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UNDERTAKING BY THE STUDENT

ADMISSION INTO H.S./DEGREE CLASSES


B.N. COLLEGE, DHUBRI
SESSION: 2019-2020

I …………………………………………………………………………………………… hereby
solemnly affirm and undertake that, total annual income of my parents is less that Rs.2.00 Lakh
(Rupees two lakhs) for the financial year 2019-2020 and I am submitting the Income Certificate
of my parents issued by the competent authority showing the annual income.

I also declare that neither I nor my parents (Father & Mother) are employed in Govt. /Semi
Govt./Private Organisation.

I further declare that if at any stage, it is found that the information given by me is false/not
true, all benefits given to me could be withdrawn and legal action as deemed fit, may be taken
against me or my parents.

Signature of the Student: ………………………………………………………….


Date: ………………………………………………………………………………..
Father’s Name : …………………………………………………………………….
Mobile No. ………………………………………………………………………..
Town/Village: ……………………………………................................................,
Ward No. ………………………………………………………………………….
P.O. ……………………………………………., P.S. …………………………...
District ………………………………………., State …………………………….
Pin Code No……………………………………………………………………….

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