 (Total) GEN/OBC): 1. Less than Rs.1.00 Lakh P.A 2. BW Rs.1 to Rs.5 lakh PA 10. Annual family Income certficate already submitted at the time of admission/reporting (Yes/No): 11 Bank Account Details of the student: Account No. : Account Holder Name, OL a Bank/Branch Name: IFSc: —— ‘mentioned order) 1. Institute Admission/Provisional letter 2. Photocopy of Fee Challan deposited atthe time of institute reporting (if any) 3. Bhotocopy of Annual income certificate (Not for SC/STIPWD, students) 4. Photocopy of SC/STIPWD Certificate (If any) 5: Students wil have to fll above hisher own bank account deals, (Photocopy of 1st Page of Passbook. Date: ‘Signature of student